Best Management of Sigmoid Volvulus: A Prospective Randomized Trial

NCT ID: NCT01682395

Last Updated: 2017-12-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

29 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-02-28

Study Completion Date

2014-04-30

Brief Summary

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The purpose of this study is to obtain a better understanding of the best management of left-sided colonic emergencies.

Detailed Description

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Participants: Patients 18 years or older presenting to Kamuzu Central Hospital in Lilongwe Malawi with sigmoid volvulus will be eligible for inclusion.

Procedures (methods): This is a prospective randomized trial. Subjects will be randomized during surgery to receive resection and anastomosis or mesosigmoidopexy (for non-gangrenous sigmoid volvulus), and resection and anastomosis or Hartmann's procedure (for gangrenous sigmoid volvulus).

Conditions

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Intestinal Volvulus Colon, Sigmoid

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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G-SV Resection and colostomy

Gangrenous sigmoid volvulus patients randomized to undergo resection with colostomy and delayed anastomosis

Group Type ACTIVE_COMPARATOR

Resection and colostomy

Intervention Type PROCEDURE

Resection of sigmoid colon with end colostomy and Hartmann's pouch, followed at a later date by Hartmann's reversal as a second surgical procedure

G-SV Resection and anastomosis

Gangrenous sigmoid volvulus subjects randomized to undergo resection and anastomosis

Group Type EXPERIMENTAL

Resection and anastomosis

Intervention Type PROCEDURE

Resection of sigmoid colon with primary anastomosis

NG-SV resection and anastomosis

Nongangrenous sigmoid volvulus subjects randomized to undergo resection and anastomosis

Group Type ACTIVE_COMPARATOR

Resection and anastomosis

Intervention Type PROCEDURE

Resection of sigmoid colon with primary anastomosis

NG-SV mesosigmoidopexy

Nongangrenous sigmoid volvulus subjects randomized to undergo mesosigmoidopexy

Group Type EXPERIMENTAL

Mesosigmoidopexy

Intervention Type PROCEDURE

Mesosigmoidopexy--the fixation of the sigmoid colon to lateral abdominal wall with concomitant shortening of the mesosigmoid length.

Interventions

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Resection and anastomosis

Resection of sigmoid colon with primary anastomosis

Intervention Type PROCEDURE

Resection and colostomy

Resection of sigmoid colon with end colostomy and Hartmann's pouch, followed at a later date by Hartmann's reversal as a second surgical procedure

Intervention Type PROCEDURE

Mesosigmoidopexy

Mesosigmoidopexy--the fixation of the sigmoid colon to lateral abdominal wall with concomitant shortening of the mesosigmoid length.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* clinical suspicion of sigmoid volvulus as deemed by the surgeon on duty

Exclusion Criteria

* pregnancy,
* age under 18 years,
* prisoners
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of North Carolina, Chapel Hill

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jonathan C Samuel, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

UNC Chapel Hill Department of Surgery

Locations

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Kamuzu Central Hospital

Lilongwe, , Malawi

Site Status

Countries

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Malawi

References

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Raveenthiran V, Madiba TE, Atamanalp SS, De U. Volvulus of the sigmoid colon. Colorectal Dis. 2010 Jul;12(7 Online):e1-17. doi: 10.1111/j.1463-1318.2010.02262.x. Epub 2010 Mar 10.

Reference Type BACKGROUND
PMID: 20236153 (View on PubMed)

Akinkuotu A, Samuel JC, Msiska N, Mvula C, Charles AG. The role of the anatomy of the sigmoid colon in developing sigmoid volvulus: a case-control study. Clin Anat. 2011 Jul;24(5):634-7. doi: 10.1002/ca.21131. Epub 2011 Feb 14.

Reference Type BACKGROUND
PMID: 21322064 (View on PubMed)

Samuel JC, Msiska N, Muyco AP, Cairns BA, Charles AG. An observational study addressing the anatomic basis of mesosigmoidopexy as a rational treatment of non-gangrenous sigmoid volvulus. Trop Doct. 2012 Jan;42(1):44-5. doi: 10.1258/td.2011.110317. Epub 2011 Dec 19.

Reference Type BACKGROUND
PMID: 22184737 (View on PubMed)

Related Links

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http://www.crd.york.ac.uk/prospero/display_record.asp?ID=CRD42012002137

Related meta-analysis and systematic review registration

Other Identifiers

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12-1091

Identifier Type: -

Identifier Source: org_study_id

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