Elective Treatment of Detorsioned Sigmoid Volvulus

Aim: Recurrence after a successful nonoperative detorsion or a nondefinitive operation is an important problem in the treatment of sigmoid volvulus (SV). This study was designed to review the outcomes of elective treatment of successfully detorsioned SV and to discuss the treatment algorithm. Materials and Methods: The records of 873 patients were reviewed retrospectively. Results: Nonoperative treatment was applied in 614 patients. The success, mortality, complication and recurrence rates were 77.5%, 0.8%, 2.8%, and 4%, respectively. Emergency surgical treatment was performed in 416 patients with 15.6% mortality, 36.5% complication, 0.7% early recurrence and 6.5% late recurrence rates. Elective surgical treatment was suggested for 436 patients, 94 of whom (21.6%) received the treatment. Open sigmoid resection and anastomosis was applied in 86 patients, while laparoscopy-assisted sigmoid resection and anastomosis was applied in 8 patients. The mortality, complication and recurrence rates were 0%, 12.8% and 0%, respectively. Conclusions: The principal strategy in the treatment of SV must be early nonoperative detorsion followed by an elective surgery in selected and well-prepared patients