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Clinical outcomes of sigmoid volvulus and risk factors for its recurrence: a multicenter study in Korea

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Sigmoid volvulus is one of the leading causes of colonic obstruction. The aims of this study were to review the treatment characteristics and clinical outcomes of patients diagnosed with sigmoid volvulus over 10 years at five university-affiliated hospitals in Korea, and to identify possible risk factors for its recurrence.

Methods

Retrospective review was performed for medical records of patients who were diagnosed with sigmoid volvulus and managed surgically or conservatively at the five Hallym University–affiliated hospitals between January 2005 and July 2018.

Results

A total of 69 patients were diagnosed, of whom 11 patients underwent emergency surgery and 58 patients were conservatively managed. Non-operative management was successful in 53 of 58 patients (91.4%) at initial admission. Of the non-operative managed patients, six patients required emergency surgery due to unsuccessful decompression or recurrence whereas 23 patients underwent regular surgery for definitive treatment. And overall recurrence rate and mortality rate were 25.8% (15/58) and 1.7% (1/58), respectively. A total of 40 patients underwent surgery; 23 underwent regular surgery and 17 underwent emergency surgery. Restoration of bowel continuity was more frequently performed in the regular surgery group than in the emergency surgery group (87.0% vs 52.9%, P = 0.03). In multivariable analysis, only non-operative management at the initial admission (P = 0.029) was independently associated with recurrence.

Conclusion

Although non-operative treatment can be initially attempted, surgery is required for preventing recurrence. Regular surgery should be considered to restore continuity of the bowel.

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Authors and Affiliations

  1. Department of Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 40, Sukwoo-Dong, Hwaseong-Si, Gyeonggi-Do, 445-170, Republic of Korea

    Eui Myung Kim, Jeong Yeon Kim & Jong Wan Kim

  2. Department of Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon- Si, 200-950, Republic of Korea

    Byung Mo Kang

  3. Department of Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 948-1, 1, Shingil-ro, Yeongdeungpo-gu, Seoul, 150-950, Republic of Korea

    Byung Chun Kim

  4. Department of Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 445 Gil-1-dong, Gangdong-gu, Seoul, 134-701, Republic of Korea

    Jun Ho Park

  5. Department of Surgery, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang-Si, 445-907, Republic of Korea

    Bo Young Oh

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  1. Eui Myung Kim
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Correspondence to Jong Wan Kim.

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Kim, E.M., Kang, B.M., Kim, B.C. et al. Clinical outcomes of sigmoid volvulus and risk factors for its recurrence: a multicenter study in Korea. Int J Colorectal Dis 35, 1841–1847 (2020). https://doi.org/10.1007/s00384-020-03526-w

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  • DOI: https://doi.org/10.1007/s00384-020-03526-w

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