title: What are the results of colonic volvulus surgery?
abstract: BACKGROUND
  Operative results of volvulus are largely unknown because of infrequent diagnosis.
  
  
  OBJECTIVE
  We examined the results of operative intervention for colonic volvulus.
  
  
  METHODS
  We merged trackable data from the California Inpatient Database with Supplemental Files for Revisit Analyses between January 1, 2005, and December 31, 2007.
  
  
  METHODS
  Trackable data from California discharge records.
  
  
  METHODS
  We identified all of the patients with colonic volvulus who underwent 1 of 4 surgical procedures, including manipulation/fixation of the colon, right colectomy, left colectomy, or total colectomy.
  
  
  METHODS
  During the 36-month study period, we identified recurrence risk, recurrence requiring reoperation, time to reoperation, stoma formation, disposition on discharge, and in-hospital mortality. Fisher exact, χ(2), and ANOVA tests were used when appropriate.
  
  
  RESULTS
  We identified 2141 patients with colonic volvulus who were undergoing intraoperative manipulation/fixation of the colon (n = 209 (12%)), right (n = 728 (41%)), left (n = 781 (44%)), or total colectomy (n = 56 (3%)). Patients treated with intraoperative manipulation/fixation were younger, more likely to be women, and more likely to have private insurance. Patients who underwent total colectomy had the highest risk of mortality (21%), highest risk of stoma creation (64%), and longest length of stay (18 days); were more likely to be readmitted (9%); and were the most likely to be discharged to a skilled nursing facility (48%). Patients treated with intraoperative manipulation/fixation had the lowest mortality, risk of stoma formation, length of stay, and likelihood of discharge to skilled nursing facility but the highest risk of subsequent procedures for volvulus (26%) over a follow-up ranging from 0 to 687 days.
  
  
  CONCLUSIONS
  This study was limited by retrospective study design, heterogeneous patient factors, and inability to identify the time of last follow-up.
  
  
  CONCLUSIONS
  The majority of patients with volvulus underwent a resectional procedure. A subset without resection had favorable initial outcomes but remained at high risk for subsequent procedures. There may be a potential role for evaluating intraoperative manipulation/fixation in a small subset of patients with colonic volvulus.
authors: Department of Colorectal Surgery, Lahey Hospital and Medical Center, Burlington, Massachusetts.
authors: Kevin R
authors: KR
authors: Kasten
authors: Peter W
authors: PW
authors: Marcello
authors: Patricia L
authors: PL
authors: Roberts
authors: Thomas E
authors: TE
authors: Read
authors: David J
authors: DJ
authors: Schoetz
authors: Jason F
authors: JF
authors: Hall
authors: Todd D
authors: TD
authors: Francone
authors: Rocco
authors: R
authors: Ricciardi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D003082:Colectomy; D003108:Colonic Diseases / Q000601:surgery*; D003125:Colostomy; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D045822:Intestinal Volvulus / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome