Surgical Emergency Unit, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU, UK.
BMC Surg. 2022 Mar 14;22(1):95. doi: 10.1186/s12893-022-01549-4.
Sigmoid volvulus is a common cause of emergency surgical admission. Those patients are often treated conservatively with a high rate of recurrence. We wondered if a more aggressive management might be indicated.
We have reviewed data of patients diagnosed with acute sigmoid volvulus over a 2-year period. The primary endpoint was patient survival.
We analysed 332 admissions of 78 patients. 39.7% underwent resection. Survival was 54.9 ± 8.8 months from the first hospitalization, irrespective of the treatment. Long-term survival was positively influenced by being female, having a low "social score", a younger age and surgery. Multivariate analysis showed that only being female and surgery were independently associated with better survival.
Early surgery may be the best approach in patients with recurrent sigmoid volvulus, as it ensures longer survival with a better quality of life, regardless of the patient's social and functional condition.
乙状结肠扭转是急诊手术入院的常见原因。这些患者通常采用保守治疗，复发率较高。我们想知道是否需要更积极的治疗。
我们回顾了过去两年中诊断为急性乙状结肠扭转的患者的数据。主要终点是患者生存。
我们分析了 78 例患者的 332 例入院病例。39.7%的患者接受了切除手术。首次住院后，无论治疗方式如何，患者的生存时间为 54.9±8.8 个月。女性、社会评分低、年龄较小和手术是长期生存的积极影响因素。多变量分析显示，只有女性和手术与更好的生存独立相关。
对于复发性乙状结肠扭转患者，早期手术可能是最佳方法，因为无论患者的社会和功能状况如何，它都能确保更长的生存时间和更好的生活质量。
