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Safe Resection and Primary Anastomosis of Gangrenous Sigmoid Volvulus
Abstract
Introduction
The management of sigmoid volvulus has remained a controversial issue to many surgeons. Rapid resection with colostomy fashioning has been done over time for gangrenous sigmoid volvulus. However, resection and
primary anastomosis has also been described with less complications and a shorter hospital stay.
Methods
We conducted a prospective study to determine the outcome of resection and primary anastomosis of sigmoid volvulus in Kisii Level 5 Hospital
Results
The causes of mechanical obstruction: sigmoid volvulus 30%, hernia 17.8%, adhesions 16.7%, faecal impaction 16.7%. Seventy five (75%) of the sigmoid volvulus was gangrenous and 85.2% of all the sigmoid volvulus was managed by resection and primary anastomosis. Complications seen after resection and primary anastomosis were anastomotic leak at 4.5%, resection and colostomy fashioning wound dehiscence (33.3%) and mortality (33.3%). The average hospital stay was
12.9 days after primary resection and anastomosis.
Conclusion
Resection and primary anastomosis in gangrenous sigmoid volvulus can be practised with few complications and a short hospital stay. Surgeons in resource limited facilities can practice resection and primary anastomosis in the management of gangrenous sigmoid volvulus with good outcomes.
