Extraperitoneal sigmoidopexy versus sigmoidectomy for sigmoid volvulus: A prospective comparative study

Abstract

Aim

Extraperitoneal sigmoidopexy is a simple, safe and effective non-resective procedure with minimal morbidity and mortality rates.

Patients and Methods

This prospective comparative study involved 105 patients with uncomplicated sigmoid volvulus at Asyut University Hospitals, Egypt, from June 2021 to January 2023. The study population was divided into two groups: Group A, which underwent extraperitoneal sigmoidopexy, and Group B, which was treated with sigmoidectomy and primary anastomosis.

Results

The study included 105 cases. A total of 56 (53.4%) patients underwent extraperitoneal sigmoidopexy (Group A) and 49 (46.6%) patients underwent sigmoidectomy (Group B). The mean age was 61.33 (standard deviation [SD] 1.65) for Group A and 67.9 (SD 1.69) for Group B (P = .36). The mean operative time (minutes) was 62.25 (SD 1.38) for Group A and 87.60 (SD 2.38) for Group B (P < .0001). The mean hospital stay (days) was 6.25 (SD 0.29) for Group A and 9.04 (SD 0.34) for Group B (P < .0001). There was a significant difference in overall morbidity and recurrence rate, while no significant difference was observed in intensive care unit admission, additional surgery and mortality between the two groups.

Conclusion

Extraperitoneal sigmoidopexy emerges as a simple, safe and effective treatment option for non-complicated sigmoid volvulus. Despite a higher recurrence rate, it demonstrates lower morbidity and mortality compared with sigmoidectomy.