title: One stage emergency resection and primary anastomosis for sigmoid volvulus.
abstract: OBJECTIVE
  To evaluate the safety of single stage resection and primary anastomosis (RPA) in cases of viable sigmoid volvulus, in terms of anastomotic healing and complications.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Surgical Unit, Hayatabad Medical Complex (HMC), Postgraduate Medical Institute, Peshawar, from November 2006 to October 2008.
  
  
  METHODS
  Study included all patients presented and admitted in Surgical Unit, HMC, with sigmoid volvulus during the above mentioned period. Resection and primary anastomosis was done without defunctioning stoma formation or on-table colonic lavage. Manual decompression was carried out pre-operatively. Patients excluded, had serious co-morbid conditions in whom colostomy was done instead of primary anastomosis. Patients were followed-up for one month after surgery.
  
  
  RESULTS
  A total of 30 patients were admitted during the study of 2 years duration, out of which there were 21 male and 09 female patients, with male to female ratio of 2.4:1. Only 1 patient had anastomotic leak while 4 patients had superficial wound infection. One patient died due to comorbid condition. Abdominal wound dehiscence or postoperative abdominal abscess was not observed in any case.
  
  
  CONCLUSIONS
  Single stage resection and primary anastomosis is a reliable current treatment modality for the emergency surgical management of sigmoid volvulus and has low morbidity and mortality. On-table colonic lavage and proximal defunctioning colostomies are unnecessary with this technique.
authors.affiliation: Surgical Unit, Postgraduate Medical Institute, Peshawar. aamer_naseer@hotmail.com
authors.forename: Aamer
authors.initials: A
authors.lastname: Naseer
authors.forename: Siddique
authors.initials: S
authors.lastname: Ahmad
authors.forename: Mohammad
authors.initials: M
authors.lastname: Naeem
authors.lastname: Safirullah
mesh_terms: D000714:Anastomosis, Surgical; D015331:Cohort Studies; D003082:Colectomy; D019299:Decompression, Surgical; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D045822:Intestinal Volvulus / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008297:Male; D012810:Sigmoid Diseases / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome