2023WSES共识指南：乙状结肠扭转管理

Tan et aL World Journalof Emergency Surgery2023)1834World Journal ofhttps:/doi.org/10.1186s13017-023-00502-×Emergency SurgeryREVIEWOpen AccessWSES consensus guidelines on sigmoidvolvulus managementBrian W.C.A.Tian',Gabriele Vigutto2,Edward Tan3,Harry van Goor3,Cino Bendinelli,Fikri Abu-Zidan5,Rao lvatury,Boris Sakakushev',Isidoro Di Carlo,Gabriele Sganga,Ronald V.Maier10,Raul Coimbra1,Ari Leppaniemi12,Andrey Litvin3,Dimitrios Damaskos14,Richard Ten Broek3,Walter Biffl15,Salomone Di Saverio6,Belinda De Simone17,Marco Ceresoli18,Edoardo Picetti19,Joseph Galante20,Giovanni D.Tebala21,Solomon Gurmu Beka22,Luigi Bonavina23,Yunfeng Cui24,Jim Khan25,Enrico Cicuttin26,Francesco Amico,Inaba Kenji27,Andreas Hecker2,Luca Ansaloni29,Massimo Sartelli,Ernest E.Moore31,Yoram Kluger32,Mario Testini3,Dieter Weber,Vanni Agnoletti3,Nicola De'Angelis%,Federico Coccolini2lbrahima Sall37and Fausto Catena?AbstractSigmoid volvulus is a common surgical emergency,especially in elderly patients.Patients can present with a widerange of clinical states:from asymptomatic,to frank peritonitis secondary to colonic perforation.These patients gener-ally need urgent treatment,be it endoscopic decompression of the colon or an upfront colectomy.The World Societyof Emergency Surgery united a worldwide group of international experts to review the current evidence and proposea consensus guidelines on the management of sigmoid volvulus.Backgroundand Western Europe [7-10].Halabi et al.[9]reported onThe term "volvulus"comes from the Latin "volvere"63,749 cases of colonic volvulus among 3,351,152 cases ofmeaning twist.It was first described by Rokitansky inintestinal obstruction over a 9-year period.During this1836 [1].Colonic volvulus is therefore the twisting of aperiod,the authors observed a stable incidence of sig-segment of colon on its mesentery.Colonic volvulus ismoid volvulus;however,the incidence of cecal volvulusthe third leading cause of colonic obstruction globally,increased by 5%per year.following colorectal cancer and complicated sigmoidAlthough any mobile segment of the colon can twistdiverticulitis[2].on itself;the sigmoid is involved in 60-75%of cases,The incidence of colonic volvulus,however,does varycecum in 25-40%of cases,transverse colon in 1-4%ofin different regions of the world.In the "volvulus belt,"ancases and splenic flexure in 1%of cases [11].The clinicalendemic area that includes Africa,South America,Rus-presentation of volvulus does appear to have some differ-sia,Eastern Europe,the Middle East,India and Brazil,ences,depending on location.In countries in the "volvu-colonic volvulus represents 13%to 42%of all intestinallus belt,"sigmoid volvulus usually occurs in young menobstructions [3-6].Conversely,volvulus accounts for(from the 4th decade onward with a male/female sex ratio10%to 15%of all large-bowel obstructions in the USAof 4:1).In Western countries,sigmoid volvulus preferen-tially affects elderly males (age>70)while cecal volvulusCorrespondence:affects som