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Objectives: Following endoscopic detorsion, sigmoid volvulus (SV) recurs in 3%-86% of patients, approximately 13% of which are early recurrence presenting during the first admission period. Although semielective surgery is the traditional approach, elective surgery following repetitive endoscopy or percutaneous endoscopic sigmoidopexy (PES) are other alternatives in the management of early SV recurrence. Our aim was to discuss the role of semielective surgery in above-mentioned rare clinical entity. Methods: Among our 1,076-case series, we retrospectively evaluated the records of 612 patients (56.9%) treated between June 1966 and June 1986, while we prospectively utilized the data of 464 patients (43.1%) managed between June 1986 and January 2024. We recorded the treatment option and prognosis for each patient. Results: Early SV recurrence was determined in 34 (5.5%) of the 621 patients with successful nonoperative detorsion. We treated all of these patients by semielective surgery. The surgical procedures were detorsion in one patient (2.9%), mesopexy in 11 (32.4%), sigmoidectomy with primary anastomosis in 17 (50.0%), and sigmoidectomy with stoma in five (14.7%). In this series, mortality and morbidity rates were 2.9% (one patient) and 14.7% (five patients), respectively. Conclusion: Semielective surgery is the traditional approach tried by most surgeons, which allows for the recovery of the general status of the patients, bowel preparation, and antibiotic prophylaxis. However, repetitive endoscopy followed by elective surgery or PES are current alternatives for some selected patients. Unfortunately, the relatively low effectuation rate of elective surgery following successful repetitive endoscopic detorsion and recurrence-related poor prognosis are still important handicaps of the latter procedure. [ABSTRACT FROM AUTHOR]

Objectives: Sigmoid volvulus (SV) recurs in about one quarter of the patients, whereas multiplex (≥3) attacks are quite rare and attacks with five or more times are extremely rare. The aim of this study was to evaluate multiplex SV attacks in our series and worldwide data. Methods: In Ataturk University Faculty of Medicine Department of General Surgery, among 1,071-case SV series, data were evaluated retrospectively in 612 patients, while prospectively in 459 with respect to age, gender, previous volvulus attacks, and prognosis. Worldwide data were obtained from Web of Science database and they were compared with our results. Results: Mean SV attack count, multiple- (≥2) and multiplex- (≥3) attack rates were 1.4, 26.1%, and 4.2%, respectively, in our series, while they were 1.7, 26.7%, and 3.2%, respectively, in worldwide data (p>0.05, in all). In our series, recurrence rates were 26.1%, 19.3%, and 51.2%, respectively, (p<0.001, in all), while mortality rates were 7.3%, 13.7%, and 19.5%, respectively, (p<0.001, in all) in single-, double-, and multiplex- (≥3) attack patients. Conclusion: Although multiplex (≥3) attacks are uncommon in SV, when it goes up, elective surgery must be considered in selected cases to avoid repetitive attacks and related high mortality. [ABSTRACT FROM AUTHOR]

Objectives: Spontaneous decompression is an uncommon outcome of sigmoid volvulus (SV). The aim of this study was to evaluate the clinical presentation, diagnosis, treatment, and follow-up of spontaneously decompressed SV. Methods: We utilized the data of our 1,063 SV patients, the most comprehensive monocenter SV series in the world. To obtain the worldwide data on the spontaneous decompression of SV, we researched the last 56-years' literature in Web of Science and PubMed databases. Results: The incidence of the spontaneous decompression was 0.1% (1/1,063) in our SV series, whereas it was 1.5% (8/549) in the worldwide data (Fisher exact test, p = 0.001). By this way, cumulative spontaneous decompression rate was found as 0.6% (9/1,602). In the spontaneously decompressed cases, the main clinical features were abdominal pain/tenderness, distention, and obstipation, which were similar to management-required patients. However, the treatment and follow-up algorithm is still a relatively undefined subject. Conclusion: Spontaneous decompression of SV is a very rare clinical entity. The clinical presentation and diagnosis of the spontaneously decompressed SV look alike the management-required SV. However, as seen in most managementrequired patients, SV tends to recur in the spontaneously decompressed cases and a recurrence-reducing procedure is required in selected patients. [ABSTRACT FROM AUTHOR]

The article evaluates the clinical profiles, surgical experience, and outcomes of 40 patients with ileosigmoid knotting (ISK) at Jimma University Medical Center. ISK is a rare condition with a complex clinical presentation, leading to a relatively long symptom period and high shock rate. Diagnosis is challenging, with CT and MRI being highly diagnostic. Emergency surgical treatment is necessary due to the high bowel gangrene rate and poor prognosis associated with ISK, particularly in certain populations. The authors provide valuable insights based on their extensive experience with ISK cases. [Extracted from the article]

Objectives: Diabetes mellitus (DM) complicates about 15.7% of sigmoid volvulus (SV) cases. However, the pathophysiology of this relation is still unclear. Our objective was to evaluate the association of DM and SV. Methods: The clinical data of 1,051 patients treated in Ataturk University Faculty of Medicine during 56 years between June 1966 and July 2022 were considered. The records of 612 cases (58.2%) were evaluated retrospectively till June 1986, while 439 (41.8%) were investigated prospectively thereafter. To obtain the worldwide data, an electronic search of the last 56-years' literature (from 1967 to date) was performed in Web of Science and PubMed databases. Results: DM was statistically higher in SV patients than of general population (15.7% vs. 8.3%, p<0.001). Conversely, SV and DM co-occurrence was statistically lower in our series than of world-wide data (2.9% vs. 15.7%, p<0.001). In our series, SV and DM comorbidity was statistically higher in elders that that of children (3.9% vs. 0.0%, p<0.05). Although sigmoid gangrene was more common in DM patients when compared with that of total, the difference was not statistically significant (42.9% vs. 27.4%, p>0.05). Conversely, the mortality rate was statistically higher in DM cases than that of no diabetics in SV (28.6% vs. 7.8%, p<0.001). Conclusion: Although the pathophysiology of SV and DM comorbidity is still relatively unexplainable, our study suggests that DM worsens the prognosis of SV. For this reason, early diagnosis and proper treatment have great importance in such patients. [ABSTRACT FROM AUTHOR]

Objectives: Recurrence is a relatively common outcome following endoscopic decompression in sigmoid volvulus (SV). This study aims to evaluate the factors affecting recurrence in SV. Methods: In 434 patients with SV treated between June 1986 and January 2022, probable recurrence-affecting factors including age, age of SV onset, gender, dietary habit, defecation habit, altitude of living area, and SV attack count were analyzed in prospectively collected data. Results: Of 434 patients, 111 (25.6%) had recurrent SV with mean 1.6 ± 2.3 of volvulus episodes (range: 1-21 attacks). SV recurrence demonstrated a significant linear increase with age (14.3%, 17.1%, 21.5%, and 29.9%, respectively, in young, middle aged, mature, and elderly patients, p < 0.001). Recurrent SV was also significantly higher in male gender (28.5% vs 12.7%, p = 0.004), high-fiber diet habit (32.9% vs 17.7%, p < 0.001), and living at high altitude (26.9% vs 12.5%, p = 0.047). Although SV recurrence was higher in patients with chronic constipation, the difference was not significant (36.7% vs. 20.3%, p = 0.594). When compared with that of the patients with mature onset or elderly onset patients, SV attack count was significantly higher in young-onset cases (1.3±0.9 and 1.1±0.3 vs 4.6±6.9, p < 0.001). Conclusion: Elderliness, early-onset, maleness, high-fiber diet habit, high altitude, and most likely chronic constipation may be the practical clinical parameters of recurrent SV. These parameters, as well as the presence of previous SV episode history, must be considered in the decision-making process in the elective treatment of SV. [ABSTRACT FROM AUTHOR]

This document is a letter to the editor regarding a research article titled "Preoperative predictor laboratory markers for complicated appendicitis: A retrospective analysis of single-center experience." The authors of the letter express their interest in the article and highlight a few aspects that they believe should be considered in future research. They suggest that the study's inclusion and exclusion criteria should be clearly articulated, elderly patients should be considered as a distinct subgroup, the criteria used to classify patients into complicated and uncomplicated groups should be explicitly outlined, and additional laboratory parameters should be evaluated. The authors also recommend categorizing postoperative complications according to the Clavien-Dindo classification. The letter concludes by congratulating the authors on their informative article and expressing anticipation for their response to the comments. [Extracted from the article]

Objectives: Ileosigmoid knotting (ISK) is a rare intestinal obstruction form worldwide. The aim of this study was to investigate changing trends in ISK. Methods: The Web of Science and PubMed databases were electronically searched to find all publications to evaluate all epidemiological, etiological, clinical, laboratory, radiological, therapeutic, and prognostic factors in ISK. Results: Most of the cases were reported from Asian and African countries. Mean age was 43.9 years with a 79.9%/20.1% of male/female ratio. Main symptom period was 48.1 hours, while the most common clinical features were abdominal pain/tenderness (99.1%), distention (88.3%), and obstipation/constipation (58.8%). Abdominal X-ray radiography, computerized tomography (CT), and magnetic resonance imaging (MRI) were diagnostic in 8.2%, 96.2%, and 100.0%, respectively, while the total diagnostic accuracy rate was 20.8%. Bowels were gangrenous in 85.6% of the patients. Ileum resection was applied in 14.0% of the cases, while sigmoid colon resection in 7.6%, and both segment resection in 67.1%. The mortality rate was 22.7%, while the morbidity rate was also 22.7%. Conclusion: ISK is a rare disease, but it is still catastrophic despite its two-century recognised past. As an exception, diagnostic convenience arising from CT or MRI looks like the most important change over the last half-century. [ABSTRACT FROM AUTHOR]

I Dear Editor, i We read the correspondence by Gosavi et al. [[1]] and watched the video vignette on laparoscopic peritoneal flap sigmoidopexy (LPFS) following endoscopic decompression in a patient with sigmoid volvulus (SV). Second, the indications for the recurrence-reducing techniques involving LPFS, used by the authors in a patient with American Society of Anesthesiologists (ASA) physical status grade 4, are not clearly identified in the literature [[2]]. Our comments relate to recurrence-preventing techniques, based on our 56.5-year (June 1966 to January 2023) and 1063-case experience with SV, the most comprehensive single-centre SV series in the world [[4]]. [Extracted from the article]

Sigmoid Volvulus (SV) is principally treated with non-operative decompression, whereas it may require surgical management in some situations. Depending upon the treatment method, SV recurs in about one fourth of the cases, which doubles the mortality and morbidity rates. In this paper, we discuss the management and related recurrence of SV in the light of the largest single-center SV series over the world. Introduction Sigmoid Volvulus (SV) is a rare disease, in which the sigmoid colon twists around its own mesentery. Non-operative decompression is tried in uncomplicated or non-gangrenous cases, while patients with above-mentioned adverse situations or those with unsuccessful endoscopic decompression are treated with emergency surgery. Volvulus Recurrence (VR) is an expected result in some SV cases and it worsens the prognosis. We discuss herein our experiment on the treatment of SV as well as the prevention of the VR by evaluating the largest single-center SV series over the world, a 1,040-patient experience with SV over a 55-year period between June 1966 and July 2021. [ABSTRACT FROM AUTHOR]

We report the case of a 74-year-old male with abdominal pain, distention and obstipation for 8 hours. He had a medical history of 24 sigmoid volvulus (SV) episodes, 23 of which treated with endoscopic detorsion, while one resolved spontaneously. Physical examination revealed abdominal distention, tenderness, hyperkinetic bowel sound and an empty rectum. Abdominal X-ray radiograph revealed dilated sigmoid loops with coffee bean sign. Computed tomography demonstrated dilated sigmoid loops with air-fluid levels and mesenteric whirl sign. Flexible colonoscopy showed a spiral-like luminal obstruction of the viable sigmoid colon at 18 cm from anal verge. A successful colonoscopic detorsion was performed. Due to the poor general health status of the patient (American Society of Anesthesiologists-ASA score 4) arising from serious comorbidities including coarctation of aorta and coronary disease, percutaneous endoscopic colostomy was suggested instead of elective sigmoid colectomy. He did not approve adjunctive therapy and was discharged following 24-hour observation.