Elective treatment of detorsioned sigmoid volvulus

Amaç: Başarılı bir ameliyatsız detorsiyon veya kalıcı olmayan bir ameliyat sonrası nüks, sigmoid volvulus (SV) tedavisinde büyük sorun oluşturur. Bu çalışma, başarıyla detorsiyone edilmiş SV’un elektif tedavisinin sonuçlarını gözden geçirmek ve tedavi algoritmasını tartışmak amacıyla yapıldı. Yöntem ve Gereç: SV'lu 873 hastanın kayıtları retrospektif olarak incelendi. Bulgular: Ameliyat dışı tedavi 614 hastaya uygulandı. Başarı, ölüm, komplikasyon ve erken nüks oranları sırasıyla % 77.5, 0.8, 2.8 ve 4 olarak bulundu. Acil cerrahi tedavi uygulanan 416 hastada, % 15.6 ölüm, % 36.5 komplikasyon, % 0.7 erken nüks ve % 6.5 oranında geç nüks oranları saptandı. Elektif cerrahi tedavi 436 hastaya önerildi, olguların 94’ü (% 21.6) tedaviyi kabul etti. Hastaların 86'sına açık sigmoid rezeksiyon ve anastomoz uygulanırken, 8 hastaya laparoskopi yardımlı sigmoid rezeksiyon ve anastomoz uygulandı. Ölüm oranı % 0, komplikasyon oranı % 12.8 ve nüks oranı % 0 olarak bulundu. Sonuç: SV tedavisinde temel strateji, erken dönemde ameliyat dışı detorsiyonu takiben seçilmiş ve iyi hazırlanmış hastada elektif cerrahi tedavi olmalıdır.

Anahtar Kelime: Ölümle sonuçlanma Cerrahi işlemler, elektif Laparoskopi Anastomoz, cerrahi Tedavi sonucu Sigmoid hastalıkları Tedavi başarısızlığı Tekrarlama İntestinal volvulus Ameliyat sonrası komplikasyonlar Geriyedönük çalışma

Konular: Cerrahi

Detorsiyone edilmiş sigmoid volvulusun elektif tedavisi

Öz:

Aim: Recurrence after a successful nonoperative detorsion or a nondefinitive operation is an important problem in the treatment of sigmoid volvulus (SV). This study was designed to review the outcomes of elective treatment of successfully detorsioned SV and to discuss the treatment algorithm. Materials and Methods: The records of 873 patients were reviewed retrospectively. Results: Nonoperative treatment was applied in 614 patients. The success, mortality, complication and recurrence rates were 77.5%, 0.8%, 2.8%, and 4%, respectively. Emergency surgical treatment was performed in 416 patients with 15.6% mortality, 36.5% complication, 0.7% early recurrence and 6.5% late recurrence rates. Elective surgical treatment was suggested for 436 patients, 94 of whom (21.6%) received the treatment. Open sigmoid resection and anastomosis was applied in 86 patients, while laparoscopy-assisted sigmoid resection and anastomosis was applied in 8 patients. The mortality, complication and recurrence rates were 0%, 12.8% and 0%, respectively. Conclusions: The principal strategy in the treatment of SV must be early nonoperative detorsion followed by an elective surgery in selected and well-prepared patients.

Anahtar Kelime: Intestinal Volvulus Postoperative Complications Retrospective Studies Fatal Outcome Surgical Procedures, Elective Laparoscopy Anastomosis, Surgical Treatment Outcome Sigmoid Diseases Treatment Failure Recurrence

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	ATAMANALP S, ÖREN D, AYDINLI B, ÖZTÜRK G, POLAT K, BAŞOĞLU M, YILDIRGAN M, Kantarci M, BALIK A (2008). Elective treatment of detorsioned sigmoid volvulus. , 227 - 234.
Chicago	ATAMANALP S. Selçuk,ÖREN Durkaya,AYDINLI Bülent,ÖZTÜRK Gürkan,POLAT K. Yalçın,BAŞOĞLU Mahmut,YILDIRGAN M. İlhan,Kantarci Mecit,BALIK Ahmet A. Elective treatment of detorsioned sigmoid volvulus. (2008): 227 - 234.
MLA	ATAMANALP S. Selçuk,ÖREN Durkaya,AYDINLI Bülent,ÖZTÜRK Gürkan,POLAT K. Yalçın,BAŞOĞLU Mahmut,YILDIRGAN M. İlhan,Kantarci Mecit,BALIK Ahmet A. Elective treatment of detorsioned sigmoid volvulus. , 2008, ss.227 - 234.
AMA	ATAMANALP S,ÖREN D,AYDINLI B,ÖZTÜRK G,POLAT K,BAŞOĞLU M,YILDIRGAN M,Kantarci M,BALIK A Elective treatment of detorsioned sigmoid volvulus. . 2008; 227 - 234.
Vancouver	ATAMANALP S,ÖREN D,AYDINLI B,ÖZTÜRK G,POLAT K,BAŞOĞLU M,YILDIRGAN M,Kantarci M,BALIK A Elective treatment of detorsioned sigmoid volvulus. . 2008; 227 - 234.
IEEE	ATAMANALP S,ÖREN D,AYDINLI B,ÖZTÜRK G,POLAT K,BAŞOĞLU M,YILDIRGAN M,Kantarci M,BALIK A "Elective treatment of detorsioned sigmoid volvulus." , ss.227 - 234, 2008.
ISNAD	ATAMANALP, S. Selçuk vd. "Elective treatment of detorsioned sigmoid volvulus". (2008), 227-234.

APA	ATAMANALP S, ÖREN D, AYDINLI B, ÖZTÜRK G, POLAT K, BAŞOĞLU M, YILDIRGAN M, Kantarci M, BALIK A (2008). Elective treatment of detorsioned sigmoid volvulus. Turkish Journal of Medical Sciences, 38(3), 227 - 234.
Chicago	ATAMANALP S. Selçuk,ÖREN Durkaya,AYDINLI Bülent,ÖZTÜRK Gürkan,POLAT K. Yalçın,BAŞOĞLU Mahmut,YILDIRGAN M. İlhan,Kantarci Mecit,BALIK Ahmet A. Elective treatment of detorsioned sigmoid volvulus. Turkish Journal of Medical Sciences 38, no.3 (2008): 227 - 234.
MLA	ATAMANALP S. Selçuk,ÖREN Durkaya,AYDINLI Bülent,ÖZTÜRK Gürkan,POLAT K. Yalçın,BAŞOĞLU Mahmut,YILDIRGAN M. İlhan,Kantarci Mecit,BALIK Ahmet A. Elective treatment of detorsioned sigmoid volvulus. Turkish Journal of Medical Sciences, vol.38, no.3, 2008, ss.227 - 234.
AMA	ATAMANALP S,ÖREN D,AYDINLI B,ÖZTÜRK G,POLAT K,BAŞOĞLU M,YILDIRGAN M,Kantarci M,BALIK A Elective treatment of detorsioned sigmoid volvulus. Turkish Journal of Medical Sciences. 2008; 38(3): 227 - 234.
Vancouver	ATAMANALP S,ÖREN D,AYDINLI B,ÖZTÜRK G,POLAT K,BAŞOĞLU M,YILDIRGAN M,Kantarci M,BALIK A Elective treatment of detorsioned sigmoid volvulus. Turkish Journal of Medical Sciences. 2008; 38(3): 227 - 234.
IEEE	ATAMANALP S,ÖREN D,AYDINLI B,ÖZTÜRK G,POLAT K,BAŞOĞLU M,YILDIRGAN M,Kantarci M,BALIK A "Elective treatment of detorsioned sigmoid volvulus." Turkish Journal of Medical Sciences, 38, ss.227 - 234, 2008.
ISNAD	ATAMANALP, S. Selçuk vd. "Elective treatment of detorsioned sigmoid volvulus". Turkish Journal of Medical Sciences 38/3 (2008), 227-234.