LAUSR

BACKGROUND Recurrent sigmoid volvulus is frequent and mostly occurs in frail patients with contraindications for surgical sigmoidectomy. Percutaneous endoscopic sigmoidopexy (PES) has recently been proposed as an alternative option to elective sigmoidectomy. We aimed to describe the efficacy and safety of PES. METHODS All consecutive patients who underwent PES in two French centers for recurrent sigmoid volvulus between January 2017 and March 2021 were included in this retrospective case series. Recurrent sigmoid volvulus was defined as at least two symptomatic episodes treated by endoscopic decompression. Under endoscopic guidance, anchors were placed to attach the sigmoid to the anterior abdominal wall, allowing the placement of pigtail Chait catheters. RESULTS Fifteen patients (60.0% female; median age: 74 years (range 49-96)) were included. Median number of previous sigmoid volvulus episodes was three (range 2-6). Procedures were technically successful with no intra-procedural adverse event for 14 patients (93.3%). Peritonitis occurred at day-2 in one patient (serious adverse event rate 6.7%). Median follow-up time was ten months (range 1-30). No sigmoid volvulus recurrence occurred during follow-up. CONCLUSION PES using Chait catheters offers an effective and feasible approach for recurrent sigmoid volvulus treatment and should be considered as an alternative option to sigmoidectomy in inoperable patients.