Resection significantly lowers recurrence in sigmoid volvulus but comes with increased mortality risks.

• Resection reduced recurrence rates to 12% compared to 69% in non-resection (NNT 6).
• Mortality increased by 69% with resection, necessitating careful patient selection (NNH 17).

In non-gangrenous cases, resection prevents recurrence with no significant mortality increase.

• Optimizing patient selection and perioperative care is crucial for improved outcomes.