Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey.
J Laparoendosc Adv Surg Tech A. 2022 Jul;32(7):763-767. doi: 10.1089/lap.2021.0613. Epub 2021 Nov 9.
Sigmoid volvulus (SV) is the twisting of the sigmoid colon around itself. Endoscopy both helps diagnosis and provides treatment in the absence of peritonitis or perforation in SV. Nevertheless, there are some controversies or limitations on this subject. The aim of this study is to evaluate the current role of the endoscopic decompression in the treatment of SV. The clinical records of 1040 patients with SV treated over a 55-year period from June 1966 to July 2021 were reviewed retrospectively until June 1986 and prospectively thereafter. For each case, preoperational parameters, treatment options, and prognosis were noted. Endoscopic decompression was tried in 748 patients (71.9%). The procedure was successful in 585 cases (83.2%), whereas unsuccessful in 118 (16.8%) of 703 patients (94.0%) with viable bowel. The mortality rate was 0.5% (4 patients), the morbidity rate was 1.9% (14 patients), the early recurrence rate was 5.5% (32 patients), whereas the mean hospitalization period was 34.6 hours (range: 24-96 hours). Despite some controversies or limitations in some subjects including the strategy in ischemic or gangrenous cases, the factors affecting the success, kind of the used instruments, technical details of the application, role of the flatus tubes, and the specific topics such as SV in childhood or pregnancy, endoscopic decompression is the first-line therapy in selected patients with SV.
乙状结肠扭转（SV）是乙状结肠自身的扭转。在没有腹膜炎或穿孔的情况下，内镜检查既有助于诊断，也提供治疗。然而，在这个主题上存在一些争议或局限性。本研究旨在评估内镜减压在 SV 治疗中的当前作用。回顾性分析了 1966 年 6 月至 2021 年 7 月 55 年间 1040 例 SV 患者的临床记录，直至 1986 年 6 月前为回顾性，此后为前瞻性。记录了每个病例的术前参数、治疗选择和预后。748 例患者（71.9%）尝试了内镜减压。在 703 例有存活肠管的患者中，585 例（83.2%）手术成功，118 例（16.8%）不成功。死亡率为 0.5%（4 例），发病率为 1.9%（14 例），早期复发率为 5.5%（32 例），平均住院时间为 34.6 小时（范围：24-96 小时）。尽管在一些主题上存在一些争议或局限性，包括缺血性或坏疽性病例的策略、影响手术成功的因素、使用器械的种类、应用的技术细节、气腹管的作用以及儿童或妊娠时 SV 等特定主题，内镜减压是 SV 患者的一线治疗方法。
