Evaluation of the primary anastomosis side effects in patients with sigmoid volvulus in Imam Hossein and Firoozgar Hospitals in 2014-2015
Mahdi Alemrajabi1, Mostafa Hosseini2, Behzad Nemati Honar3, Mahdi Kayyal4, Adnan Tizmaghz5, Amirmohsen Jalaeefar6
1 MD., Assistant Professor of colorectal surgery, Firoozgar Clinical Research Development Center (FCRDC), University of Medical Sciences, Tehran, Iran
2 MD., Associate Professor of surgical oncology, University of Medical Sciences, Tehran, Iran
3 MD., Assistant Professor of general surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 MD., Resident in general surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5 MD., Resident in general surgery, University of Medical Sciences, Tehran, Iran
6 MD., Assistant Professor of surgical oncology, Tehran and Shahid Beheshti University of Medical Sciences, Cancer Institute, Tehran, Iran
Tehran and Shahid Beheshti University of Medical Sciences, Cancer Institute, Tehran
Source of Support: None, Conflict of Interest: None
Objective: The term volvulus is derived from a Latin word volvere means to turn, twist which is mainly referred to as twisting of sigmoid and can lead to ischemia and gangrene. Nowadays, it is the 3rd most common reason of bowel obstruction mostly in the Middle East countries, Africa, India, and Russia where average age is younger compared to the west (about 40 to 50).
Methods: In this study, patients who referred to Imam Hossein and Firoozgar Hospitals within2014 and 2015were included by the first impression of obstruction and finally diagnosis of sigmoid volvulus that were not in septic shock. After primary survey, routine lab profile, electrolyte correction and resuscitation if needed, the process of choices of patients and terms and conditions were explained for patients. They were prepared for operation after obtaining a written consent. During operation, those who are not necrotic sigmoid and do not have peritonitis undergone primary resection and anastomosis of intestine as suggested by surgeon. Anastomosis has given by 3-0 silk thread separately.
Results: Twenty-five patients, 7 females (28 %) and 18 males (72%), underwent primary resection and anastomosis whose age ranged from 18 to 84 (mean 61.5 years, variance 56, 25). Average leukocytes count for our patients once they entered the emergency ward was 8500(with max level of 14/9 and min of 4/1). Two patients had fever after operation. Five patients experienced tachycardia within 24hours after surgery and one patient experienced infectious wound and 2 cases passed away.
Conclusions: With regard to the obtained results, examining all aspects of patients is recommended to conduct primary anastomosis. Primary anastomosis is not recommended for patients with multiple underlying diseases considering the longer operation time.