In support of blind tube cecostomy in acute obstruction of the descending colon. Analysis of ninety-three emergency cecostomies.
Explore the source record for details and available documents.
Acute Disease↗
SEARCH · PubMed Health
Results for “Cecostomy”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Is tube cecostomy safe in the surgery of Hirschsprung's disease?
The use of concomitant tube cecostomy remains an option for decompression after distal large-bowel surgery but has been criticised because of a reported high complication rate. Two hundred and three patients who underwent a Soave endorectal pull-through procedure for Hirschsprung's disease (1974-1990) were evaluated. Operative technique included a modified sutured Soave endorectal pull-through procedure and a Stamm tube cecostomy utilising a large-lumen catheter. One hundred and twenty patients who had a modified two-stage procedure plus concomitant tube cecostomy were compared with 83 patients who underwent a three-stage procedure with colostomy cover. Early postoperative complications occurred in 8 patients (6.6%) in whom cecostomies were performed. A distal cuff abscess developed in 1 patient (0.8%), an anastomotic leak in 1 (0.8%) and 3 patients (2.5%) had colo-anal stenosis. The cecostomy tube dislodged in 2 patients and 1 required operative closure of a faecal fistula at the cecostomy site. Colonic venting was adequate and little nursing care was required. In 2 instances colonic distension developed after cecostomy clamping. Decompression was achieved by opening the cecostomy tube; this resulted in relief of symptoms and a good subsequent recovery. In contrast, there were 11 postoperative complications in the 83 patients undergoing a three-stage procedure (13.2%). In 2 patients (2.4%) an anastomotic leak occurred and 5 distal cuff abscesses (6%), 3 (3.6%) early strictures and 1 (1.2%) neorectal retraction developed. The use of a concomitant tube cecostomy with a two-stage Soave procedure is an effective and safe means of providing proximal colonic venting and did not add to mortality or morbidity.(ABSTRACT TRUNCATED AT 250 WORDS)
Cecostomy↗
[Is cecostomy still current for emergency relief of the colon?].
The policy of treatment in patients with acute obstruction of the left colon remains controversial. One-stage emergency colectomy and primary anastomosis is usually recommended. Is a multiple-stage approach with primary blowhole cecostomy still a valuable solution? This retrospective analysis of 117 patients with emergency cecostomies shows an overall perioperative mortality and morbidity which are favourable compared with those reported in series of similar cases treated by one-stage procedures. In all patients the colon obstruction was treated effectively by the cecostomy. Only two of the stoma-related complications required operative intervention. The second operation was performed after a mean interval of 12 days. The low perioperative mortality of 2.1% shows, that the time was successfully used to optimize the perioperative conditions. It is concluded that patients with a very poor risk may profit by preliminary decompression by blowhole cecostomy.
Aged↗
[Effect of cecostomy on the pathophysiology and prognosis of acute experimental pancreatitis].
In 76 male wistar rats with a median weight of 340 g acute pancreatitis was induced by injection of 2% sodium taurocholate into a temporarily closed duodenal loop. 40 animals received an additional cecostomy (group B), the others served as controls (group A). The postoperative figures for amylase, leucocyte count, and hemoglobin were nearly identical in both groups. According to histologic criteria acute pancreatitis was comparable in both groups, too. In nine rats endotoxin was found elevated postoperatively (13.4%). Seven animals belonged to the control (22.6%) and only two to the cecostomy group (5.6%). The difference was statistically significant (p less than 0.05). Also the differences between the median serum endotoxin levels reached statistic significance (79 ng/l in group B vs. 219 ng/l in group A). Mortality was significantly increased in endotoxin-positive animals (42.9% vs. 19.4%). Additionally, among the animals of the control group alterations of the colonic mucosa were observed more frequently than in the cecostomy group. The results are in favour of a translocation of endotoxin from the gut lumen into the circulation during acute experimental pancreatitis.
Acute Disease↗
Cecostomy revisited. Still a useful operation.
The necessity of a cecostomy in the management of large-bowel obstruction continues to be debated. Recent reviews have tended to discredit or disregard this therapeutic method in favor of the colostomy. Past criticism has focused on three central issues. First, local stomal care is difficult. Second, satisfactory bowel preparation cannot be accomplished. Third, a high incidence of surgical closure of the cecostomy is reported. In light of this continuous controversy, a retrospective review of tube cecostomies was conducted to assess the indications, morbidity, and success or failure associated with this treatment modality.
Adult↗
Percutaneous cecostomy for decompression of the massively distended cecum.
Massive dilatation of the cecum developed in an elderly man following admission for an acute episode of upper gastrointestinal hemorrhage complicated by myocardial infarction, ventricular fibrillation, and pulmonary edema. A diagnosis of pseudo-obstruction was made. After an unsuccessful attempt at colonoscopy, percutaneous cecostomy was performed under computed tomographic guidance, using trocar technique. The cecal distention resolved and did not recur. Percutaneous cecostomy is an alternative to colonoscopy and to surgical cecostomy in the treatment of massive cecal distention.
Aged↗
Tube cecostomy revisited.
A retrospective review of 59 tube cecostomies, performed between 1971 and 1981, was undertaken to evaluate current operative indications, outcome and associated morbidity. Tube cecostomy was performed as a complementary procedure in 81.4% of cases; in the other 18.6%, it represented either the only operative intervention or the initial stage of a two-stage procedure. Complications included local infection in 32% of cases, peri-catheter leak in 25%, skin excoriation in 24% and pain in 12%. Catheters remained in place an average of 14 days, but function was adequate in only 40% of cases. Cecal drainage persisted from 24 hours to 90 days after the tube was removed. Two additional procedures were required to close persistent cecal fistulas. The authors conclude that the high morbidity associated with this procedure militates against its routine use. Decompression by cecostomy may be inadequate for treating acute colonic obstruction.
Adolescent↗
Tube cecostomy as a cause of cecal pseudotumor.
A 60-year-old male presented with findings on radiographic and physical examination which were compatible with colonic obstruction. A tube cecostomy was performed. Colonoscopy seven months later revealed a pseudotumor composed of granulation tissue in the cecum at the site of the previous cecostomy.
Cecal Diseases↗
[The use of the TA-55 mechanical suturing device in the closure of the cecostomy. The authors' experience].
The authors confirm the actuality and validity of decompressive cecostomy in emergency treatment of large bowel obstructions. Taking into account that staplers have substantially reduced the rate of complications and inconvenient of gastrointestinal surgery, their use of cecostomy closure is proposed. Advantages obtained with this technique, namely lack of infections and incisional hernias, are underlined.
Acute Disease↗
Complete extraperitoneal cecostomy. An ileo-colic diversion procedure after colonic operations.
A new external diversion technique of ileo-colonic content through an extraperitoneal cecostomy is presented. This technique avoids the draw back of the classical cecostomy: intraperitoneal leakage intestinal content, reoperation for closure the stoma. The procedure is simple, easily performed and efficient in protecting the colonic anastomosis, and diverting the ileo-colonic content.
Cecostomy↗
Continent cecostomy. An account of 30 patients.
In this paper, an account is given of our experience with continent colostomy in man. In five patients, the end-sigmoidostomy was provided with an intussusception valve. Evacuation of the bowel by irrigation through a catheter was laborious and time-consuming and this method was abandoned. In another group of 30 patients, the cecum was isolated from the rest of the colon and its distal end was provided with an intussusception valve. Of the 30 patients, eight were later given continent ileostomies, two were converted to conventional sigmoidostomies, and one patient with fecal incontinence preferred to have intestinal continuity reestablished. Thus, 19 patients still have continent cecostomies and are satisfied with their function. When comparing the function of the continent cecostomy with that of the continent ileostomy, however, it is obvious that the ileostomy function is superior. The experience obtained with this group of patients has resulted in a widening of the indications for constructing a continent ileostomy, including selected patients with various anorectal disorders.
Animals↗
Transcolonoscopic extraperitoneal cecostomy. A new therapeutic and technical proposal.
The authors propose a new technique of decompression of the colon consisting in percutaneous cecostomy with previous extraperitonization of the cecum under colonoscopic orientation. The technique permits decompression of the entire colon through the insertion of a ceco-anal multiperforated Levine tube on withdrawing the colonoscope. It is a new therapeutic choice for the treatment of the Ogilvie syndrome, toxic megacolon and other morbid entities, which may permit the performance of the procedure and require decompression of the colon, which proved to be extremely effective in the treatment of a patient with the Ogilvie syndrome.
Aged↗
Percutaneous cecostomy for Ogilvie syndrome: laboratory observations and clinical experience.
Percutaneous cecostomy (PCC) was evaluated in dogs and cadavers and by means of review of intraperitoneal contrast material-enhanced computed tomographic (CT) scans and clinical experience in five patients with Ogilvie syndrome. It was shown that PCC can be accomplished with a variety of techniques (e.g. Seldinger or trocar puncture, tacking) and instruments (various types and sizes of retention and nonretention catheters). Anatomic studies revealed that the cecum is surrounded by the peritoneum for as much as 270 degrees of its circumference, so that a retroperitoneal approach to PCC would probably be unfeasible in most patients. PCC was effective in treating all five patients in this study, despite their advanced age and complicated medical conditions. Decompression of colonic gas was achieved with 8-12-F catheters, and no major complications occurred. Endoscopic decompression had been unsuccessfully attempted in four of the patients previously. It is concluded that PCC may be an important option in the treatment of Ogilvie syndrome and that the procedure may obviate surgery and be lifesaving in certain high-risk patients.
Adult↗
Percutaneous cecostomy: controlled transperitoneal approach.
The authors present two cases of percutaneous cecostomy performed with a modified approach previously described for percutaneous gastrostomy and cholecystostomy. T-fastener devices were used to affix the cecum to the anterior abdominal wall; thus, the potential problem of fecal spillage was prevented. In both cases, adequate fecal drainage was provided without complication.
Aged↗
Tube cecostomy using a wire wrapped endotracheal tube.
A modified technique of decompressing tube cecostomy for transverse and left colonic obstructions is presented, using a large (9 millimeter) wire wrapped endotracheal tube. In this limited experience with five patients, this technique has shown a low morbidity, decreased hospitalization time and has given good decompression in preparation for the definitive operation.
Aged↗
Blowhold cecostomy for cecal decompression.
Blowhole cecostomy is a method for achieving decompression of the distended cecum. Emphasis is placed on a McBurney-type incision, a watertight suture line joining bowel to muscle, and avoidance of opening the cecum until the suturing is done.
Aged↗
CT-guided percutaneous catheter cecostomy.
A patient with pseudomembranous colitis is described in whom a percutaneous cecostomy was performed using computed tomographic guidance. Several lines of evidence indicate the safety of this approach, and clinical circumstances are suggested in which the procedure may have potential therapeutic benefit.
Aged↗
Tube cecostomy with cecal extraperitonealization in the management of obstructing left sided carcinoma of the large intestine.
The technique of tube cecostomy has enabled us to manage safely and expeditiously patients with obstruction of the large intestine secondary to left sided carcinoma. Extraperitonealization of the cecum and insertion of a large bore catheter are each critical to the success of this modality.
Catheterization↗