title: Cecostomy is a useful surgical procedure: study of 113 colonic obstructions caused by cancer.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Surgery, CHU Charles Nicolle, Rouen University Hospital, France.
authors.forename: G
authors.initials: G
authors.lastname: Perrier
authors.forename: C
authors.initials: C
authors.lastname: Peillon
authors.forename: N
authors.initials: N
authors.lastname: Liberge
authors.forename: L
authors.initials: L
authors.lastname: Steinmetz
authors.forename: L
authors.initials: L
authors.lastname: Boyet
authors.forename: J
authors.initials: J
authors.lastname: Testart
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D000768:Anesthesia, General; D000772:Anesthesia, Local; D002277:Carcinoma / Q000150:complications* / Q000601:surgery; D002423:Cause of Death; D002431:Cecostomy / Q000295:instrumentation / Q000379:methods; D003082:Colectomy; D003106:Colon / Q000601:surgery; D003108:Colonic Diseases / Q000209:etiology / Q000601:surgery*; D003110:Colonic Neoplasms / Q000150:complications* / Q000601:surgery; D003125:Colostomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology; D015996:Survival Rate