Sigmoid volvulus: Evaluating identification strategies and contemporary multicenter outcomes

Loria, Anthony; Jacobson, Tricia; Melucci, Alexa D.; Bartell, Nicholas; Nabozny, Michael J.; Temple, Larissa K.; Fleming, Fergal J.

doi:10.1016/j.amjsurg.2022.07.025

Cited by 6 publications

(20 citation statements)

References 24 publications

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“…2 5 10 13 17 19 Following resection, bowel continuity is provided via primary anastomosis or stoma with 5 to 10% or 20 to 30% mortality and 10 to 30% or 30 to 60% morbidity rates, respectively, in addition to 0 to 1% recurrence rates in both. 2 5 9 10 13 17 19 20 24 27 28…”

Section: Urgent Managementmentioning

confidence: 99%

“…2,5,7,9,14,19,[21][22][23] This procedure may be performed with 0 to 10% of mortality and 1 to 25% of morbidity rates. 2,10,14,19,22,24 Following a successful endoscopic detorsion, early recurrence, during the first hospitalization, is about 5 to 25%. 2,5,10,14,19,22 Medium-term recurrence, within about 1 month, is 15 to 30%, while longterm recurrence rises up to 43 to 90% with a mean of 4.4 (range: 2-25) volvulus attacks.…”

Section: Urgent Managementmentioning

confidence: 99%

“…2,5,10,13,17,19 Following resection, bowel continuity is provided via primary anastomosis or stoma with 5 to 10% or 20 to 30% mortality and 10 to 30% or 30 to 60% morbidity rates, respectively, in addition to 0 to 1% recurrence rates in both. 2,5,9,10,13,17,19,20,24,27,28 Recurrence An elongated and dilated sigmoid colon with a long mesentery, dolichosigmoid, is the main factor in the development of both primary and recurrent SV. 15,23,[28][29][30][31][32] Other factors affecting recurrence are advanced age, male gender, early onset, highfiber diet, high altitude, and chronic constipation.…”

Section: Urgent Managementmentioning

confidence: 99%

“…3,5,7,10,13,19,27,36 The mortality is 0 to 2%, the morbidity is 10 to 25%, and the recurrence is 0 to 1%. 1,3,5,10,19,24,26,36,42,43 In this field, the best innovation of the recent time is natural orifice specimen extraction with laparoscopic sigmoidectomy and primary anastomosis. [44][45][46] Percutaneous endoscopic sigmoidopexy (PES; or PE colopexy or PE colostomy [PEC]) is the fixation of the apex of the sigmoid colon to the anterior abdominal wall by using endoscopic stoma kits (►Fig.…”

Section: Recurrence-preventive Managementmentioning

confidence: 99%

“…5,19,32,47,48 Observation without any surgical or endoscopic intervention is the last ditch in high operative risk and elderly cases with high mortality rates up to 10% in early, 20% in medium, and 35% in late periods due to its recurrence rates as high as 90%. 5,10,14,24,26 Patient Selection Criteria for Recurrence-Preventive Management…”

Section: Recurrence-preventive Managementmentioning

confidence: 99%

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Management of Sigmoid Volvulus: A Literature Review

Atamanalp,

Disci,

Peksoz

et al. 2023

Ibnosina Journal of Medicine and Biomedical Sciences

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Sigmoid volvulus (SV) is a rare form of intestinal obstruction in which the sigmoid colon twists around its own base. Endoscopic detorsion is the primary treatment in uncomplicated patients, while urgent surgery is required in the cases with bowel perforation, peritonitis, and unsuccessful endoscopic detorsion. In surgery, the gangrenous sigmoid colon is managed by resection, whereas sigmoid detorsion alone or with an additional recurrence-reducing procedure is applied in patients with viable bowel. However, the risk of recurrence following endoscopic or operative detorsion alone is as high as 90% with a risk of mortality up to 35%. To prevent or reduce SV recurrence, some selected cases require emergent or elective recurrence-preventive management including sigmoidopexy, mesopexy, mesoplasty, extraperitonealization, sigmoidectomy, and endoscopic percutaneous sigmoidopexy. However, the indications, techniques, and results of the above-mentioned procedures are controversial. In this review, the treatment options of SV and patient selection criteria for recurrence-preventive treatments are discussed.

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Section: Urgent Managementmentioning

confidence: 99%

Section: Urgent Managementmentioning

confidence: 99%

Section: Urgent Managementmentioning

confidence: 99%

Section: Recurrence-preventive Managementmentioning

confidence: 99%

Section: Recurrence-preventive Managementmentioning

confidence: 99%

See 3 more Smart Citations

Management of Sigmoid Volvulus: A Literature Review

Atamanalp,

Disci,

Peksoz

et al. 2023

Ibnosina Journal of Medicine and Biomedical Sciences

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Comparative analysis of short-term outcomes after semielective and elective surgery for sigmoid volvulus

Hilty Chu,

Loria,

Cai

et al. 2024

Surgery

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Development and validation of multivariable predictive models for recurrence and mortality following nonoperative management of sigmoid volvulus

Loria,

Cai,

Gao

et al. 2023

Colorectal Disease

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AimSigmoid volvulus is a challenging condition, and deciding between elective surgery or expectant management can be complex. The aim of this study was to develop a tool for predicting the risk of recurrent sigmoid volvulus and all‐cause mortality within 1 year following initial nonoperative management.MethodThis is a retrospective cohort study using Medicare claims data from 2016 to 2018 of beneficiaries admitted urgently/emergently for volvulus, undergoing colonic decompression and discharged alive without surgery (excluding those discharged to hospice). The primary outcomes were recurrent sigmoid volvulus and all‐cause mortality within 1 year. Proportional hazards models and logistic regression were employed to identify risk factors and develop prediction equations, which were subsequently validated.ResultsAmong the 2078 patients managed nonoperatively, 36.1% experienced recurrent sigmoid volvulus and 28.6% died within 1 year. The prediction model for recurrence integrated age, sex, race, palliative care consultations and four comorbidities, achieving area under the curve values of 0.63 in both the training and testing samples. The model for mortality incorporated age, palliative care consultations and nine comorbidities, with area under the curve values of 0.76 in the training and 0.70 in the testing sample.ConclusionThis study provides a straightforward predictive tool that utilizes easily accessible data to estimate individualized risks of recurrent sigmoid volvulus and all‐cause mortality for older adults initially managed nonoperatively. The tool can assist clinicians and patients in making informed decisions about such risks. While the accuracy of the calculator was validated, further confirmation through external validation and prospective studies would enhance its clinical utility.

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Sigmoid volvulus: Evaluating identification strategies and contemporary multicenter outcomes

Cited by 6 publications

References 24 publications

Management of Sigmoid Volvulus: A Literature Review

Management of Sigmoid Volvulus: A Literature Review

Comparative analysis of short-term outcomes after semielective and elective surgery for sigmoid volvulus

Development and validation of multivariable predictive models for recurrence and mortality following nonoperative management of sigmoid volvulus

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