British Journal of Medicine and Medical Research, ISSN: 2231-0614,Vol.: 5, Issue.: 4
Factors Influencing Outcome of Management of Sigmoid Volvulus in Northern Uganda: A Prospective Observational Study
David Lagoro Kitara1* and Richard Wismayer1,2 1Department of Surgery, Faculty of Medicine, Gulu University, Uganda.
2Department of Surgery, University of Edinburgh, Scotland, United Kingdom.
David Lagoro Kitara1* and Richard Wismayer1,2
1Department of Surgery, Faculty of Medicine, Gulu University, Uganda.
(1) Salomone Di Saverio, Emergency Surgery Unit, Department of General and Transplant Surgery, S. Orsola Malpighi University Hospital, Bologna, Italy.
(1) Ketan Vagholkar, General Surgery, Dr. D.Y. Patil Vidyapeeth, India.
(2) Anonymous, Al Azhar University, Egypt.
Complete Peer review History: http://www.sciencedomain.org/review-history/6115
Aims: To determine the factors that influence outcome of management of sigmoid volvulus in Northern Uganda
Study Design: A prospective observational study was conducted on 103 sigmoid volvulus patients admitted and surgically managed in 19 hospitals in northern Uganda and followed-up postoperatively for 30 days.
Place and Duration of the Study: This study was conducted in 19 hospitals in Northern Uganda from January 2012 to December 2012.
Methodology: One hundred and three patients with sigmoid volvulus were consecutively recruited and admitted in 19 of the 20 hospitals in Northern Uganda and were surgically managed by resection and primary anastomosis or Hartmann’s procedure or double barrel colostomy. Patients 13 years and above with sigmoid volvulus and who had consented/Assented were included in the study and followed up to the 30th postoperative day. Ethical approval for the study was obtained from the Institutional Review Committee of Gulu University Medical School. Data analysis was carried out using STATA/IC version 12.1. The outcome events observed were uneventful recovery, morbidity and mortality.
Results: Eighteen patients (17.48%) developed complications including wound sepsis 10(9.7%); wound dehiscence 8(7.7%) and anastomotic leak 8(7.7%). There were 8 deaths, thus giving a mortality rate of 7.7%. The factors associated with a high risk of morbidity and mortality were hypernatraemia (RR=14.9; 95% CI: 1.46-152.9) and ileosigmoid knotting (RR=4.94; 95% CI: 1.30-18.78). Resection and primary anastomosis had a better outcome compared to the Hartmann’s procedure (RR=0.15; 95% CI: 0.02-0.099).
Conclusion: The risk factors associated with morbidity and mortality of sigmoid volvulus management were preoperative hypernatraemia and ilio-sigmoid knotting. Hartmann’s procedure was associated with a higher risk of morbidity and mortality than resection and primary anastomosis.
Note: This paper has been investigated by Uganda National Council for Science and Technology for ‘authorship dispute’. Uganda National Council for Science and Technology informed the editorial office of the journal by a letter, dated 19th January, 2015, as "We confirm that Dr. Richard Wismayer conducted the studies, wrote and submitted to us his Master thesis entitled, "Incidence and factors influencing outcome of sigmoid volvulus in northern Uganda: a prospective observational study", from which the articles were derived. Our attempt, as evidenced by the attached/enclosed letter to Dr. David Lagoro Kitara to obtain any other relevant information from him in respect of the disputed publication was futile. We therefore have no evidence, so far, that Dr. David Lagoro Kitara sought authorship consent from Dr. Richard Wismayer." This journal waited another six months to get any further communication from Uganda National Council for Science and Technology. As we have not received any other communication from the apex body of Uganda, we therefore consider the letter received on 19th Janyary-2015 as final ruling. Therefore on 17th July-2015 this manuscript has been retracted by following "SDI Correction and retraction policy". We thank all related persons/organization for kind cooperation, patience and support during this process.
Sigmoid volvulus; resection; primary anastomosis; risk factors; Gulu; Northern Uganda.
Full Article - PDF Page 444-456
DOI : 10.9734/BJMMR/2015/12283Review History Comments