The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Colonic Volvulus and Acute Colonic Pseudo-Obstruction

Abstract

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The Unfolding Situation of Caecal Volvulus: A Retrospective Analysis of 36 Cases From a Single Center

“…In its 2021 edition of the clinical practice guidelines, the American Society of Colon and Rectal Surgeons (ASCRS) recommends early imaging of suspected volvulus to confirm the diagnosis and expedite care [ 17 ]. Abdominal radiographs are only suggestive or diagnostic of CV in 26-42% of cases [ 17 ].…”

“…In its 2021 edition of the clinical practice guidelines, the American Society of Colon and Rectal Surgeons (ASCRS) recommends early imaging of suspected volvulus to confirm the diagnosis and expedite care [ 17 ]. Abdominal radiographs are only suggestive or diagnostic of CV in 26-42% of cases [ 17 ]. The ASCRS guidelines strongly recommend segmental resection in all patients and limiting non-resectional procedures to those patients who are medically unfit to undergo resection [ 17 ].…”

“…Abdominal radiographs are only suggestive or diagnostic of CV in 26-42% of cases [ 17 ]. The ASCRS guidelines strongly recommend segmental resection in all patients and limiting non-resectional procedures to those patients who are medically unfit to undergo resection [ 17 ]. They have found sufficient data to support reducing mortality and leak rate after colectomy and anastomosis for CV [ 17 ].…”

Comments on 'Sigmoidectomy following sigmoid volvulus: who is at risk of anastomotic failure?'

“…First, according to the authors' evaluation, age > 80 years and American Society of Anesthesiologists (ASA) class 3-4 are associated with an increased risk of anastomotic leakage [1]. Although age alone is a controversial criterion in the elective treatment of SV, it is well known that the high incidence of comorbid diseases in advanced age increases mortality and morbidity [3]. For this reason, I prefer 'life expectancy' as a checkpoint in the decision-making process and I suggest elective surgery in patients < 70-75 years old [4].…”

“…Regarding surgical practice, I wonder about the indications of elective Hartmann's procedure used in 17 patients (17.2%) in the series evaluated by the authors [1]. Although stoma is a life-saving procedure in the emergency surgical treatment of selected high-risk, bed-bound, and elderly patients [4], sigmoidectomy and primary anastomosis, preferably laparoscopic, is preferable in the elective surgical treatment of SV [3].…”