Endoscopic treatment and outcomes of sigmoid volvulus: A single-center experience

INTRODUCTION: There are many different approaches in the treatment of sigmoid volvulus (SV) in the literature, the first choice in patients without peritonitis findings is endoscopic treatment, while the standard treatment in complicated cases is surgery. The aim of this study is to evaluate the demographic characteristics, diagnostic methods, and post-treatment results of patients who underwent endoscopic detorsion with the diagnosis of SV in our clinic.
METHODS: Between January 2016 and December 2020, 39 patients with the diagnosis of SV were treated endoscopically or surgically in our clinic. Eighteen SV patients had successful detorsion and decompression procedures were included in the study.
RESULTS: The mean age of 18 patients was 66.55±20.26 years and 14 (77.8%) patients were male. The median time between the onset of symptoms and admission to the hospital was 3.52±2.23 days. Elective surgery was performed in a total of 6 (33.3%) patients whose performance status was appropriate. Hartmann end colostomy was performed in only one patient, while anastomosis was preferred in five patients. Remaining 12 patients whom outpatient follow-up was recommended due to performance status were followed at our outpatients clinic. Eight (66.67%) of these 12 patients were hospitalized for recurrent SV. Six of these patients can be successfully treated with endoscopic redetorsion and two patients were operated urgently.
DISCUSSION AND CONCLUSION: SV is a surgical emergency with high morbidity and mortality rates if effective treatment is not applied. Endoscopic detorsion can be preferred and safely applied as first-line treatment in non-complicated cases without peritoneal irritation findings.