Our Summary

This research paper looks at two different ways to restore bowel function after an emergency surgery to remove the sigmoid colon (a part of the large intestine), a condition known as sigmoid volvulus (SV). The two methods are: primary anastomosis, where the two ends of the colon are sewn back together; and stoma, where an opening is made in the abdomen to allow waste to leave the body.

The researchers studied over 1,000 patients who had this surgery at a hospital in Turkey over a 58-year period. They found that both methods were used almost equally, but patients who had primary anastomosis were generally younger and healthier before surgery.

They found that patients who had primary anastomosis had a shorter operation time, lower rates of complications and death, and spent less time in the hospital, which also made it cheaper. However, the rate of needing another surgery was similar for both methods.

In conclusion, the researchers found that primary anastomosis has some advantages over stoma, but the stoma method is usually preferred for older or less healthy patients. More studies are needed to determine the best choice for different patients.

FAQs

  1. What are the two methods to restore bowel function after the removal of the sigmoid colon?
  2. What were the key findings in the comparison between primary anastomosis and stoma methods in this research?
  3. Why is the stoma method usually preferred for older or less healthy patients?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sigmoidectomy is to discuss with their healthcare provider the best option for restoring bowel function after surgery, whether it be primary anastomosis or stoma. Factors such as age, overall health, and individual circumstances should be taken into consideration when making this decision. It is important to follow post-operative care instructions carefully and attend follow-up appointments to ensure a successful recovery.

Suitable For

Typically, patients who are younger and healthier before surgery are recommended sigmoidectomy with primary anastomosis. Older or less healthy patients may be recommended sigmoidectomy with stoma instead. It is important for healthcare providers to consider the individual patient’s overall health and risk factors when determining the best treatment option for sigmoid volvulus. Further research is needed to determine the optimal approach for different patient populations.

Timeline

Before sigmoidectomy:

  • Patient experiences symptoms of sigmoid volvulus, such as abdominal pain, bloating, constipation, and vomiting.
  • Patient undergoes diagnostic tests, such as imaging studies and blood tests, to confirm the diagnosis.
  • Surgery is recommended as the treatment for sigmoid volvulus.
  • Patient is prepared for surgery, which may include bowel preparation and fasting.

After sigmoidectomy:

  • Patient undergoes sigmoidectomy surgery to remove the affected part of the colon.
  • If primary anastomosis is performed, the two ends of the colon are sewn back together. If stoma is performed, an opening is made in the abdomen to allow waste to leave the body.
  • Patient is monitored in the hospital for complications, such as infection or bowel obstruction.
  • Patient starts a recovery process, which may include pain management, wound care, and physical therapy.
  • Patient may need additional surgeries or procedures in the future to address complications or to reverse the stoma.
  • Patient follows up with healthcare providers for long-term care and monitoring of bowel function.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a sigmoidectomy surgery?
  2. How long is the recovery process after a sigmoidectomy surgery?
  3. Will I need a stoma (opening in the abdomen) after the surgery, and if so, is it permanent?
  4. What factors will determine whether I am a candidate for primary anastomosis or stoma after the surgery?
  5. How will my bowel function be affected after the surgery, and what lifestyle changes may be necessary?
  6. What type of follow-up care will be needed after the surgery?
  7. Are there any dietary restrictions or recommendations I should follow post-surgery?
  8. What is the long-term outlook for bowel function and overall health after a sigmoidectomy surgery?
  9. Are there any alternative treatment options available for sigmoid volvulus?
  10. How experienced is the surgical team in performing sigmoidectomy procedures, and what is their success rate?

Reference

Authors: Agirman E, Disci E, Peksoz R, Atamanalp SS. Journal: Pak J Med Sci. 2024 Dec;40(11):2513-2517. doi: 10.12669/pjms.40.11.10543. PMID: 39634902