scholarly journals Operative Management and Outcomes of Patients with Sigmoid Volvulus at a Tertiary Public Hospital in Malawi

2021 ◽  
Vol 18 (3) ◽  
pp. 176-179
Author(s):  
Ephraim Bitilinyu-Bangoh ◽  
Fatsani Mwale ◽  
Loveness Ulunji Chawinga ◽  
Gift Mulima
Keyword(s):  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Primary Anastomosis ◽  
Length Of Hospital Stay ◽  
Operative Management ◽  
Sigmoid Resection ◽  
Sigmoid Volvulus ◽  
Hartmann’S Procedure ◽  
Hartmann's Procedure ◽  
Kamuzu Central Hospital

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.

The Effect of Omentoplasty on the Rate of Anastomotic Leakage after Intestinal Resection: A Randomized Controlled Trial

2017 ◽  
Vol 83 (2) ◽  
pp. 157-160 ◽  
Author(s):  
Shirzad Nasiri ◽  
Babak Mirminachi ◽  
Reyhaneh Taherimehr ◽  
Roya Shadbakhsh ◽  
Mohsen Hojat
Keyword(s):  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Controlled Trial ◽  
Randomized Study ◽  
Intestinal Resection ◽  
Length Of Hospital Stay ◽  
Fistula Formation ◽  
Intestinal Surgery ◽  
Increased Risk ◽  
Significant Difference

Anastomotic leakage is a major postoperative complication after intestinal surgery leading to increased risk of morbidity and mortality. Omentoplasty has been evaluated to prevent anastomotic leakage in several studies. However, there is no consensus regarding whether or not omentoplasty should be used to decrease the rate of anastomotic leakage after intestinal resection. A prospective, randomized study was conducted to evaluate the influence of omentoplasty on anastomotic leakage after intestinal resection. A total of 124 patients who underwent intestinal resection were enrolled in this prospective study. Patients were randomly assigned to receive either the omentoplasty or nonomentoplasty. In the omentoplasty group, the omentum was wrapped around the anastomotic region. Age, gender, site and type of anastomosis, duration of hospital stay, and performance of omentoplasty were recorded. This study was registered in Iranian Registry of clinical trial (number: IRCT201412316925N3). The rate of anastomotic leakage was significantly lower in the omentoplasty group (P = 0.04). Patients in the omentoplasty group developed a significantly lower rate of postoperative infection and peritonitis (P < 0.05). There was no significant difference of abscess and fistula formation between the two groups (P > 0.05). The length of hospital stay was longer in the nonomentoplasty group, compared with that for omentoplasty patients (P < 0.05). No death occurred in the omentoplasty subjects, while six nonomentoplasty patients died (P < 0.05). Our data demonstrated that omentoplasty is useful to lower the rate of postoperative complications in patients underwent intestinal surgery.

scholarly journals Emergency Left Colon Resection for Acute Perforation. Primary Anastomosis or Hartmann’s Procedure? A Case-matched Control Study

2007 ◽  
Vol 31 (11) ◽  
pp. 2117-2124 ◽  
Author(s):  
Stefan Breitenstein ◽  
Armin Kraus ◽  
Dieter Hahnloser ◽  
Marco Decurtins ◽  
Pierre-Alain Clavien ◽  
...  
Keyword(s):  
Matched Control ◽  
Primary Anastomosis ◽  
Colon Resection ◽  
Left Colon ◽  
Hartmann’S Procedure ◽  
Hartmann's Procedure ◽  
Acute Perforation ◽  
Control Study

Primary anastomosis with transverse colostomy as an alternative to Hartmann's procedure

1995 ◽  
Vol 82 (2) ◽  
pp. 170-171 ◽  
Author(s):  
G. J. Maddern ◽  
Y. Nejjari ◽  
A. Dennison ◽  
F. Siriser ◽  
E. Bardoxaglou ◽  
...  
Keyword(s):  
Primary Anastomosis ◽  
Transverse Colostomy ◽  
Hartmann’S Procedure ◽  
Hartmann's Procedure

scholarly journals Risk Factors of Anastomotic Leakage After Esophagectomy With Intrathoracic Anastomosis

2021 ◽  
Vol 8 ◽  
Author(s):  
Huan Li ◽  
Shimin Zhuang ◽  
Honghong Yan ◽  
Wenxiao Wei ◽  
Quanguan Su
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Old Age ◽  
Multivariate Logistic Regression Analysis ◽  
Rank Correlation ◽  
Length Of Hospital Stay ◽  
Cancer Center ◽  
Intrathoracic Anastomosis

Purpose: Anastomotic leakage is one of the most common complications of esophagectomy, it serves as one of the main causes of postoperative death of esophageal cancer. It is of clinical significance to try to discover the risk factors that cause anastomotic leakage.Methods: This retrospective study was conducted on 1,257 consecutive esophageal cancer patients who underwent esophagectomy with intrathoracic anastomosis from January 2010 to December 2015 at a high volume cancer center. Multivariate Logistic Regression analysis, Spearman rank correlation analysis, Mann-Whitney U test and Kruskal-Wallis test were performed to identify the risk factors to the occurrence of anastomotic leakage and the length of hospital stay.Results: Intrathoracic anastomotic leakage occurred in 98 patients (7.8%). Older patients were more likely to develop anastomotic leakage. Patients with diabetes had a higher leakage rate. Intrathoracic anastomotic leakage, old age as well as comorbidities were associated with longer hospital stay.Conclusion: Our study suggested that old age and diabetes were risk factors to intrathoracic anastomotic leakage. In-hospital stay would be lengthened by intrathoracic anastomotic leakage, old age and comorbidities.

Sign in / Sign up

Export Citation Format

Share Document