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Patience is key: Association of surgical timing with clinical outcomes in elderly patients with sigmoid volvulus.
Arnold, Suzanne C; Rafaqat, Wardah; Abiad, May; Lagazzi, Emanuele; Hoekman, Anne H; Panossian, Vahe S; Nzenwa, Ikemsinachi C; Paranjape, Charudutt N; Velmahos, George C; Kaafarani, Haytham M A; Hwabejire, John O.
Afiliación
  • Arnold SC; Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States; Division of Trauma Surgery, Leiden University Medical Center, Leiden, the Netherlands.
  • Rafaqat W; Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
  • Abiad M; Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
  • Lagazzi E; Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
  • Hoekman AH; Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
  • Panossian VS; Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
  • Nzenwa IC; Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
  • Paranjape CN; Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
  • Velmahos GC; Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
  • Kaafarani HMA; Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
  • Hwabejire JO; Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States. Electronic address: JHWABEJIRE@PARTNERS.ORG.
Am J Surg ; 232: 81-86, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38278705
ABSTRACT

BACKGROUND:

Current guidelines for sigmoid volvulus recommend endoscopy as a first line of treatment for decompression, followed by colectomy as early as possible. Timing of the latter varies greatly. This study compared early (≤2 days) versus delayed (>2 days) sigmoid colectomy.

METHODS:

2016-2019 NRD database was queried to identify patients aged ≥65 years admitted for sigmoid volvulus who underwent sequential endoscopic decompression and sigmoid colectomy. Outcomes included mortality, complications, hospital length of stay, readmissions, and hospital costs.

RESULTS:

842 patients were included, of which 409 (48.6 â€‹%) underwent delayed sigmoid colectomy. Delayed sigmoid colectomy was associated with reduced cardiac complications (1.1 â€‹% vs 0.0 â€‹%, p â€‹= â€‹0.045), reduced ostomy rate (38.3 â€‹% vs 29.4 â€‹%, p â€‹= â€‹0.013), an increased overall length of stay (12 days vs 8 days, p â€‹< â€‹0.001) and increased overall costs (27,764 dollar vs. 24,472 dollar, p â€‹< â€‹0.001).

CONCLUSION:

In geriatric patient with sigmoid volvulus, delayed surgical resection after decompression is associated with reduced cardiac complications and reduced ostomy rate, while increasing overall hospital length of stay and costs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades del Sigmoide / Colectomía / Vólvulo Intestinal Tipo de estudio: Guideline / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Am J Surg Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades del Sigmoide / Colectomía / Vólvulo Intestinal Tipo de estudio: Guideline / Risk_factors_studies Límite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Am J Surg Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos