Scholarlink

<p>This study aimed to compare clinical outcomes and treatment costs between emergency surgery and an endoscopic-first strategy, including endoscopic decompression followed by elective surgery when feasible, in patients with sigmoid volvulus (SV). This retrospective cohort study enrolled 118 patients with SV treated at two centers between January 2019 and December 2024. Patients were categorized according to their initial treatment strategy into an emergency surgery group (<i>n</i> = 58) and an endoscopic-first group (<i>n</i> = 60). Outcomes included ICU admission, overall complications, stoma creation, any second-stage operation, length of stay during the index hospitalization, and treatment costs. Multivariable regression models were used to adjust for age, BMI, sex, comorbidity count, previous abdominal surgery, and intraoperative or treatment-confirmed bowel ischemia/necrosis. Among 60 patients managed with an endoscopic-first strategy, endoscopic decompression was successful in 37 patients (61.7%). Compared with the emergency surgery group, the endoscopic-first group had lower rates of stoma creation (15.0% vs. 74.1%), ICU admission (20.0% vs. 56.9%), and any second-stage operation (10.0% vs. 37.9%), whereas overall complication rates were similar (25.0% vs. 32.8%). The median total treatment cost was lower in the endoscopic-first group (RMB 25,762.83 vs. RMB 52,649.29). In adjusted analyses, the endoscopic-first strategy remained associated with lower odds of ICU admission, any second-stage operation, and stoma creation, but not with overall complications. In selected patients with SV, an endoscopic-first strategy was associated with lower rates of stoma creation, ICU admission, and any second-stage operation, second-stage operation, and treatment costs, without a significant difference in overall complications. Because treatment allocation was not randomized and disease severity differed between groups, these findings should be interpreted as associations rather than evidence of causal superiority.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Clinical outcomes and treatment costs of endoscopic-first strategy compared with emergency surgery for sigmoid volvulus in a multicenter retrospective study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月8日

查看全文
  • Mureaihemaitijiang Mutalifu,
  • Paierda Aine,
  • Gulirena Abula,
  • Tuhongkare Yasheng

摘要

This study aimed to compare clinical outcomes and treatment costs between emergency surgery and an endoscopic-first strategy, including endoscopic decompression followed by elective surgery when feasible, in patients with sigmoid volvulus (SV). This retrospective cohort study enrolled 118 patients with SV treated at two centers between January 2019 and December 2024. Patients were categorized according to their initial treatment strategy into an emergency surgery group (n = 58) and an endoscopic-first group (n = 60). Outcomes included ICU admission, overall complications, stoma creation, any second-stage operation, length of stay during the index hospitalization, and treatment costs. Multivariable regression models were used to adjust for age, BMI, sex, comorbidity count, previous abdominal surgery, and intraoperative or treatment-confirmed bowel ischemia/necrosis. Among 60 patients managed with an endoscopic-first strategy, endoscopic decompression was successful in 37 patients (61.7%). Compared with the emergency surgery group, the endoscopic-first group had lower rates of stoma creation (15.0% vs. 74.1%), ICU admission (20.0% vs. 56.9%), and any second-stage operation (10.0% vs. 37.9%), whereas overall complication rates were similar (25.0% vs. 32.8%). The median total treatment cost was lower in the endoscopic-first group (RMB 25,762.83 vs. RMB 52,649.29). In adjusted analyses, the endoscopic-first strategy remained associated with lower odds of ICU admission, any second-stage operation, and stoma creation, but not with overall complications. In selected patients with SV, an endoscopic-first strategy was associated with lower rates of stoma creation, ICU admission, and any second-stage operation, second-stage operation, and treatment costs, without a significant difference in overall complications. Because treatment allocation was not randomized and disease severity differed between groups, these findings should be interpreted as associations rather than evidence of causal superiority.