Cecostomy is a useful surgical procedure
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
PURPOSE: There is a large choice of treatment for obstructing carcinoma of the left colon. We report our experience of tube cecostomy as the initial treatment for obstructing colonic carcinoma followed by elective resection. METHODS: From 1975 to 1995, 113 patients presenting with colonic obstruction caused by cancer were initially treated by tube cecostomy. RESULTS: The cecostomy was performed under local anesthesia in 26 cases (23 percent) and general anesthesia in 87 cases (77 percent). In the postoperative period 15 patients died (13 percent) and 26 (23 percent) had wound infection in the area around the cecostomy. A second operation performed on the 98 surviving patients comprised 74 left colonic resections with anastomosis, 9 without anastomosis (Hartmann's operation), 1 right colectomy, 3 total colectomies eliminating the cecostomy, 3 internal bypasses, and 8 proximal lateral colostomies. Surgical closure of the cecostomy was performed during six of the second operations. No deaths occurred from any of the second operations. The cecostomy closed spontaneously in 78 patients (89 percent). In ten cases (11.4 percent) a third operation was performed to close the cecostomy, without mortality. CONCLUSIONS: Comparison our cecostomy results with published studies of proximal diverting loop colostomies for the same indications showed comparable mortality after the first operation. Cecostomy decrease mortality of the second operation. This retrospective study suggests that cecostomy is a useful and less invasive surgical procedure for patients presenting with colonic obstruction caused by cancer.
- Mackenzie S, Thompson SR, Baker LW. Management options in malignant obstruction of the left colon. Surg Gynecol Obstet 1992;74:337–44.
- Cubertafond P, Gainant A, Barbier J, Coste G. Colostomies. Indications et complications. Chirurgie 1985;111:331–41.
- Bresler L, Braun E, Debs A, Boissel P, Grosdidier J. Chirurgie d'urgence face aux occlusions coliques. J Chir 1986;123:713–8.
- Guivarc'h M, Boche O, Roullet-Audy JC, Mosnier H. Soixante et une occlusions aiguës du colon par cancer. Indications chirurgicales en urgence. Ann Chir 1992;46:239–43.
- Parc R, Bouteloup PY, Kartheuser A. Faut-il condamner la colostomie premi re dans les cancers coliques gauches en occlusion? Chirurgie 1989;115:112–6.
- Malafosse M, Goujard F, Gallot D, Sezeur A. Traitement des occlusions aiguës par cancer du côlon gauche. Chirurgie 1989;115:123–6.
- Stephenson BM, Shandall AA, Farouk R, Griffith G. Malignant left sided large bowel obstruction managed by subtotal/total colectomy. Br J Surg 1990;77:1098–102.
- Sjödahl R, Franzen T, Nyström PO. Primary versus staged resection for acute obstructing colorectal carcinoma. Br J Surg 1992;79:685–8.
- Verhaeghe P, Stoppa R, Trinquier-Lautard JL, Abolo L. Les occlusions coliques gauches. Peut-on les traiter d'urgence en un temps? Chirurgie 1989;115:99–100.
- Carty NJ, Corder AP, Johnson CD. Colostomy is no longer appropriate in the management of uncomplicated large bowel obstruction: true of false? Ann R Coll Surg Engl 1993;75:46–51.
- Koruth NM, Krukowski ZH, Young Son GG. Intraoperation colonic migration in the management of left-sided bowel emergencies. Br J Surg 1985;72:708–11.
- Thomson WH, Carter SS. On-table lavage to achieve safe restorative rectal and emergency left colonic resection without covering colostomy. Br J Surg 1988;73:61–3.
- Pollock AV, Playforth MJ, Evans M. Peroperative lavage of the obstructed left colon to allow safe primary anastomosis. Dis Colon Rectum 1987;30:171–3.
- Duley HA, Radchiffe AG, Mc Geehan D. Intraoperative migration of the colon to permit primary anastomosis. Br J Surg 1980;67:80–1.
- Goligher JC. Treatment of carcinoma of the colon with acute obstruction. In: Surgery of the anus, rectum, and colon. 4th ed. London: Baillere Tindall, 1980;475–90.
- Hoffmann J, Jensen HE. Tube cecostomy and staged resection for obstructing carcinoma of the left colon. Dis Colon Rectum 1984;27:24–32.
- Lechaux JP, Murciano G. Traitement chirurgical des cancers obstructifs du colon gauche. Intérêt de la caecostomie latérale. Ann Chir 1986;40:463–5.
- Goldstein SD, Salvati EP, Rubin RJ, Eisenstat TE. Tube cecostomy with cecal extraperitonealization in the management of obstructing left sided carcinoma of the large intestine. Surg Gynecol Obstet 1986;162:379–80.
- Lethai B, Gugenheim J, Bismuth H. Pour la réhabilitation de la caecostomie sur drain comme traitement initial des occlusions coliques tumorales. J Chir 1987;124:346–8.
- Huber PJ, Dreicer V, Hunt J. Cecostomy revisited: still a useful operation. Dis Colon Rectum 1987;30:959–61.
- Maury D. Plaidoyer en faveur de la caecostomie. Ann Chir 1991;45:432–3.
- Brewer MS, Brewer RJ. Tube cecostomy for obstructing cancer of the left colon. J Ky Med Assoc 1993;91:14–6.
- Cecostomy is a useful surgical procedure
Diseases of the Colon & Rectum
Volume 43, Issue 1 , pp 50-54
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Colon obstruction
- Colonic cancer
- Industry Sectors