Mustafa Ateş, Sinan Hatipoğlu, Abuzer DİRİCAN, Cemalettin KOÇ, Burak IŞIK, Mehmet Yılmaz

Kolon Volvulusunda Cerrahi Tedavi: Altı Yıllık Deneyimimiz

Amaç: Kolon volvulusları acil tedavi gerektiren bir akut batın sebebidir. Tedavide endoskopik dekompresyon gibi nonoperatif girişimler de kullanılmakla beraber gerçek tedavi cerrahidir. Bu çalışmada kolon volvulusu nedeniyle ameliyat edilen olguların sonuçlarının değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Ocak 2005- Mayıs 2011 tarihleri arasında İnönü Üniversitesi Tıp Fakültesi Genel Cerrahi Kliniğinde, kolon volvulusu tanısı ile cerrahi tedavi edilen hastaların dosyaları geriye dönük olarak incelendi. Bulgular: Ameliyat edilen 62 hastanın 55'i (%87,3) erkek, 8'i (%12,7) kadın olup ortalama yaş 67,3 (20-94 arası) idi. Sigmoid kolon volvulusu 62 hastada mevcutken, 1 hastada ise çekal volvulus mevcut idi. Sigmoid kolon volvulusu olan 20 (%31,7) hastaya başlangıç tedavisi olarak endoskopik dekompresyon uygulandı. Endoskopik yaklaşımla 11(%55) hastada başarılı dekompresyon sağlandı. 27 (%42,9) olguya rezeksiyon ve kolostomi, 33 (%52,3) olguya rezeksiyon ve anastomoz, çekal volvulus bulunan 1 (%1,6) olguda sağ hemikolektomi+ileotransversostomi, 1 (%1,6) olguda cerrahi dekompresyon ve 1 (%1,6) olguda ise cerrahi dekompresyon ve sigmoidopeksi yapıldı. Mortalite 4 (%6,3) olguda görüldü. Sonuç: Kolon volvulusu cerrahisinin zamanlaması ve uygun seçenekleri için hastanın klinik durumu göz önünde tutulmalı, uygun vakalarda cerrahi öncesi endoskopik dekompresyon teknikleri de uygulanmalıdır. Anahtar kelimeler: Kolon Volvulusu; Cerrahi Tedavi; Detorsiyon.

Anahtar Kelimeler:

Kolon Volvulusu; Cerrahi Tedavi; Detorsiyon.

Surgical Treatment of Colonic Volvulus: Six Years Experience

Objective: Colonic volvulus is an acute condition which needs emergency treatment. Although, nonoperative procedures such as endoscopic decompression can be used in treatment, actual treatment is surgery. The aim of this study was to evaluate results of the patients operated due to colonic volvulus Material and Methods: The dates of surgically treated patients with a diagnosis of colonic volvulus between January 2005 - May 2011 at Inonu University Medical Faculty, Department of General Surgery, were examined retrospectively. Results: 55 of 62 patients who were operated (87.3%) were male and 8 (12.7%) were female, mean age 67.3 (between 20-94). Sigmoid colon volvulus was present in 62 patients; cecal volvulus was present in 1 patient. Twenty (31.7%) patients with sigmoid volvulus underwent endoscopic decompression as an initial therapy. Endoscopic decompression approach was achieved successfully in 11 (55%) patients. Twenty seven (42,9%) patients were treated with resection and colostomy, 33 (%52,3) patients were treated with resection and anastomosis, 1 (1.6%) case with cecal volvulus treated with right hemicolectomy and ileotransversostomi, 1 (1.6%) case treated with surgical decompression, and 1 (1.6%) case treated with surgical decompression and sigmoidopeksi. Mortality was seen with 4 cases (%6,3) Conclusion: Patient's clinical status should be taken into consideration for the suit timing and appropriate surgical options in surgery of colonic volvulus, and preoperative endoscopic decompression techniques are also applied in suitable cases. Key words: Colonic Volvulus; Surgical Treatment; Detorsion.

Keywords:

Colonic Volvulus; Surgical Treatment; Detorsion.,

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