Original articleAcute sigmoid volvulus: Results of surgical treatment in the teaching hospitals of Bamako

SummaryObjectiveThe aim was to evaluate the results of surgical treatment of occlusion of the sigmoid colon due to volvulus.Patients and MethodsThis was a retrospective study from 1996 to 2010 of all patients undergoing surgery for sigmoid volvulus in surgical wards of the University Hospital of Bamako.ResultsA total of 417 patients were identified including 379 men and 38 women. The mean patient age was 45.7 ± 18.3 years. The general condition of the patients was good in 70.5% and altered in 29.5% of cases. Colonic necrosis was present in 80 patients (19.2%). Single-stage resection with immediate anastomosis was performed in 149 patients (35.73%). Two-stage surgery was performed in 268 cases (64.27%). The initial stage of the two-stage procedure was colostomy in 167 cases and simple detorsion in 101 cases. The surgical approach had an impact on mortality in patients who were in poor general condition. Single-stage surgery resulted in higher mortality (12/149; 8.05%) than two-stage surgery (5/268; 1.87%), and the difference was statistically significant (P = 0.0005).ConclusionSingle-stage surgery for sigmoid volvulus carries a high risk of death when it is performed in patients with poor general condition. Indications for surgery must take into account the patient's general condition and the viability of the torsed sigmoid colon.