Diseases of the Colon & Rectum

, Volume 38, Issue 5, pp 530–534 | Cite as

Cecostomy

Therapeutic indications and results
  • Joseph C. Benacci
  • Bruce G. Wolff
Original Contributions
  • 58 Downloads

Abstract

PURPOSE: The role and effectiveness of catheter tube cecostomy as a means of colonic decompression are not clearly defined. Our aim was to clarify the clinical indications, functional performance, and concomitant morbidity associated with tube cecostomy. METHOD: This was a retrospective chart review of patients receiving catheter tube cecostomy at the Mayo Clinic over an 11-year period. RESULTS: Sixty-seven patients (median age, 69 years) had catheter tube cecostomy placement. Clinical indications for tube cecostomy were colonic pseudo-obstruction, distal colonic obstruction, cecal perforation, cecal volvulus, preanastomotic decompression, and miscellaneous usage. Operation was emergent in 43 (64 percent) patients and elective in 24 (36 percent) patients. Tube cecostomy was the primary procedure in 47 (70 percent) patients and complimentary in 20 (30 percent) patients. Minor complications were seen in 30 patients (45 percent), including pericatheter leak, superficial wound infection, tube occlusion, skin excoriation, premature tube dislodgment, colocutaneous fistula, and ventral hernia. No patient required reoperation for tube-related morbidity. CONCLUSIONS: Catheter tube cecostomy is of therapeutic value in select clinical situations including refractory colonic pseudo-obstruction, cecal volvulus, cecal perforation, or distal colonic obstruction. Proper patient selection, careful tube placement, and vigilant postoperative tube care should provide adequate function with minimal morbidity.

Key words

Cecostomy Colonic decompression Colonic pseudo-obstruction Colonic obstruction Cecal perforation Cecal volvulus 

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References

  1. 1.
    Goligher JC, Smiddy FG. The treatment of acute obstruction or perforation with carcinoma of the colon and rectum. Br J Surg 1957;45:270–4.PubMedGoogle Scholar
  2. 2.
    Rosenburg L, Gordon PH. Tube cecostomy revisited. Can J Surg 1986;29:38–40.PubMedGoogle Scholar
  3. 3.
    Goldberg SM, Meese DL. Tube cecostomy. Can J Surg 1986;29:228–9.Google Scholar
  4. 4.
    Moses Y, Weissberg D, Kaufman M, Weizbard E. Acute pseudo-obstruction of the colon. S Afr J Surg 1991;29:18–20.PubMedGoogle Scholar
  5. 5.
    Rabinovici R, Simansky DA, Kaplan O, Mavor E, Manny J. Cecal volvulus. Dis Colon Rectum 1990;33:765–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Maynard AD, Turell R. Acute left colon obstruction with special reference to cecostomyversus transversostomy. Surg Gynecol Obstet 1955;100:667–74.PubMedGoogle Scholar
  7. 7.
    Campbell JA, Gunn AA, McLaren IF. Acute obstruction of the colon. J R Coll Surg Edinb 1956;1:231–9.PubMedGoogle Scholar
  8. 8.
    Hughes ES. Cecostomy: a part of an efficient method of decompressing the colon obstructed by cancer. Dis Colon Rectum 1963;53:454–6.Google Scholar
  9. 9.
    Gerber A, Thompson RJ. Use of tube cecostomy to lower the mortality in acute large intestinal obstruction due to carcinoma. Am J Surg 1965;110:893–6.CrossRefPubMedGoogle Scholar
  10. 10.
    King RD, Kaiser GC, Lempke RE, Shumaker HB. An evaluation of catheter cecostomy. Surg Gynecol Obstet 1966;123:779–86.PubMedGoogle Scholar
  11. 11.
    Jackson PP, Baird RM. Cecostomy: an analysis of 102 cases. Am J Surg 1967;114:297–301.PubMedGoogle Scholar
  12. 12.
    Chaitin H. Value of complementary cecostomy in geriatric surgery. Geriatrics 1967;22:148–9.Google Scholar
  13. 13.
    Hopkins JE. Tube cecostomyan appraisal. Dis Colon Rectum 1969;12:379–85.PubMedGoogle Scholar
  14. 14.
    Westdahl PR, Russell T. In support of blind tube cecostomy in acute obstruction of the descending colon. Am J Surg 1969;118:577–81.CrossRefPubMedGoogle Scholar
  15. 15.
    Balslev I, Jensen HE, Nielsen J. The place of cecostomy in the relief of obstructive carcinoma of the colon. Dis Colon Rectum 1970;13:207–10.PubMedGoogle Scholar
  16. 16.
    Clark DD, Hubay CA. Tube cecostomy: an evaluation of 161 cases. Ann Surg 1972;175:55–61.PubMedGoogle Scholar
  17. 17.
    Smith WR, Goodwin JN. Cecal volvulus. Am J Surg 1973;126:215–22.PubMedGoogle Scholar
  18. 18.
    Stainback WC, Christiansen KH, Salva JB. Complementary tube cecostomy. Surg Clin North Am 1973;53:593–601.PubMedGoogle Scholar
  19. 19.
    Melzig EP, Terz JJ. Pseudo-obstruction of the colon. Arch Surg 1978;113:1186–90.PubMedGoogle Scholar
  20. 20.
    Hopkins JE. Acute colon obstruction-cecostomy of colostomy? Am J Proctol Gastroenterol Colon Rectal Surg 1979;30:24–8.Google Scholar
  21. 21.
    Jordan MH, Sessions HR, Smith LE. A new look at tube cecostomy. Mil Med 1979;144:167–8.PubMedGoogle Scholar
  22. 22.
    Wolff LH, Wolff WA, Wolff LH. A Re-evaluation of tube cecostomy. Surg Gynecol Obstet 1980;151:257–9.PubMedGoogle Scholar
  23. 23.
    Hoffman J, Jensen HE. Tube cecostomy and staged resection for obstructing carcinoma of the left colon. Dis Colon Rectum 1984;27:24–32.PubMedGoogle Scholar
  24. 24.
    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.PubMedGoogle Scholar
  25. 25.
    Huber PJ, Dreicer V, Hunt J. Cecostomy revisited-still a useful option. Dis Colon Rectum 1987;30:959–61.PubMedGoogle Scholar
  26. 26.
    Eisenstat S. Tube cecostomy using a wire wrapped endotracheal tube. Surg Gynecol Obstet 1988;166:473–4.PubMedGoogle Scholar
  27. 27.
    Law NW, Ellis H. Caecostomy in the management of the sloughed appendix: a report of two cases. J R Coll Surg Edinb 1990;35:311.PubMedGoogle Scholar
  28. 28.
    Moore SW, Millar AJ, Rode H, Cywes S. Is tube caecostomy safe in the surgery of Hirschsprung's disease? S Afr J Surg 1992;30:114–7.PubMedGoogle Scholar

Copyright information

© American Society of Colon and Rectal Surgeons 1995

Authors and Affiliations

  • Joseph C. Benacci
    • 1
  • Bruce G. Wolff
    • 1
  1. 1.Division of Colon and Rectal SurgeryMayo Clinic, and Mayo FoundationRochester

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