Akademik Veri Yönetim Sistemi
INDIAN JOURNAL OF SURGERY, cilt.80, sa.5, ss.470-473, 2018 (SCI-Expanded)
Ileosigmoid knotting (ISK) is the wrapping of ileum and sigmoid colon around each other. The purpose is to evaluate the changes in incidence, treatment, and outcomes over several decades to the present. The clinical records of 78 patients over the last 50years were reviewed retrospectively until June 1986, and prospectively thereafter, and the results of the first and last 25years were compared. The incidence of ISK decreased during the reviewed 50-year period (p<0.001). Although most of the diseased patient characteristics including age, gender, previous incidence, comorbidity, and shock rates were similar (p>0.05 for each), the typical symptomatic period shortened (p<0.05) over the last 25years. Clinical symptoms and signs were also similar (p>0.05), but the preoperative diagnostic accuracy rate increased (p<0.001) due to the increased usage of CT and/or MRI (p<0.001). Operative findings, including the type of ISK, extent of over-rotation, and bowel gangrene rates were also similar (p>0.05 for each). The predominant surgical treatment was modified, as resection with primary anastomosis generally took the place of resection with stoma for both ileum (p<0.01) and sigmoid colon (p<0.005). Finally, the morbidity, mortality, and recurrence rates did not change (p>0.05 for each), though the average hospitalization period shortened (p<0.05). As a result, over time, we found a decrease in the incidence of ISK as well as some changes in the diagnostic and therapeutic strategies, although the clinical features and prognosis did not change.