I have reviewed the paper by Awedew et al. (1) on the treatment of gangrenous sigmoid volvulus (SV). Although SV is not widespread globally, it is prevalent in our region of eastern Anatolia (2,3). Over 57.5 years (from June 1966 to the present), my team and I have treated 1,076 SV patients, representing the largest single-center series worldwide (3). Based on this extensive experience, I offer the following comments on the surgical management of SV.

Author's Response

I want to express my sincere appreciation for your valuable insights and recommendations. I have come to recognize the profound expertise of Dr. Atamanalp and his colleagues in the management of sigmoid volvulus (SV). Their contributions have been instrumental in shaping practical recommendations for addressing SV cases. It is evident that SV is prevalent in regions often referred to as the "Volvulus belt," encompassing countries like Turkey, the Middle East, and various parts of Africa, particularly in Eastern Africa, including countries like Ethiopia and Kenya. In Ethiopia, SV stands as the most common cause of bowel obstruction. Despite its prevalence, there remains a significant gap in the development of guidelines and a comprehensive analysis akin to the practices seen among surgeons in Turkey. Acknowledging this disparity, we have endeavored to fill this void by synthesizing existing studies to generate a robust evidence base for the management of SV, aiming to elevate the standards of care and decision-making in regions affected by this condition.