A COMPARATIVE STUDY BETWEEN HARTMANN'S PROCEDURE VERSUS PRIMARY RESECTION AND ANASTOMOSIS IN CASES OF ACUTE SIGMOID VOLVULUS AT MADRAS MEDICAL COLLEGE, RAJIV GANDHI GOVERNMENT GENERAL HOSPITAL, CHENNAI, TAMIL NADU

S. P. Gayathre, M. Senthil Kumar, R. Kannan, S. Karthik, Manasa Ananda, R. Jayachander

Abstract


BACKGROUND: Sigmoid volvulus contributes to 8% of abdominal surgical emergency in India.  It causes significant morbidity and mortality as it usually seen in patient with higher age mostly 5 or 6th decade. It can present as acute type or sub-acute type or chronic form. Treatment is always surgery. But which procedure is best is still debatable.

AIM: To compare Hartmann Procedure Versus Primary Resection and Anastomosis in acute sigmoid volvulus.

METHODS: This prospective study was conducted in 50 patients, admitted with acute sigmoid volvulus in Institute of General Surgery, Madras Medical College, Rajiv Gandhi Government General Hospital, Chennai, Tamilnadu. Patients were divided in to two equal groups. Group A underwent Hartmann’s procedure. Group B patients underwent resection and primary anastomosis. All patients with sigmoid volvulus were taken after excluding patients with gangrenous bowel. Outcome measured in terms of mortality, wound infection, duration of surgery and hospital stay, colostomy complications and anastomotic leak.

RESULTS: There was significant difference in terms of lesser hospital stay, wound infection in Resection anastomosis group and no significant differences in duration of surgery and mortality.

 CONCLUSION: Primary resection and anastomosis is a single stage operation suitable in all cases with uncomplicated acute sigmoid volvulus.


Keywords


Hartmann’s procedure, sigmoid volvulus, Resection anastomosis.

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