Clinical Outcomes After Failed Endoscopic Detorsion for Sigmoid Volvulus: A Single‐Center Retrospective Cohort Study

作者：Hidehiro Kamezaki, Arisa Kato, Nana Yamada, T. Iwanaga, Takafumi Sakuma, Koji Takahashi, Junichi Senoo, Sadahisa Ogasawara, Tomoaki Matsumura, Jun Kato · 发表于：DEN Open · 年份：2026 · DOI：10.1002/deo2.70368 · 研究领域：Intestinal Malrotation and Obstruction Disorders、Gastroesophageal reflux and treatments、Esophageal and GI Pathology

ABSTRACT Objectives Endoscopic detorsion is the first‐line treatment for sigmoid volvulus (SV); however, detorsion is not always successful. We evaluated clinical outcomes after failed endoscopic detorsion and assessed recurrence in patients who achieved clinical success after decompression. Methods This single‐center retrospective cohort study included 47 patients with first‐episode SV, of whom 43 underwent endoscopic management. Baseline characteristics and short‐term outcomes were compared between successful and failed detorsion groups. Among patients with clinical success, the in‐hospital course and 1‐year cumulative recurrence were compared between the successful detorsion and successful decompression groups. Cumulative recurrence was evaluated using the Kaplan–Meier method. Results Successful detorsion was achieved in 21 of 43 patients (48.8%). Among 22 patients with failed detorsion, 17 achieved clinical success after decompression, whereas five had clinical failure, including four who underwent emergency surgery and one who died the following day. The overall clinical success rate was 88.4% (38/43). Failed detorsion was associated with lower room‐air oxygen saturation and higher lactate levels. Clinical success was less frequent in the failed detorsion group (77.3% vs. 100%, p = 0.065), and hospital stay was longer (median 13 vs. 7 days, p = 0.071). Among patients with clinical success, time to resumption of oral intake was shorter in the successful detorsion group (m...