Incidence and Factors Influencing the Outcome of Sigmoid Volvulus in Northern Uganda. A Prospective Observational Study
Uganda. The purpose of this study was to determine the incidence and the factors influencing the outcome of management of SV in Northern Uganda Methodology: This study was divided into two parts. The purpose of the retrospective study was to determine the incidence over a two-year period. Patients 13 years and older with SV were included in the one-year prospective study to determine the factors influencing outcome and were followed up to the 30th postoperative day. The Gulu University IRB provided ethical approval. STATA/IC version 12.1 was used for data analysis. The end result was an uneventful recovery, morbidity, and mortality. In Northern Uganda, the incidence of SV was 251.8 per 100,000 surgical population in two years. Data from 103 patients were analyzed; 18 (17.48 percent) of them developed complications such as wound sepsis (10.7%), wound dehiscence (8.7%), and anastomotic leak (8.7%). (7.7 percent ). There were 8 deaths, for a 7.7 percent mortality rate. Hypernatraemia (RR=14.9; 95 percent CI: 1.46-152.9) and ileo-sigmoid knotting (RR = 4.94; 95 percent CI: 1.3018.78) were factors associated with a high risk of adverse outcome. When compared to Hartmann’s procedure, resection and primary anastomosis had a better outcome (RR=0.15; 95 percent CI: 0.02- 0.099). In Northern Uganda, the incidence of SV was 251.8 per 100,000 surgical population in two years. Preoperative hypernatraemia and ileo-sigmoid knotting were risk factors for morbidity and mortality. Colostomy had a higher risk of morbidity and mortality than resection and primary anastomosis.
Author (s) Details
Department of Surgery, Faculty of Medicine, University of Edinburgh, United Kingdom and Department of Surgery, Faculty of Medicine, Gulu University, Gulu, Uganda.
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