在西北埃塞俄比亚，乙状结肠解剖尺寸在乙状结肠扭转发展中的作用。
The role of sigmoid colon anatomic dimensions in the development of sigmoid volvulus, North-Western Ethiopia.
机构信息
Department of General Surgery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara Regional State, Ethiopia.
Department of Biomedical Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara Regional State, Ethiopia.
出版信息
PLoS One. 2021 Dec 1;16(12):e0260708. doi: 10.1371/journal.pone.0260708. eCollection 2021.
INTRODUCTION
Sigmoid colon anatomic dimensions have been studied to have roles in the occurrence of sigmoid volvulus; however, these studies are few in number and failed to control the confounding effect of acute sigmoid obstruction on the anatomic dimensions. The main objective of this study was to assess the role of sigmoid colon anatomic dimensions in the development of sigmoid volvulus controlling the effect of acute sigmoid obstruction on the anatomic dimensions.
MATERIALS AND METHODS
The study was carried out from Dec, 2019 to April, 2021 at Tibebe Ghion Specialized Hospital and Felege Hiwot Comprehensive Specialized Hospital, two referral hospitals in Bahir Dar city, North-Western Ethiopia to compare sigmoid anatomic dimensions among three independent groups of participants: patients with no history of sigmoid volvulus (I), those for whom elective surgery was done after non-surgical detorsion of sigmoid volvulus (II), and patients for whom emergency surgery was done for sigmoid volvulus (III). The anatomic dimensions were compared using fixed effects one-way ANOVA or Kruskal-Wallis H test at p-value ≤ .05 (two-sided) and Tukey method or Dunn-Bonferroni's test was used for post-hoc comparisons.
RESULTS
A total of 66 consecutive eligible patients (22 for each of the three groups) were included and analyzed in the study. The means of anatomic dimensions (in cm) for groups (I, II, III) were: sigmoid colon length-SCL (35.91, 71.07, 80.86), meso-sigmoid height-MSH (17.11, 26.52, 28.86), meso-sigmoid maximal width-MSMW (9.70, 14.89,16.80), and meso-sigmoid root width-MSRW (8.34, 7.48, 8.11). SCL, MSH, MSMW, MSH/MSRW, and MSMW/MSRW were found to be statistically significantly different in patients with sigmoid volvulus. MSRW and MSH/MSMW were not different between the study groups.
CONCLUSION
A long sigmoid colon with long and wide mesentery, but with a constant base is highly likely to predispose individuals to sigmoid volvulus.
简介
乙状结肠的解剖尺寸在乙状结肠扭转的发生中起作用；然而，这些研究数量较少，未能控制急性乙状结肠梗阻对解剖尺寸的混杂影响。本研究的主要目的是评估乙状结肠解剖尺寸在乙状结肠扭转发展中的作用，同时控制急性乙状结肠梗阻对解剖尺寸的影响。
材料和方法
这项研究于 2019 年 12 月至 2021 年 4 月在埃塞俄比亚西北部巴赫达尔市的 Tibebe Ghion 专科医院和 Felege Hiwot 综合专科医院进行，该研究将参与者分为三组：无乙状结肠扭转病史的患者（I 组）、非手术复位乙状结肠扭转后择期手术的患者（II 组）和急诊手术治疗乙状结肠扭转的患者（III 组）。使用固定效应单因素方差分析或 Kruskal-Wallis H 检验比较三组之间的解剖尺寸，p 值≤.05（双侧），并使用 Tukey 法或 Dunn-Bonferroni 检验进行事后比较。
结果
共纳入并分析了 66 例连续合格的患者（每组 22 例）。组（I、II、III）的解剖尺寸平均值（cm）为：乙状结肠长度-SCL（35.91、71.07、80.86）、乙状结肠系膜高度-MSH（17.11、26.52、28.86）、乙状结肠系膜最大宽度-MSMW（9.70、14.89、16.80）和乙状结肠系膜根部宽度-MSRW（8.34、7.48、8.11）。SCL、MSH、MSMW、MSH/MSRW 和 MSMW/MSRW 在乙状结肠扭转患者中存在统计学显著差异。MSRW 和 MSH/MSMW 在研究组之间没有差异。
结论
具有长乙状结肠、长而宽系膜、但基部恒定的个体很可能易患乙状结肠扭转。
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