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Category: Volume 06 Issue 12 December 2018
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Title: Primary Resection and Anastomosis in Gangrenous Sigmoid Volvulus- A Prospective Study

Authors: Prof Dr Braja Mohan Mishra, Dr Sandeep Mishra, Dr Bishwajyoti Sahoo

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i12.110

Abstract

Introduction: The management of sigmoid volvulus has remained a controversial issue to many surgeons. Rapid resection with colostomy fashioning has been done over time for gangrenous volvulus. However resection and primary anastomosis has also been described with less complications and a shorter hospital stay. Our aim was to study the safety and efficacy of emergency resection and primary anastomosis in gangrenous sigmoid volvulus without a proximal colostomy.

Materials and Methods: It was a prospective observational study at VIMSAR, Burla, Surgery dept. from October 2016 to July 2018. Includes all gangrenous volvulus cases who were subjected to emergency resection and primary anastomosis without proximal stoma. Cardiorespiratory unstable patients and obstruction due to malignant cases were excluded. Primary outcomes studied were faecal fistula, wound infection, intestinal obstruction and mortality. Follow up period was 2 months.

Results: Total 32 cases were having gangrenous volvulus. 8 cases we did Hartmann’s procedure due to distal mobilisation of bowel could not be done due to extension of gangrene .So we did Primary resection and anastomosis in 24 cases. 0ut of 24 cases (15 males and 9 females) there were two cases of anastomotic leak and fecal fistula(8.33%), seven cases of wound infection(29.16%), four cases of paralytic ileus(16.66%), one in shock(4.16%), one chest complication(4.16%) and mortality(12.5%).

Conclusion: Resection and primary anastomosis in gangrenous volvulus can be practised with few complications and a shorter hospital stay.

Keywords: Sigmoid volvulus, Gangrene, Primary anastomosis.

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Corresponding Author

Dr Bishwajyoti Sahoo

Junior Resident, Dept of General Surgery, VIMSAR, Burla, Sambalpur, Odisha, India

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