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Treatment of Sigmoid Volvulus

NCT06771349 · Status: COMPLETED · Type: OBSERVATIONAL · Enrollment: 70

Last updated 2025-01-14

No results posted yet for this study

Summary

Colonic volvulus, where part of the colon twists, is a significant cause of large bowel obstruction, representing 15% of cases, second only to cancer and diverticulitis. Acute sigmoid volvulus (SV), which affects the sigmoid colon, is the most common type, with morbidity rates ranging from 6% to 42% and mortality varying from 7% to 90%. The incidence of SV varies globally, being more common in regions such as Africa, Ethiopia, Australia, and East Asia, where it can account for up to 50% of bowel obstructions.

SV often presents as partial or complete obstruction and can lead to severe complications such as ischemia, necrosis, and perforation, especially in older patients. The primary treatment goals are relieving the obstruction, reducing pressure, and correcting the twist. According to the World Society of Emergency Surgery (WSES), endoscopic decompression is recommended for patients without infection, perforation, or hemodynamic instability. However, surgery is necessary if decompression fails, with options including sigmoidopexy, sigmoidectomy, or colostomy. Sigmoidopexy is less invasive but has a higher recurrence rate, while sigmoidectomy, though riskier, may reduce recurrence and improve long-term survival.

This retrospective study aims to compare the outcomes of sigmoidopexy and sigmoidectomy in patients with acute SV undergoing emergency surgery at West China Hospital, Sichuan University, over a 14-year period. The primary outcome is the recurrence rate of SV, with secondary outcomes including 30-day mortality and morbidity (complications).

Conditions

  • Sigmoid Volvulus

Interventions

PROCEDURE

sigmoidopexy

Both Sigmoidectomy and sigmoidopexy can be used for the treatment of sigmoid volvulus. The former is the treatment of sigmoid volvulus by removing a portion of the sigmoid colon, and depending on the patient's condition, a bowel reconstruction or anastomosis may be performed to reattach the healthy bowel segment. The procedure may result in long-term bowel changes and may even require an stomy. sigmoidopexy is a procedure that immobilizes the sigmoid colon to the abdominal wall or pelvic structure, preventing it from twisting again. The goal of sigmoidectomy is primarily to remove damaged or necrotic portions of the sigmoid colon and to treat complications resulting from sigmoid volvulus, especially when the volvulus results in intestinal necrosis, ischemia, or other serious complications. The goal of sigmoidopexy is to prevent the sigmoid from re-twisting by immobilizing the sigmoid, and it is suitable for those cases of sigmoid torsion without severe ischemia or necrosis.

Sponsors & Collaborators

  • West China Hospital

    lead OTHER

Eligibility

Min Age
18 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2023-10-01
Primary Completion
2024-10-01
Completion
2024-12-01

Countries

  • China

Study Locations

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Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT06771349 on ClinicalTrials.gov