Mesosigmoplasty in Treatment of Sigmoid Volvulus

Takeshi Asakura, Satoshi Tukikawa, Hiroaki Itou, Kazuhiro Miura, Masasumi Miyazaki, Akiyoshi Noda, Shinnjirou Kobayashi, Satoshi Koizumi, Hiroshi Nakano and Takehito Ohtsubo

Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine

Sigmoid volvulus (SV) is one cause of bowel obstruction in elder patients. Successful endoscopic SV repositioning, still involves a high recurrence rate, frequently involving surgical treatment. We introduce a mesosigmoplasty (MSP) surgical procedure and five long-term follow-up cases. In the original procedure, a vertical incision is made in the mesosigmoid peritoneal layer and peritoneal flaps pulled horizontally and sutured vertically to immobilize the sigmoid colon, "original" MSP. "Modified" MSP involves vertical sutures on both sides of the mesosigmoid layer to immobilize the sigmoid colon. In five MSPs-two original and three modified-conducted from February 1999 to July 2004, all cases improved their initial symptom at relief. One original case, unfortunately required reoperation (sigmoidectomy) due to SV recurrent 27 months after the first operation. Another case required one endoscopic repositioning caused by recurrent symptoms 26 months after operation, but has had no recurrence. None of the patients with "modified" MSP had recurrence after the first operation, indicating that "modified" MSP is useful in treating SV in elderly and high-risk patients.

Key words
sigmoid volvulus, mesosigmoplasty

Reprint requests
Takeshi Asakura Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine
2-16-1 Sugao, Miyamae-ku, Kawasaki, 216-8511 JAPAN

Accepted
October 28, 2009

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