Stereological evaluation of ganglion cells in the sigmoid colon in primary and recurrent sigmoid volvulus

Authors: SABRİ SELÇUK ATAMANALP, CEMAL GÜNDOĞDU, DENİZ ÜNAL, ZEKAİ HALICI, ABDULLAH KISAOĞLU, BÜNYAMİ ÖZOĞUL

Abstract: To clarify the role of ganglion cells in Auerbach’s plexus of the sigmoid colon in the development and recurrence of sigmoid volvulus (SV). Materials and methods: Pathological block samples of colonic resection materials of 28 patients who underwent sigmoidectomy for SV and, for comparison, samples of 28 patients who underwent sigmoidectomy or low anterior resection for rectosigmoid cancer (RSC) were analyzed using stereological methods. Results: The mean numerical density of ganglion cells was significantly lower in the SV group than in the RSC group (140.70 mm^{-2} and 669.42 mm^{-2}, respectively, P = 0.005), whereas there was no significant difference between the revolvulus and nonrevolvulus SV groups (128.45 mm^{-2} and 185.67 mm^{-2}, respectively, P > 0.05). Similarly, the mean numerical density of ganglion cells in elderly SV patients was found to be significantly lower than that in nonelderly SV patients (66.57 mm^{-2} and 214.86 mm-2, respectively, P = 0.002), while there was no significant difference between elderly and nonelderly RSC patients (638.60 mm^{-2} and 705.00 mm^{-2}, respectively, P > 0.05). Conclusion: SV may be related to a decreased numerical density of ganglion cells in Auerbach's plexus, and the degenerative loss of ganglion cells due to advancing age is possible in elderly SV patients.

Keywords: Sigmoid colon, volvulus, ganglion cell, Auerbach's plexus

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