A novel technique to relieve a closed-loop obstruction secondary to a competent ileocecal valve and an unresectable mid-colon tumor.
A competent ileocecal valve complicates the surgical treatment of an unresectable obstructing mid-colon tumor. Specifically, it may not be feasible to bypass with a colocolotomy, especially when the sigmoid colon has limited mobility or if the ascending colon is severely distended and edematous. A technique is described in which the closed loop obstruction is relieved at its proximal extent by an ileocecal valvuloplasty. A circular stapling device is fired across the ileocecal valve. Once the ileocecal valve is rendered competent, a loop ileostomy or a colocolotomy can be constructed, providing effective palliation for this difficult situation.
McKay
Andrew
A
Department of Surgery, University of Calgary, Calgary, AB, Canada.
Bathe
Oliver F
OF
D003110:Colonic Neoplasms / Q000150:complications*; D019299:Decompression, Surgical / Q000379:methods*; D013505:Digestive System Surgical Procedures; D006801:Humans; D007080:Ileocecal Valve / Q000601:surgery*; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D010166:Palliative Care; D013528:Surgical Staplers