Endoscopic sigmoidopexy for recurrent sigmoid volvulus in inoperable patients: a retrospective series of 15 patients.


Journal

Endoscopy
ISSN: 1438-8812
Titre abrégé: Endoscopy
Pays: Germany
ID NLM: 0215166

Informations de publication

Date de publication:
12 2022
Historique:
pubmed: 23 4 2022
medline: 2 12 2022
entrez: 22 4 2022
Statut: ppublish

Résumé

Recurrent sigmoid volvulus is frequent and sometimes occurs in frail patients with contraindications to surgical sigmoidectomy. Percutaneous endoscopic sigmoidopexy (PES) has recently been proposed as an alternative to elective sigmoidectomy. We aimed to describe the efficacy and safety of PES. All consecutive patients who underwent PES for recurrent sigmoid volvulus at two French centers between January 2017 and March 2021 were included in this retrospective case series. Recurrent sigmoid volvulus was defined as at least two symptomatic episodes treated by endoscopic decompression. Under endoscopic guidance, anchors were placed to attach the sigmoid to the anterior abdominal wall, allowing the placement of pigtail Chait catheters. 15 patients (60 % female; median age 74 years [range 49-96]) were included. Median number of previous sigmoid volvulus episodes was 3 (range 2-6). Procedures were technically successful with no intraprocedural adverse events for 14 patients (93 %). Peritonitis occurred at Day 2 in one patient (serious adverse event rate 7 %). Median follow-up time was 10 months (range 1-30). No sigmoid volvulus recurrence occurred during follow-up. PES using Chait catheters was feasible and effective for recurrent sigmoid volvulus and should be considered as an alternative to sigmoidectomy in inoperable patients.

Sections du résumé

BACKGROUND
Recurrent sigmoid volvulus is frequent and sometimes occurs in frail patients with contraindications to surgical sigmoidectomy. Percutaneous endoscopic sigmoidopexy (PES) has recently been proposed as an alternative to elective sigmoidectomy. We aimed to describe the efficacy and safety of PES.
METHODS
All consecutive patients who underwent PES for recurrent sigmoid volvulus at two French centers between January 2017 and March 2021 were included in this retrospective case series. Recurrent sigmoid volvulus was defined as at least two symptomatic episodes treated by endoscopic decompression. Under endoscopic guidance, anchors were placed to attach the sigmoid to the anterior abdominal wall, allowing the placement of pigtail Chait catheters.
RESULTS
15 patients (60 % female; median age 74 years [range 49-96]) were included. Median number of previous sigmoid volvulus episodes was 3 (range 2-6). Procedures were technically successful with no intraprocedural adverse events for 14 patients (93 %). Peritonitis occurred at Day 2 in one patient (serious adverse event rate 7 %). Median follow-up time was 10 months (range 1-30). No sigmoid volvulus recurrence occurred during follow-up.
CONCLUSION
PES using Chait catheters was feasible and effective for recurrent sigmoid volvulus and should be considered as an alternative to sigmoidectomy in inoperable patients.

Identifiants

pubmed: 35451039
doi: 10.1055/a-1831-4177
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1205-1210

Informations de copyright

Thieme. All rights reserved.

Déclaration de conflit d'intérêts

The authors declare that they have no conflict of interest.

Auteurs

Salome Ouazana (S)

Hepatogastroenterology Department, University Hospital Centre Reims, Reims, France.
Sorbonne University, Centre for Digestive Endoscopy, Saint Antoine Hospital, APHP Paris, Paris, France.

Emmanuel Coron (E)

Department of Gastroenterology and Hepatology, University Hospital of Geneva, Geneva, Switzerland.
University of Nantes, INSERM, IMAD, The Enteric Nervous System in Gut and Brain Disorders, Nantes, France.

Marc Le Rhun (M)

Digestive Disease Institute, University Hospital Centre, Nantes, France.

Marianne Le Rhun (M)

Geriatric Department, Erdre et Loire Hospital, Ancenis, France.

Xavier Dray (X)

Sorbonne University, Centre for Digestive Endoscopy, Saint Antoine Hospital, APHP Paris, Paris, France.

Lucille Quénéhervé (L)

Gastroenterology Department, University and Regional Hospital Centre Brest, Brest, France.

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