Surgical management of cecal volvulus using endoscopic reduction as a bridge to elective laparoscopic surgery: a three-case series
Kaita Suzuki, Koshiro Harata, Ryo Taguchi, Rena Saito, Nobuaki Kagohashi, Ryosuke Niwamoto, Motoki Futamata, Tsuyoshi Saito, Shuji Koide, Takeyasu Katada, Futoshi Teranishi, Shuji TakiguchiAbstract
Cecal volvulus is a rare cause of bowel obstruction, typically managed by emergency surgery. Endoscopic reduction is generally not recommended due to its low success rate and risk of perforation. However, emergency surgery often requires laparotomy and may be associated with substantial surgical invasiveness. To reduce surgical invasiveness and avoid the risks associated with emergency surgery, we adopted a bridge-to-surgery strategy using endoscopic reduction followed by elective laparoscopic resection, limited to patients without suspected necrosis or perforation. We report three cases. Endoscopic reduction was successful in two patients, allowing subsequent elective laparoscopic surgery. In contrast, reduction failed in one patient, who underwent emergency surgery, during which cecal necrosis and perforation were identified. The patient subsequently died postoperatively. This case series discusses the potential role, indications, and current limitations of endoscopic reduction as a bridge to surgery in cecal volvulus.