The twisted gut: Role of primary anastomosis without colonic lavage
Abstract
Background : The twisted gut or the sigmoid volvulus has a multitude of treatment options ranging from colonic decompression to staged procedures such as primary resection anastomosis with covering colostomy followed by colostomy closure at a later date.
Objective : This study aims to evaluate the efficacy and safety of primary resection and anastomosis followed by anal dilatation without on table colonic irrigation or diversion colostomy in cases of acute sigmoid volvulus.
Methods : This study was carried out over a span of three years and seven months at a teaching hospital in West Bengal. One hundred consecutive cases of acute sigmoid volvulus who underwent primary resection and anastomosis without diversion colostomy were included in the study.
Results : There were 94 males and 6 females. The age ranged from 35 to 72 years, the majority ( 65 % ) of the patients being in the age group of 41-60 years. All the patients underwent primary resection and anastomosis without on table colonic irrigation. Superficial wound infection was detected in 18% patients.. There was no clinical anastomotic leak, intra abdominal abscess or recurrence of volvulus or mortality in our series.
Conclusion : In conclusion, primary resection and anastomosis of the colon without faecal diversion for acute sigmoid volvulus is safe and can be accomplished without any mechanical bowel preparation or on table colonic irrigation.
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