The changing survival scenario in gangrenous sigmoid volvulus: a four-decade study.

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dc.contributor.authorBhatnagar, B N Sen_US
dc.contributor.authorSharma, C L Nen_US
dc.contributor.authorGautam, Amitabhen_US
dc.contributor.authorReddy, D C Sen_US
dc.date.accessioned2006-06-25en_US
dc.date.accessioned2009-05-31T08:59:19Z
dc.date.available2006-06-25en_US
dc.date.available2009-05-31T08:59:19Z
dc.date.issued2006-06-25en_US
dc.description.abstractThere is a suspicion that mortality in gangrenous sigmoid volvulus has considerably declined over the recent years. This study was aimed to assess if this is a genuine trend, applicable to the patients, of this study too, and to identify factors responsible for the change, if any. Seventy-eight patients operated for gangrenous sigmoid volvulus, in the last four decades of the just gone century, were analysed. Nine clinical parameters were studied to identify factors responsible for mortality and to see if there was a change in clinical presentation in the later decades. Mortality in the 4 studied decades varied between 15.4% and 65%. Differences were significant (p<0.05) only between the decades of the seventies and eighties and between bunched pre 1980 (48%) and post 1980 (20%) decades. A sea change in survival scene occurred at the end of the decade of the seventies. The change was not accompanied by a concomitant improvement in clinical presentation (p>0.05). Two facts which could explain improved survivals in the post. 1980 period were, the increased recognition of gangrene extending beyond the area of constriction and improved survival after primary anastomoses (p<0.05). These indicated a more accurate assessment of viability and the distance between the cut bowel ends, a stricter selection of cases for primary anastomosis and using Hartmann operation in doubtful situations. Mortality in gangrenous sigmoid volvulus, without knotting in the Indian population has genuinely declined from over 50% in an earlier time to 20% in the later 20 years of the last century, the watershed in the changed scenario being the year 1980.en_US
dc.description.affiliationDepartment of Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005.en_US
dc.identifier.citationBhatnagar BN, Sharma CL, Gautam A, Reddy DC. The changing survival scenario in gangrenous sigmoid volvulus: a four-decade study. Journal of the Indian Medical Association. 2006 Jun; 104(6): 292, 294-7en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/98194
dc.language.isoengen_US
dc.source.urihttps://www.jimaonline.org.in/en_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshColon, Sigmoid --pathologyen_US
dc.subject.meshColonic Diseases --mortalityen_US
dc.subject.meshFemaleen_US
dc.subject.meshGangrene --etiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshIndia --epidemiologyen_US
dc.subject.meshIntestinal Volvulus --mortalityen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshSigmoid Diseases --mortalityen_US
dc.subject.meshSurvival Rateen_US
dc.subject.meshTime Factorsen_US
dc.titleThe changing survival scenario in gangrenous sigmoid volvulus: a four-decade study.en_US
dc.typeComparative Studyen_US
dc.typeJournal Articleen_US
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