Article

Cecostomy: indications and technic.

The American Journal of Surgery (Impact Factor: 2.52). 06/1957; 93(5):865-8. DOI: 10.1016/0002-9610(57)90564-0
Source: PubMed

ABSTRACT 1.1. Cecostomy performed by the large tube technic is superior to small tube or catheter cecostomy. The cecum can be opened at the time of surgery. Healing is hastened by the use of a clamp placed on the cecum at the opening.2.2. Cecostomy is indicated as a decompressive agent in certain lesions of the proximal colon.3.3. Cecostomy is a procedure of choice in debilitated patients who may not tolerate a transverse colostomy.4.4. Cecostomy is indicated in patients who are operated upon and found to have a partial obstruction but who are otherwise suitable cases for primary resection.5.5. Cecostomy is particularly useful in patients who demonstrate evidence of a large amount of gas and/or fluid in the obstructed colon.6.6. Cecostomy is not suggested when there is need for total defunctionalization of the colon. Neither is cecostomy suggested in sigmoidal or more distal obstructions.

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    ABSTRACT: 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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