Operative Management and Outcomes of Patients with Sigmoid Volvulus at a Tertiary Public Hospital in Malawi
| Autor: | Loveness Ulunji Chawinga, Fatsani Mwale, Ephraim Bitilinyu-Bangoh, Gift Mulima |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
sigmoid volvulus RD1-811 business.industry Primary anastomosis Sigmoid colon medicine.disease resection and primary anastomosis Surgery Resection Bowel obstruction mesosigmoidopexy medicine.anatomical_structure hartmann's procedure Anastomotic leakage Public hospital medicine Sigmoid volvulus business Hospital stay |
| Zdroj: | The Annals of African Surgery, Vol 18, Iss 3, Pp 176-179 (2021) |
| ISSN: | 2523-0816 1999-9674 |
| Popis: | Background: Sigmoid Volvulus (SV) is a common cause of acute bowel obstruction in Malawi. We aimed to describe the surgical management of SV and its outcomes at Kamuzu Central Hospital, Lilongwe, Malawi. Methods: We retrospectively reviewed records from January 2019 to December 2019 of all SV patients, aged 18 years and above. Data extracted included age, sex, admission date, surgery date, bowel viability at time of surgery, procedure done, suspected anastomotic leakage, length of hospital stay and mortality. The data was analyzed using STATA 14.0. Results: There were more males (n= 59, 81.9 %) than females. The median (IQR) age was 50.5 (38-60) years. A viable sigmoid colon was present in 61 (84.7%) patients. The commonest procedures done were sigmoid resection and primary anastomosis (RPA) (59.7%, n=43) and Hartmann’s procedure (HP) (36.1%, n=26). The median length of hospital stay was 5 days in HP, 7 days in RPA and longest in mesosigmoidopexy (10 days). Suspected anastomotic leakage occurred in 2(4.7%) patients. The overall mortality was 6.9% with all deaths occurring in RPA patients. Conclusion: Mortality is high in SV patients who undergo RPA. We recommend Hartmann’s procedure in cases where the bowel has significant oedema or is gangrenous. |
| Databáze: | OpenAIRE |
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