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World Journal of Surgery

, Volume 42, Issue 6, pp 1590–1596 | Cite as

Novel Approach to Treat Uncomplicated Sigmoid Volvulus Combining Minimally Invasive Surgery with Enhanced Recovery, in a Rural Hospital in Zambia

  • Niels van der Naald
  • Marloes I. Prins
  • Kars Otten
  • Dayson Kumwenda
  • Robert P. BleichrodtEmail author
Original Scientific Report with Video

Abstract

Aim

In sub-Saharan Africa, sigmoid volvulus is a frequent cause of bowel obstruction. The aim of this study was to evaluate the results of acute sigmoid resection and anastomosis via a mini-laparotomy in patients with uncomplicated sigmoid volvulus, following the principles of “Enhanced Recovery After Surgery (ERAS)”, in a low-resource setting.

Materials and methods

Patients with uncomplicated sigmoid volvulus were operated acutely, via a mini-laparotomy, according to the principles of ERAS. Intraoperative complications, duration of operation, morbidity, mortality and length of hospital stay were evaluated, retrospectively.

Results

From 1 March 2012 to 1 September 2017, 31 consecutive patients were treated with acute sigmoid resection and anastomosis, via a mini-laparotomy. There were 29 men and 2 women, median age 57 (range 17–92) years. Patients were operated after a median period of 4 (range 1.5–18) hours. The median duration of the operative procedure was 50 (range 30–105) minutes. Two patients died (6.3%). One patient died during an uncomplicated operation. The cause of death is unknown. One patient with a newly diagnosed HIV infection had an anastomotic dehiscence. After Hartmann’s procedure, he died on the 17th post-operative day as a result of a HIV-related double-sided pneumonia, without signs of abdominal sepsis. One patient had an urinary retention and 1 patient haematuria after bladder catheter insertion.

Conclusion

Acute sigmoid resection and primary anastomosis via a mini-laparotomy for uncomplicated sigmoid volvulus, without preoperative endoscopic decompression is a safe procedure with a low morbidity and mortality.

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Supplementary material

Supplementary material 1 (MP4 171545 kb)

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Copyright information

© Société Internationale de Chirurgie 2017

Authors and Affiliations

  • Niels van der Naald
    • 1
    • 2
  • Marloes I. Prins
    • 1
  • Kars Otten
    • 1
  • Dayson Kumwenda
    • 1
  • Robert P. Bleichrodt
    • 1
    Email author
  1. 1.Department of SurgerySaint Francis Mission HospitalKatete (Eastern Province)Zambia
  2. 2.Department of SurgeryAmsterdam Medical CentreAmsterdamThe Netherlands

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