Acute sigmoid volvulus: Results of surgical treatment in the teaching hospitals of Bamako

Objective. - The aim was to evaluate the results of surgical treatment of occlusion of thesigmoid colon due to volvulus.Patients and methods. - This was a retrospective study from 1996 to 2010 of all patients under-going surgery for sigmoid volvulus in surgical wards of the University Hospital of Bamako.Results. - A total of 417 patients were identified including 379 men and 38 women. The meanpatient age was 45.7 ± 18.3 years. The general condition of the patients was good in 70.5%and altered in 29.5% of cases. Colonic necrosis was present in 80 patients (19.2%). Single-stageresection with immediate anastomosis was performed in 149 patients (35.73%). Two-stage sur-gery was performed in 268 cases (64.27%). The initial stage of the two-stage procedure wascolostomy in 167 cases and simple detorsion in 101 cases. The surgical approach had an impacton mortality in patients who were in poor general condition. Single-stage surgery resulted inhigher mortality (12/149; 8.05%) than two-stage surgery (5/268; 1.87%), and the difference wasstatistically significant (P = 0.0005).Conclusion. - Single-stage surgery for sigmoid volvulus carries a high risk of death when itis performed in patients with poor general condition. Indications for surgery must take intoaccount the patient's general condition and the viability of the torsed sigmoid colon.