Management of Acute Sigmoid Volvulus, Using One Stage Resection and Anastomosis, without Colonic Lavage

Background: One stage primary resection and anastomosis of left sided colonic obstruction with on-table antegrade colonic lavage is in vogue, to reduce the risk of postoperative infective complications and anastomotic dehiscence. The purpose of our study was to evaluate the safety of single-stage resection and anastomosis for acute left-sided colonic obstruction due to acute sigmoid volvulus, without intra operative colonic lavage. Material & Methods: This study was conducted in a consecutive series of patients admitted to our department with acute sigmoid volvulus. Patients with perforation and peritonitis at presentation were excluded from the study. Emergency resection was performed by consultant grade surgeon, followed by primary anastomosis without on-table colonic lavage, after a manual decompression. The data obtained was analyzed. Results: A total of 83 patients underwent resection and primary anastomosis of acute sigmoid volvulus. Four patients presented with gangrenous bowels, which were resected and primary anastomosis performed. One patient had caecal volvulus in addition to sigmoid. He had double resection and primary anastomosis. Post-operatively there were 7 superficial wound infections, 3 required surgical drainage. Death or clinical anastomotic failure was not recorded in the series. Mean hospital stay was 9.3 days. Conclusion: Our results suggest that resection of acute sigmoid volvulus and primary anastomosis after decompression is a safe procedure.