Cecostomy. Therapeutic indications and results.
OBJECTIVE
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.


METHODS
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 dislodgement, 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.
Benacci
J C
JC
Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
Wolff
B G
BG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects; D002408:Catheters, Indwelling / Q000009:adverse effects; D002429:Cecal Diseases / Q000601:surgery; D002431:Cecostomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D002432:Cecum / Q000601:surgery*; D002648:Child; D003108:Colonic Diseases / Q000601:surgery; D017577:Cutaneous Fistula / Q000209:etiology; D005260:Female; D006555:Hernia, Ventral / Q000209:etiology; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology; D007415:Intestinal Obstruction / Q000601:surgery; D007416:Intestinal Perforation / Q000601:surgery; D007418:Intestinal Pseudo-Obstruction / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology