Open AccessOperative Management and Outcomes of Patients with Sigmoid Volvulus at a Tertiary Public Hospital in Malawi
Author(s) -
Ephraim Bitilinyu-Bangoh,
Fatsani Mwale,
Loveness Ulunji Chawinga,
Gift Mulima
Publication year - 2021
Publication title -
the annals of african surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.114
H-Index - 4
eISSN - 2523-0816
pISSN - 1999-9674
DOI - 10.4314/aas.v18i3.9
Subject(s) - medicine , sigmoid volvulus , anastomosis , sigmoid colon , surgery , volvulus , general surgery , rectum
Background: Sigmoid Volvulus (SV) is a common cause of acute bowel obstruction in Malawi. We aimed to describe the surgical management of SV and its outcomes at Kamuzu Central Hospital, Lilongwe, Malawi.
Methods: We retrospectively reviewed records from January 2019 to December 2019 of all SV patients, aged 18 years and above. Data extracted included age, sex, admission date, surgery date, bowel viability at time of surgery, procedure done, suspected anastomotic leakage, length of hospital stay and mortality. The data was analyzed using STATA 14.0.
Results: There were more males (n= 59, 81.9 %) than females. The median (IQR) age was 50.5 (38-60) years. A viable sigmoid colon was present in 61 (84.7%) patients. The commonest procedures done were sigmoid resection and primary anastomosis (RPA) (59.7%, n=43) and Hartmann’s procedure (HP) (36.1%, n=26). The median length of hospital stay was 5 days in HP, 7 days in RPA and longest in mesosigmoidopexy (10 days). Suspected anastomotic leakage occurred in 2(4.7%) patients. The overall mortality was 6.9% with all deaths occurring in RPA patients.
Conclusion: Mortality is high in SV patients who undergo RPA. We recommend Hartmann’s procedure in cases where the bowel has significant oedema or is gangrenous.