Our Summary

This study discusses a new surgical technique for treating a condition called sigmoid volvulus, which is a type of intestinal blockage. The method involves removing the blocked part of the intestine through a natural opening in the body, such as the rectum, instead of making a large incision in the abdomen. This approach is less invasive but can be more challenging and risky, especially for cancer-related surgeries.

In the study, the researchers used a method called double-stapled anastomosis transrectal natural orifice specimen extraction. This involves cutting the rectum and using special instruments to pull the blocked part of the intestine out through the rectum.

The team performed this procedure on six patients between 2015 and 2020. The average surgery time was around three hours, and the average hospital stay was four days. One patient needed to be readmitted due to a complication with another part of their intestine. One patient had a recurrence of the blockage over two years after the surgery.

The researchers concluded that this method is an effective treatment for uncomplicated sigmoid volvulus. While surgeons performing this procedure should be skilled in laparoscopy (a less invasive type of surgery), they don’t necessarily need experience with natural orifice specimen extraction to perform the surgery successfully.

FAQs

  1. What is the new surgical technique for treating sigmoid volvulus discussed in the study?
  2. What is the average surgery time and hospital stay for patients who underwent the double-stapled anastomosis transrectal natural orifice specimen extraction procedure?
  3. Do surgeons need experience with natural orifice specimen extraction to perform the surgery successfully?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sigmoidectomy is to follow post-operative care instructions carefully, including taking prescribed medications, attending follow-up appointments, and gradually reintroducing solid foods into their diet. It is also important to listen to their body and report any unusual symptoms or complications to their healthcare provider promptly. Additionally, engaging in gentle physical activity, such as walking, can help promote healing and prevent complications like blood clots.

Suitable For

Patients who are typically recommended sigmoidectomy include those with sigmoid volvulus, a condition where the sigmoid colon twists on itself, causing a blockage. This condition can lead to symptoms such as severe abdominal pain, constipation, bloating, and nausea. Sigmoidectomy may be recommended for patients with recurrent episodes of sigmoid volvulus or those who do not respond to other treatments such as decompression or endoscopic detorsion.

Additionally, patients with other conditions affecting the sigmoid colon, such as colorectal cancer or diverticulitis, may also be recommended sigmoidectomy. In the case of colorectal cancer, sigmoidectomy may be part of the treatment plan to remove the cancerous part of the colon. For patients with diverticulitis, sigmoidectomy may be recommended if they have recurrent episodes of inflammation or complications such as perforation or abscess formation.

Patients who are generally healthy and able to tolerate surgery may be good candidates for sigmoidectomy. However, the decision to proceed with sigmoidectomy should be made on a case-by-case basis, taking into consideration the patient’s overall health, the severity of their condition, and the risks and benefits of surgery. It is important for patients to discuss their options with their healthcare provider to determine the most appropriate treatment plan for their specific situation.

Timeline

Before the sigmoidectomy:

  1. Patient presents with symptoms of sigmoid volvulus such as severe abdominal pain, bloating, constipation, and vomiting.
  2. Patient undergoes diagnostic tests such as imaging studies and colonoscopy to confirm the diagnosis.
  3. Patient is evaluated by a surgical team to determine the best treatment option, which may include sigmoidectomy.
  4. Patient undergoes pre-operative preparation including bowel cleansing and fasting.

After the sigmoidectomy:

  1. Patient undergoes the sigmoidectomy procedure using the double-stapled anastomosis transrectal natural orifice specimen extraction method.
  2. Patient recovers in the hospital for an average of four days post-surgery.
  3. Patient may experience post-operative complications such as infection, bleeding, or recurrence of the blockage.
  4. Patient is monitored closely for any signs of complications and may need to be readmitted for further treatment if necessary.
  5. Patient undergoes follow-up appointments with their surgical team to monitor their recovery and ensure the success of the surgery.

What to Ask Your Doctor

  1. What is sigmoid volvulus and why do I need a sigmoidectomy?
  2. What are the risks and benefits of the double-stapled anastomosis transrectal natural orifice specimen extraction method compared to traditional surgery?
  3. How experienced are you in performing this new surgical technique?
  4. What is the expected recovery time and potential complications of the surgery?
  5. Will I need any additional treatments or follow-up care after the surgery?
  6. Are there any alternative treatment options for my condition?
  7. How likely is it that the blockage will recur after the surgery?
  8. Can you provide me with information on your success rates with this procedure?
  9. Will I need to make any lifestyle changes after the surgery to prevent future blockages?
  10. Are there any long-term effects or risks associated with this surgery that I should be aware of?

Reference

Authors: Seow-En I, Chang SC, Ke TW, Shen MY, Chen HC, William Tzu-Liang Chen. Journal: Dis Colon Rectum. 2021 May;64(5):e90-e93. doi: 10.1097/DCR.0000000000001922. PMID: 33496476