ENDOSCOPIC SIGMOIDOPEXY AS A TREATMENT FOR RECURRENT SIGMOID VOLVULUS IN FRAIL PATIENTS

Sigmoid volvulus is a common cause of colonic obstruction in old and frail patients. Its standard management includes the endoscopic detorsion of the colonic loop, followed by an elective sigmoidectomy to prevent recurrence. However, these patients are often poor candidates for surgery. In frail patients, other options such as endoscopic sigmoidopexy must be developed.

By analogy with the caecostomy procedure, sigmoidopexy procedure consists in anchoring the sigmoid to the abdominal wall and placing a Chait catheter tube in the colonic lumen to perform antegrade enemas.

As a mini-invasive, reversible technique, endoscopic sigmoidopexy might be a promising treatment of recurrent sigmoid volvulus, when surgery appears to be at risk. Efficacy and safety need to be validated in prospective cohorts.