title: Comparison of two surgical techniques for resection of uncomplicated sigmoid volvulus: laparoscopy or open surgical approach?
abstract: OBJECTIVE
  The optimal treatment for acute sigmoid volvulus has not been defined. Our aim was to compare the results of two techniques for the management of uncomplicated sigmoid volvulus coming from two separate surgical services, which had each chosen a different technique: open surgical versus laparoscopic.
  
  
  METHODS
  Patients with sigmoid volvulus who underwent a surgical resection with immediate anastomosis, either emergency or scheduled, were included. Risk of morbidity (Dindo-Clavien criteria) and mortality (criteria of the AFC-French Association of Surgery) were evaluated.
  
  
  RESULTS
  Thirteen patients in the open surgical group were operated in a 10-year period and 17 patients in the laparoscopy group were operated on in a seven-year period. The mean age (57 years in both groups) and sex ratio (0.7 versus 0.6, respectively), and the length of hospital stay (18 versus 15 days, respectively) were comparable in the two groups. The open surgical procedure was performed urgently in 62% (n=8/13) versus 24% (n=4/17) in the laparoscopic group. The two groups were comparable in terms of risk factors for mortality by AFC score. The anastomotic leak rate was 8% (n=1/13) for the open surgical group versus 18% (n=3/17) for the laparoscopic group, while serious morbidity was 15% (n=2/13) versus 12% (n=2/17). No recurrence of volvulus was observed in the open group (mean follow-up of 26 months) versus 12% (n=2) in the laparoscopy group (mean follow-up of 32 months).
  
  
  CONCLUSIONS
  We did not find any significant difference between the two techniques. But the technical simplicity and the absence of recurrence in the open surgical group emphasize the importance of this technique.
authors.affiliation: Service de Chirurgie Digestive et Cancérologique, Hôpital Lariboisière, AP-HP, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, 2, rue Ambroise-Paré, 75010 Paris, France. Electronic address: silviabasato@inwind.it.
authors.forename: S
authors.initials: S
authors.lastname: Basato
authors.affiliation: Service de Chirurgie Générale, Viscérale, Endocrinienne, Hôpital de la Pitié-Salpêtrière, Université Pierre et Marie Curie-Paris VI, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Lin Sun Fui
authors.affiliation: Service de Chirurgie Digestive et Cancérologique, Hôpital Lariboisière, AP-HP, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, 2, rue Ambroise-Paré, 75010 Paris, France.
authors.forename: K
authors.initials: K
authors.lastname: Pautrat
authors.affiliation: Service de Chirurgie Générale, Viscérale, Endocrinienne, Hôpital de la Pitié-Salpêtrière, Université Pierre et Marie Curie-Paris VI, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Tresallet
authors.affiliation: Service de Chirurgie Digestive et Cancérologique, Hôpital Lariboisière, AP-HP, Université Paris Diderot-Paris VII, Sorbonne Paris Cité, 2, rue Ambroise-Paré, 75010 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Pocard
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D003082:Colectomy / Q000379:methods* / Q000401:mortality; D012809:Colon, Sigmoid / Q000601:surgery*; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D045822:Intestinal Volvulus / Q000401:mortality / Q000601:surgery*; D010535:Laparoscopy / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012810:Sigmoid Diseases / Q000401:mortality / Q000601:surgery*; D017792:Surgical Stapling; D016896:Treatment Outcome
keywords: Laparoscopy; Morbidity; Mortality; Sigmoid volvulus