Cecostomy

Now infrequently performed, cecostomy is used as a temporary treatment for distal colonic obstruction, usually carcinoma, or severe colonic ileus in patients deemed to be poor surgical candidates for colostomy or more definitive procedures. Traditionally, a tube is placed in the cecum and brought to the surface of the anterior abdominal wall under local or general anesthesia. The gastroenterologist and interventional radiologist are now performing this procedure as well. Mortality in a series of 113 patients who underwent cecostomy for obstructing colon cancer, was found to be comparable to that for patients undergoing diverting loop colostomy, but there was a decrease in mortality for the second operation [52]. Complications from the procedure include displacement of the catheter out of the cecum (Fig. 6.33).

Figure 6.33. Cecostomy with displacement of the tube outside the cecum. Coned-down view from a contrast enema showing the cecostomy tube to be displaced outside the cecum in a tract connected with it.

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