Volume : 7, Issue : 6, June - 2018

A COMPARATIVE STUDY OF DETORSION AND SIGMOIDOPEXYVS RESECTION AND ANASTOMOSIS FOR SURGICAL MANAGEMENT OF SIGMOID VOLVULUS.

Dr. M H C Pragna Sree, Dr Y Prabhakar Rao

Abstract :

<p class="MsoNormal"><span style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-fareast-font-family:&quot;Times New Roman&quot;;color:black">BACKGROUND <o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:6.5pt;margin-right:0in;margin-bottom:0in;&#10;margin-left:0in;margin-bottom:.0001pt;text-align:justify;text-justify:inter-ideograph;&#10;line-height:normal"><span style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-fareast-font-family:&quot;Times New Roman&quot;;color:black">Sigmoid volvulus is an acute surgical emergency. Modalities of surgery for the management of sigmoid volvulus are Detorsion&amp; Plication { Sigmoidopexy }, Resection &amp; Anastomosis, Resection &amp; Colostomy.{Haartmans procedure}.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:6.5pt;margin-right:0in;margin-bottom:0in;&#10;margin-left:0in;margin-bottom:.0001pt;text-align:justify;text-justify:inter-ideograph;&#10;line-height:normal"><span style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-fareast-font-family:&quot;Times New Roman&quot;;color:black">AIM<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:6.5pt;margin-right:0in;margin-bottom:0in;&#10;margin-left:0in;margin-bottom:.0001pt;text-align:justify;text-justify:inter-ideograph;&#10;line-height:normal"><span style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-fareast-font-family:&quot;Times New Roman&quot;;color:black">To compare and contrast the two surgical procedures namely detorsion&amp;sigmoidopexyVs Resection and Anastomosis for surgical management of sigmoid volvolus in terms of recurrences, mortality</span><span style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;&#10;mso-fareast-font-family:&quot;Times New Roman&quot;">, </span><span style="mso-ascii-font-family:&#10;Calii;mso-fareast-font-family:Calii;mso-hansi-font-family:Calii;&#10;mso-bidi-font-family:Calii;color:black">duration of hospital stay andPost operative complications.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:6.5pt;margin-right:0in;margin-bottom:0in;&#10;margin-left:0in;margin-bottom:.0001pt;text-align:justify;text-justify:inter-ideograph;&#10;line-height:normal"><span style="mso-ascii-font-family:Calii;mso-fareast-font-family:&#10;Calii;mso-hansi-font-family:Calii;mso-bidi-font-family:Calii"><o:p>&nbsp;</o:p></span></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph"><span style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&quot;Times New Roman&quot;">MATERIALS AND METHODS<o:p></o:p></span></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph"><span style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&quot;Times New Roman&quot;"><span style="mso-spacerun:yes">&nbsp;</span>It is a prospective study of 16 cases of sigmoid volvolus which presented to Emergency Department of NRI Medical college Hospital, Guntur in a period of 2 years.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph"><span style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&quot;Times New Roman&quot;">STATISTICAL ANALYSIS<b style="mso-bidi-font-weight:normal"><o:p></o:p></b></span></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph"><span style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&quot;Times New Roman&quot;">In this study we used FISCHERS EXACT TEST to know it is statistically significant and P value was 0.0373 which is statistically significant.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph"><span style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&quot;Times New Roman&quot;">RESULTS<u><o:p></o:p></u></span></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph"><span style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&quot;Times New Roman&quot;">37.5% undergoing sigmoidopexy showed recurrence whereas 12.5% of those undergoing resection and anastamosis showed recurrence.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph"><span style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&quot;Times New Roman&quot;">CONCLUSION<o:p></o:p></span></p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph"><span style="font-family:&quot;Times New Roman&quot;,&quot;serif&quot;;mso-fareast-font-family:&quot;Times New Roman&quot;"><span style="mso-spacerun:yes">&nbsp;</span>Fixation of sigmoid colon in the form of sigmoidopexy is associated with high recurrence rate. Unless general condition precludes ,fixation of sigmoid colon should not be done as it is associated with high recurrence rate. Sigmoidopexy<span style="mso-spacerun:yes">&nbsp;&nbsp; </span>should be definitely followed by elective sigmoid resection.<o:p></o:p></span></p>