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Endoscopic Management of Sigmoid Volvulus in a Debilitated Population: What Relevance?

dc.contributor.authorCoelho da Rocha, M
dc.contributor.authorCapela, T
dc.contributor.authorSilva, MJ
dc.contributor.authorRamos, G
dc.contributor.authorCoimbra, J
dc.date.accessioned2020-10-20T14:33:46Z
dc.date.available2020-10-20T14:33:46Z
dc.date.issued2020-04
dc.description.abstractBackground: Colonic volvulus, mainly from the sigmoid, is a relatively common cause of intestinal obstruction, particularly in the elderly and in patients with debilitating conditions. The high morbi-mortality of emergency surgery places the endoscopic approach as the first-line treatment for the resolution of this acute obstructive condition. Objectives: To assess the importance of endoscopic treatment for the resolution of colonic volvulus in a debilitated population. Method: This is a retrospective analysis of emergency lower gastrointestinal endoscopies in patients with colonic volvulus as diagnosis, performed over a 9-year period (2009-2018), as well as population characterization and follow-up after the first exam. Results: We performed 88 procedures in 52 patients (56.4% males, median age 83 years, range 33-94). Endoscopic resolution was effective in 86.4% (76/88) of the exams, without procedure complications. Eighty-one percent of patients presented with volvulus recurrence, 50% of which occurred during the 3 months after the initial procedure. Twenty-one were submitted to surgery, 12 of which were emergency procedures after endoscopic failure as the primary treatment (5 of which had mucosal necrosis at endoscopy). There was no mortality in elective surgery. In the emergency plus necrosis group, mortality was 60% (3/5) and 14.3% (1/7) in the emergency without necrosis group. Conclusions: Despite the high recurrence of volvulus after endoscopic treatment, it seems to be an adequate and low-risk first-line therapy for sigmoid volvulus in debilitated patients, allowing improvement of surgical conditions.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationGE Port J Gastroenterol . 2020 Apr;27(3):160-165.pt_PT
dc.identifier.doi10.1159/000504721pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3508
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSociedade Portuguesa de Gastrenterologiapt_PT
dc.subjectCHLC GASpt_PT
dc.subjectVolvuluspt_PT
dc.subjectSigmoidpt_PT
dc.subjectElderlypt_PT
dc.subjectEndoscopypt_PT
dc.subjectSurgerypt_PT
dc.titleEndoscopic Management of Sigmoid Volvulus in a Debilitated Population: What Relevance?pt_PT
dc.title.alternativeTerapêutica Endoscópica do Volvo Sigmoideu numa População Debilitada. Qual a Relevância?pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage165pt_PT
oaire.citation.issue3pt_PT
oaire.citation.startPage160pt_PT
oaire.citation.titleGE Portuguese Journal of Gastroenterologypt_PT
oaire.citation.volume27pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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