Summary
Tube cecostomy as anelective and as anemergency surgical procedure has been reviewed. Although the number of cases in each group is small, decompression has been entirely effective with care in technic and postoperative management.
In selected cases elective cecostomy is simple, rapid and safe, with very low morbidity and mortality rates.
The incidence of cancer of the large bowel is increasing. A growing number of cases will be those of elderly poor-risk patients with acute obstruction which will require emergency decompression. Tube cecostomy should be in the armamentarium of all surgeons, and should be included in the surgical resident’s training, with emphasis on the need for close attention to detail in the postoperative period. Decompression and subsequent preparation of the bowel for elective resection have been completely satisfactory. Morbidity is low, and no deaths in the emergency group were directly related to the cecostomy.
In the cases reviewed here the five-year survival rate after emergency cecostomy for acute obstructing primary cancer of the colon followed by resection and recovery was 50 per cent.
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References
Albers, J. H., and L. I. Smith: A comparison of cecostomy and transverse colostomy in complete colon obstruction. Surg. Gynec. Obstet.95: 410, 1952.
Baronofsky, I. D.: Primary resection and aseptic end-to-end anastomosis for acute or subacute large bowel obstructions. Surgery.27: 664, 1950.
Barrkman, M. F.: Intestinal explosion after opening a caecostomy with diathermy. Brit. Med. J.1: 1594, 1965.
Chang, W. Y. M., and W. E. Burnett: Complete colonic obstruction due to adenocarcinoma. Surg. Gynec. Obstet.114: 353, 1962.
Florer, R. E.: Cecostomy: Indications and technic. Am. J. Surg.93: 865, 1957.
Floyd, C. E., and I. Cohn, Jr.: Obstruction in cancer of the colon. Ann. Surg.165: 721, 1967.
Gerber, A., and R. J. Thompson, Jr.: Use of a tube cecostomy to lower the mortality in acute large intestinal obstruction due to carcinoma. Am. J. Surg.110: 893, 1965.
Gerber, A., R. J. Thompson, Jr., O. K. Reiswig, and R. S. Vannix: Experiences with primary resection for acute obstruction of the large intestine. Surg. Gynec. Obstet.115: 593, 1962.
Hickey, R. C., and H. P. Hyde: Neoplastic obstruction of the large bowel. S. Clin. N. Amer.45: 1157, 1965.
Jackson, P. P., and R. M. Baird: Cecostomy: An analysis of 102 cases. Am. J. Surg.114: 297, 1967.
King, R. D., G. C. Kaiser, R. E. Lempke, and H. B. Schumacker, Jr.: An evaluation of catheter cecostomy. Surg. Gynec. Obstet.123: 779, 1966.
Minster, J. J.: Comparison of obstructing and nonobstructing carcinoma of the colon. Cancer.17: 242, 1964.
Prioleau, W. H.: Appendico-cecostomy in cases of advanced appendicitis (editorial). Virginia Med. Monthly.93: 59, 1966.
Rosemond, G. P., W. E. Burnett, and F. N. Cooke: One stage end-to-end anastomosis of the colon: An analysis of the complications in 79 cases with a comparison of open and aseptic types of anastomoses. Surg. Gynec. Obstet.88: 209, 1949.
Stainback, W. C., and K. H. Christiansen: The value of Foley catheter cecostomy in conjunction with resection of the left colon and rectosigmoid. S. Clin. N. Amer.42: 1475, 1962.
Wangensteen, O. H.: Intestinal Obstructions: A Physiological and Clinical Consideration with Emphasis on Therapy; Including Description of Operative Procedures. Ed. 2. Springfield, Charles C Thomas, 1942, 484 pp.
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Read at the Meeting of the Philadelphia Academy of Surgery, Philadelphia, Pa., October 7, 1968.
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Hopkins, J.E. Tube cecostomy—An appraisal. Dis Colon Rectum 12, 379–385 (1969). https://doi.org/10.1007/BF02617752
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DOI: https://doi.org/10.1007/BF02617752