Caecal Volvulus: A District General Hospital Experience and Review of the Literature

Round 1

Reviewer 1 Report

The study is aimed to describe the authors’ experience in the largest series of caecal volvulus reported in the United Kingdom.   The title is “Caecal volvulus: A District General Hospital Experience and Review of the Literature”.

1. This is a retrospective study.
2. The sample size of the study is relatively small.
3. Several factors influence the outcome of the study. Please discuss these.
4. Please add the limitations of the study in the discussion section.
5. What is the new knowledge of this report?
6. Please recommend to the readers “How to apply this knowledge?”.

Author Response

Dear Reviewer, 

Our team thanks you for taking time to review our article. This has helped us to make it better. We have made following changes as per your suggestions as highlighted below, 

1. This is a retrospective study. We have highlighted this in our limitations in the section after discussion.
2. The sample size of the study is relatively small. Yes, we acknowledge the sample size is small to derive any major conclusion. This has been again reiterated in our limitations.
3. Several factors influence the outcome of the study. Please discuss these. We have discussed these in the section 'Discussion' now in further detail.
4. Please add the limitations of the study in the discussion section. Thankyou for this suggestion. We have added this
5. What is the new knowledge of this report? This report describes differences in the demographic profile of Caecal volvulus in the western population. Encourages laparoscopic approach in the stable patient whereas also reinforces that treatment be individualised e.g. in frail and comorbid patient, end of life pathway / palliative treatment could be the best management. It informs readers that the mortality is not as high as previously reported- largely perhaps due to early diagnosis and better preoperative care.
6. Please recommend to the readers “How to apply this knowledge?”.We have added learning points section in the article. We appreciate this valuable suggestion. 

Kind regards 

Anang Pangeni

Corresponding author

Reviewer 2 Report

In the manuscript of Pangeni et al. the authors provided a retrospective study of 16 cecal volvuli and a review of the literature. 

The topic is interesting as cecal volvulus is a rare and life-threatening disorder, without surgical intervention large bowel obstruction and the death of a patient can be developed. 

The description of the cases is correct. The patient and clinical characteristics and perioperative findings are all well described. 

The discussion contains the review of literature which is also correct. The used images all help the understanding of this surgical disease. 

The English language needs major moderate polishing. 

After language polishing, I suggest accepting the manuscript for publication. 

 

Author Response

Dear Reviewer, 

We want to thank you for your valuable time reviewing this article. We have reviewed our English composition to make it better. 

Kind regards 

Anang Pangeni 

Corresponding Author 

Reviewer 3 Report

The article is written scientifically and is methodically acceptable. However I could not see any detail about funding, acknowledgment & interest conflict in the end of manuscript.

Author Response

Dear Reviewer, 

We have added funding, acknowledgement and Conflict of interest section in the main manuscript as you suggested. 

Many Thanks for reviewing our article and providing us with feedback and suggestions. We really appreciate your time. 

Kind regards, 

Anang Pangeni

Corresponding Author 

Round 2

Reviewer 1 Report

Overall, the revised version is O.K.