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Endoscopic versus surgical management for colonic volvulus hospitalizations in the United States
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Dushyant Singh Dahiya, Abhilash Perisetti, Hemant Goyal, Sumant Inamdar, Amandeep Singh, Rajat Garg, Chin-I Cheng, Mohammad Al-Haddad, Madhusudhan R. Sanaka, Neil Sharma
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Clin Endosc 2023;56(3):340-352. Published online April 17, 2023
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DOI: https://doi.org/10.5946/ce.2022.166
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Graphical Abstract
Abstract
PDFPubReaderePub
- Background
/Aims: Colonic volvulus (CV), a common cause of bowel obstruction, often requires intervention. We aimed to identify hospitalization trends and CV outcomes in the United States.
Methods We used the National Inpatient Sample to identify all adult CV hospitalizations in the United States from 2007 to 2017. Patient demographics, comorbidities, and inpatient outcomes were highlighted. Outcomes of endoscopic and surgical management were compared.
Results From 2007 to 2017, there were 220,666 CV hospitalizations. CV-related hospitalizations increased from 17,888 in 2007 to 21,715 in 2017 (p=0.001). However, inpatient mortality decreased from 7.6% in 2007 to 6.2% in 2017 (p<0.001). Of all CV-related hospitalizations, 13,745 underwent endoscopic intervention, and 77,157 underwent surgery. Although the endoscopic cohort had patients with a higher Charlson comorbidity index, we noted lower inpatient mortality (6.1% vs. 7.0%, p<0.001), mean length of stay (8.3 vs. 11.8 days, p<0.001), and mean total healthcare charge ($68,126 vs. $106,703, p<0.001) compared to the surgical cohort. Male sex, increased Charlson comorbidity index scores, acute kidney injury, and malnutrition were associated with higher odds of inpatient mortality in patients with CV who underwent endoscopic management.
Conclusions Endoscopic intervention has lower inpatient mortality and is an excellent alternative to surgery for appropriately selected CV hospitalizations.
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Citations
Citations to this article as recorded by
- Navigating Abdominal Volvulus: A Comprehensive Review of Management Strategies
Simran Chauhan, Raju K Shinde, Yashraj Jain Cureus.2024;[Epub] CrossRef - Clinicopathological Features of Elderly Patients with Colonic Volvulus
Mehmet Onur Gul, Selda Oğuz Aşlayan, Kadir Çorbacı, Aytaç Selman, Emre Berat Akçay, Oğuzhan Sunamak, Cebrail Akyüz European Journal of Therapeutics.2024; 30(3): 303. CrossRef - Incidental Sigmoid Volvulus after a Ground-level Fall: An Unusual Case Report
Ziya Karimov, Elchin Shirinov, Gunay Huseynova, Mirhuseyn Mammadov, Meltem Songür Kodik Caucasian Medical Journal.2023; 1(3): 36. CrossRef - Colonic Volvulus
Samantha L. Savitch, Calista M. Harbaugh Clinics in Colon and Rectal Surgery.2023;[Epub] CrossRef
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Peroral endoscopic myotomy versus Heller’s myotomy for achalasia hospitalizations in the United States: what does the future hold?
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Dushyant Singh Dahiya, Vinay Jahagirdar, Manesh Kumar Gangwani, Muhammad Aziz, Chin-I Cheng, Sumant Inamdar, Madhusudhan R. Sanaka, Mohammad Al-Haddad
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Clin Endosc 2022;55(6):826-828. Published online November 3, 2022
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DOI: https://doi.org/10.5946/ce.2022.283
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PDFPubReaderePub
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Prospective Assessment of the Performance of a New Fine Needle Biopsy Device for EUS-Guided Sampling of Solid Lesions
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Ihab I. El Hajj, Howard Wu, Sarah Reuss, Melissa Randolph, Akeem Harris, Mark A. Gromski, Mohammad Al-Haddad
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Clin Endosc 2018;51(6):576-583. Published online July 13, 2018
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DOI: https://doi.org/10.5946/ce.2018.053
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Abstract
PDFPubReaderePub
- Background
/Aims: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) remains the most common EUS-guided tissue acquisition technique. This study aimed to evaluate the performance of a new Franseen tip fine needle biopsy (FNB) device for EUSguided sampling of solid lesions and compare it with the historical FNA technique.
Methods Acquire® 22 G FNB needle (Boston Scientific Co., Natick, MA, USA) was used for solid tumor sampling (Study group). Tissue was collected for rapid on-site evaluation, and touch and crush preparations were made. Historical EUS-FNA samples obtained using Expect® 22 G FNA needle (Boston Scientific Co.) were used as controls (Control group). All specimens were independently evaluated by two cytopathologists blinded to the formal cytopathological diagnosis.
Results Mean cell block histology scores were significantly higher (p=0.046) in the FNB group (51 samples) despite a significantly lower (p<0.001) mean number of passes compared to the FNA group (50 specimens). The overall diagnostic yields for the FNB vs. FNA groups were 96% vs. 88%. The degree of tumor differentiation was adequately assessed in all cell block qualifying lesions in the FNB group. Two patients developed post-FNB abdominal pain.
Conclusions The new Franseen tip FNB device provides histologically superior and cytologically comparable specimens to those obtained by FNA, but with fewer passes.
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