Patients
acute sigmoid volvulus
EMERGENCY, BOWEL ISCHEMIA
This prospective randomized controlled clinical trial included all patients who developed acute sigmoid volvulus and were referred to the Zagazig University Hospital Emergency Department between December 2020 and August 2022. The study was prospectively approved by Zagazig University Faculty of Medicine Institutional Review Board (Approval Number: 9989/23-10-2022) and was retrospectively submitted in clinicaltrials.gov in November 2022 (ClinicalTrials.gov ID: NCT05620446). The study was conducted under the code of ethics of the World Medical Association (Declaration of Helsinki) for studies involving human subjects. Written informed consent was obtained from all participants. This study has been reported in line with Consolidated Standards of Reporting Trials (CONSORT) guidelines.We included patients aged ≥65 years-old, patients with no prior management by rectal deflating tube, patients with no evidence of bowel ischemia, patients with body mass index <35 Kg/mIncluded eligible patients were simply randomized at a 1:1 ratio to “Endoscopic Group (EG)” or “Surgical Group (SG)” via drawing of sealed envelopes containing computer-generated random numbers prepared by a third party before the start of the intervention.The sample size was calculated by using an open Epi program depending on the following data; confidence interval 95%, power of the test 80%, ratio of unexposed/ exposed 1, the success rate of surgical sigmoid fixation versus endoscopic fixation was 90% versus 15% respectively [