Comparison of primary resection and anastomosis with Hartmann’s procedure in management of acute sigmoid volvulus

Pattanayak, Sibaprashad; Saha, Debabrata; Bara, Bipin Kishore; Nayak, Sanjit Kumar

doi:10.1007/s13126-016-0329-3

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…Hartmann's procedure is to be preferred in complicated cases. 9 In our case there was not only gangrene of the sigmoid loop but it involved the complete colon. We assume that there were simultaneously two closed loop obstructions.…”

Section: Discussionmentioning

confidence: 42%

Sigmoid Volvulus Necessitating Total Colectomy

Ahmad¹,

Saleem²,

Bhutta³

et al. 2022

J. Bahria Uni. Med. Dent. Coll.

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Sigmoid volvulus is a well-known cause of large bowel obstruction. Its management includes urgent endoscopic decompression or emergency laparotomy. The gangrenous sigmoid colon is resected with either end to end anastomosis or Hartmann’s procedure. Here we present a rare presentation of sigmoid volvulus causing gangrene of the whole colon. It was probably due to double closed loop obstruction caused distally by the volvulus itself and proximally by the competent ileo-caecal valve. It was managed by total colectomy with terminal ileostomy and Hartmann’s procedure. To our knowledge only one such case report has been published in the literature so for.

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Section: Discussionmentioning

confidence: 42%

Sigmoid Volvulus Necessitating Total Colectomy

Ahmad¹,

Saleem²,

Bhutta³

et al. 2022

J. Bahria Uni. Med. Dent. Coll.

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“…Some of the included articles suggested primary resection and anastomosis for gangrenous sigmoid volvulus with specific prerequisites like intraoperative hemodynamic stability, absence of gross contamination, capability to achieve a tensionfree anastomosis, presence of viable and well-vascularized bowel ends after resection, and good functional status ( 22 , 24 - 26 , 31 ). In contrast, some of the included studies in this review recommended stoma due to low mortality rates, fear of anastomotic leaks, quick procedure time, and short hospital stays ( 23 , 27 , 30 ).…”

Section: Resultsmentioning

confidence: 98%

Comparing Resection and Primary Anastomosis versus Hartmann’s Stoma on the Mortality and Morbidity of Gangrenous Sigmoid Volvulus: Systematic Review and Meta-Analysis

Atalel Fentahun Awedew,

Zelalem Asefa,

Biruktawit Destaw Enkoye

2023

Ethiop J Health Sci

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BACKGROUND: Gangrenous sigmoid volvulus has a significant impact on morbidity and mortality. This study was conducted to compare sigmoid resection and primary anastomosis (RPA) with sigmoid resection and end colostomy (Hartmann’s procedure) for gangrenous sigmoid volvulus. METHODS: A systematic review and meta-analysis study design was employed to summarize retrospective cohort, prospective cohort, and randomised control trial studies published from inception to march 31, 2023. Searching was performed on Medline, CINAHAL, Web of Science, Google Scholar, the Cochrane Library, and ClinicalTrials.gov to locate eligible articles. Data searching, selection and screening, quality assessment of the included articles, and data extraction were done by two separate reviewers. RevMan 5.4 software with a fixed-effect Mantel-Haenszel model and Stata version 14 were used to analyze the data. The protocol registered on PROSPERO registration website (CRD42023413367). RESULTS: Ten cohort studies and one randomised control trial with 724 patients were found; all of them were rated as being of moderate quality. The overall mortality after RPA was 15% (95%CI: 11-19%), and after Hartmann’s procedure it was 19% (95%CI: 15-23%). Resection and primary anastomosis (RPA) for gangrenous sigmoid volvulus had slightly lower mortality rate than stoma (OR=0.98(95%CI: 0.68-1.42), p=0.07, I2=43%), which had no statistically significant difference. Resection and primary anastomosis (RPA) had a slightly higher morbidity rate than Hartmann’s procedure (OR=1.01(95%CI: 0.66-1.55), p=0.30, I2=18%), which had no statistically significant difference. CONCLUSION: Sigmoid resection and primary anastomosis (RPA) and Hartmann’s procedure had no significant differences in mortality and morbidity for the treatment of gangrenous sigmoid volvulus. Choice of the intervention for gangrenous sigmoid volvulus should be individualized with consideration of different detrimental factors.

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“…Development of complications and type of procedure (Resection + colostomy) were identified as factors associated with prolonged hospital stay, which is in contrast to a study from India that reported prolonged hospital stay in the resection and primary anastomosis groups. 47 …”

Section: Discussionmentioning

confidence: 99%

Perioperative Adverse Outcome and Its Predictors After Emergency Laparotomy Among Sigmoid Volvulus Patients: Retrospective Follow-Up Study

Deresse,

Tesfahun,

Gebreegziabher

et al. 2023

OAEM

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Background Acute sigmoid volvulus is a surgical emergency with closed-loop obstruction of the colon that often requires emergency laparotomy, which is associated with a multitude of post-operative complications. Although sigmoid volvulus is the main cause of intestinal obstruction in Ethiopia, local studies of its management outcomes are limited. Objective To assess the magnitude and predictors of adverse perioperative outcomes of emergency laparotomy for acute sigmoid volvulus in the Debre Markos Comprehensive Specialized Hospital (DMCSH), Amhara region, Ethiopia in 2023. Methods This was a retrospective follow-up study. Descriptive statistics were used to measure perioperative outcomes and other study variables. Bivariable and multivariable logistic regression models were used to identify the predictors of adverse surgical outcomes. Associations were considered significant at p < 0.05 (95% confidence interval). Results In total, 170 study participants were enrolled, with a response rate of 91.4%. Forty-nine patients (28.8%) developed perioperative adverse outcomes. Pneumonia (29 patients, 28.1%), surgical site infection (19 patients, 18.4%), and wound dehiscence (10 patients, 9.7%) were the most common complications. Pre-operative shock [AOR: 3.87 (95% CI: (1.22, 12.28))], pus or fecal matter contamination of the peritoneum [AOR: 4.43 (95% CI: (1.35, 14.47)], and a higher American Society of Anesthesiologists (ASA) score [AOR: 2.37 (95% CI: (1.05, 5.34))] were identified as predictors of perioperative adverse events. Conclusion The perioperative adverse outcomes in this study were higher than those reported in Ethiopian national and global reports following emergency laparotomies. Hypotension at presentation, pus and/or fecal matter contamination of the peritoneum, and higher ASA scores are strong predictors of increased perioperative adverse outcomes. Therefore, healthcare providers and institutions involved in the delivery of emergency surgical care should emphasize the importance of early surgical intervention, adequate resuscitation, and patient monitoring to improve perioperative outcomes.

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Comparison of primary resection and anastomosis with Hartmann’s procedure in management of acute sigmoid volvulus

Cited by 4 publications

References 19 publications

Sigmoid Volvulus Necessitating Total Colectomy

Sigmoid Volvulus Necessitating Total Colectomy

Comparing Resection and Primary Anastomosis versus Hartmann’s Stoma on the Mortality and Morbidity of Gangrenous Sigmoid Volvulus: Systematic Review and Meta-Analysis

Perioperative Adverse Outcome and Its Predictors After Emergency Laparotomy Among Sigmoid Volvulus Patients: Retrospective Follow-Up Study

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