Results
volvulus, chronic liver cirrhosis, intestinal injury, peritonitis
OBESE, ISCHEMIC HEART DISEASE, CHRONIC RENAL FAILURE, SIGMOID VOLVULUS, RECURRENCE, CHEST INFECTION, WOUND INFECTION, DIABETES MELLITUS, SKIN NECROSIS, VOLVULUS, PELVIC ABSCESS, PERITONITIS, HYPERTENSION, COMPLICATIONS
Of 25 patients who presented with manifestations of acute sigmoid volvulus, eligible 18 patients were randomized into 2 groups: 9 patients in endoscopic group, and 9 patients in surgical group. Seven patients were excluded (in 5 patients: volvulus was resolved by deflating rectal tube and the remaining 2 patients refused to participate in the study) as shown in Fig. CONSORT flow diagramIn this study, male patients constituted 33.3% (6/18). Six (33.3%) patients had past history of abdominal operations while 10 (44.4%) patients had recurrent volvulus. Regarding general condition, there were 12 patients with American Society of Anesthesiologists III class (66.70%) and 6 patients with American Society of Anesthesiologists IV class (33.30%) as shown in Table Comparison between qualitative and quantitative variables of both groupsAll patients in surgical group needed general anesthesia. Patients in both groups had comorbidities; there were 5 (27.80%) patients with diabetes mellitus, 5 (27.80%) patients with hypertension, 5 (27.80%) obese patients, one (5.60%) patient with ischemic heart disease, one (5.60%) patient with compensated chronic liver cirrhosis, and one (5.60%) patient with chronic renal failure. In both groups, there was no recurrence of volvulus. The reported complications were chest infection, skin necrosis, peritonitis, pelvic abscess, small intestinal injury, wound infection, and mortality with incidence of occurrence as follows: (5/18; 27.80%), (3/18; 16.66%), (3/18; 16.66%), (3/18; 16.66%), (1/18; 5.60%), (3/18; 16.66%), and (1/18; 5.60%) patient, respectively. During the 9-month follow-up period, endoscopic group demonstrated no cases of recurrence post-fixation as shown in Table In comparison between both groups regarding age, body mass index, length of hospital stay, procedure time, and observational time post procedure, there was a statistically significance difference regarding hospital stay and procedure time as shown in Table Eight patients in the endoscopy group had an excellent quality of life, and one had good quality of life; unlike the surgical group, there were 3 patients with excellent quality of life, 5 patients with good quality of life, and 1 patient with poor quality of life, so there was statistically significant difference regarding quality of life among both groups as shown in Tables Quality of life