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World Journal of Surgery
Published in: World Journal of Surgery 6/2018

01-06-2018 | Original Scientific Report with Video

Novel Approach to Treat Uncomplicated Sigmoid Volvulus Combining Minimally Invasive Surgery with Enhanced Recovery, in a Rural Hospital in Zambia

Authors: Niels van der Naald, Marloes I. Prins, Kars Otten, Dayson Kumwenda, Robert P. Bleichrodt

Published in: World Journal of Surgery | Issue 6/2018

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Abstract

Aim

In sub-Saharan Africa, sigmoid volvulus is a frequent cause of bowel obstruction. The aim of this study was to evaluate the results of acute sigmoid resection and anastomosis via a mini-laparotomy in patients with uncomplicated sigmoid volvulus, following the principles of “Enhanced Recovery After Surgery (ERAS)”, in a low-resource setting.

Materials and methods

Patients with uncomplicated sigmoid volvulus were operated acutely, via a mini-laparotomy, according to the principles of ERAS. Intraoperative complications, duration of operation, morbidity, mortality and length of hospital stay were evaluated, retrospectively.

Results

From 1 March 2012 to 1 September 2017, 31 consecutive patients were treated with acute sigmoid resection and anastomosis, via a mini-laparotomy. There were 29 men and 2 women, median age 57 (range 17–92) years. Patients were operated after a median period of 4 (range 1.5–18) hours. The median duration of the operative procedure was 50 (range 30–105) minutes. Two patients died (6.3%). One patient died during an uncomplicated operation. The cause of death is unknown. One patient with a newly diagnosed HIV infection had an anastomotic dehiscence. After Hartmann’s procedure, he died on the 17th post-operative day as a result of a HIV-related double-sided pneumonia, without signs of abdominal sepsis. One patient had an urinary retention and 1 patient haematuria after bladder catheter insertion.

Conclusion

Acute sigmoid resection and primary anastomosis via a mini-laparotomy for uncomplicated sigmoid volvulus, without preoperative endoscopic decompression is a safe procedure with a low morbidity and mortality.
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Metadata
Title
Novel Approach to Treat Uncomplicated Sigmoid Volvulus Combining Minimally Invasive Surgery with Enhanced Recovery, in a Rural Hospital in Zambia
Authors
Niels van der Naald
Marloes I. Prins
Kars Otten
Dayson Kumwenda
Robert P. Bleichrodt
Publication date
01-06-2018
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 6/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-017-4405-9

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