Safe Resection and Primary Anastomosis of Gangrenous Sigmoid Volvulu
Riogi B. MBChB, Odhiambo K. MBChB, MMed,
Kisii Level 5 Hospital, Kisii, Kenya.
Correspondence to: Dr Bahaty Riogi, P.O Box 13449-00100 Nairobi, Kenya, Email:
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.
We conducted a prospective study to determine the outcome of resection and primary anastomosis of sigmoid volvulus in Kisii Level 5 Hospital
The causesofofmechanicalobstruction:weresigmoidvolvulus 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.
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.