Cecostomy

Abstract

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.

Secretory diarrhea and hypokalemia associated with colonic pseudo‐obstruction: A case study and systematic analysis of the literature

“…or subcutaneous neostigmine were successful in only 17% of patients with SD‐CPO, significantly lower compared to C‐CPO. Similarly, decompressive colonoscopy with tube placement was less effective in SD‐CPO compared to C‐CPO (successful in 84%‐88% of cases), and surgical cecotomy was ineffective in one case of SD‐CPO in contrast to the majority of C‐CPO patients in the pooled results from major studies . All these features suggest that SD‐CPO is a more severe form of CPO, with profound hypokalemia potentially contributing to the inadequate response to neostigmine administration, as documented in the literature …”

An Alternative Approach to the Terminal Management of Ogilvie Syndrome

“…This is advantageous as it allows decompression of the large bowel and can be performed outside of the operating room in severely ill patients. Additionally, this method has proven efficacious in most reported cases [10, 11]. The most aggressive treatment, including the definitive treatment in our patient, involves subtotal or total colectomy with ileostomy.…”

“…A 1995 review of tube cecostomies used for the treatment of mechanical and pseudo-obstruction of the colon showed high complication rates. In a review of 67 patients, 45% had minor complications following placement of a tube cecostomy, including infection, occlusion, and premature dislodgment [11]. However, reoperation was not required in any of these patients, demonstrating both the success of this method and the lack of severe complications.…”

Primary cecal pathologies presenting as acute abdomen and critical appraisal of their current management strategies in emergency settings with review of literature

“…Benacci and Wolff defined the use of cecostomy 1995 for the following indications – colonic pseudo-obstruction, distal colonic obstruction, cecal perforation, cecal volvulus, preanastomotic decompression, and miscellaneous usage. [ 54 ] However, in the current day practice, cecostomy is no longer used for any of the above-mentioned indications. The only frequently required indication for cecostomy (open/laparoscopic) today is in children and includes: intractable fecal incontinence (as seen in cases of myelomeningocele, anorectal malformations, caudal regression syndrome, and Hirschsprung disease with encephalopathy with convulsions) and constipation with encopresis (as seen in sacrococcygeal teratoma and patients of cerebral palsy and acquired megarectum with psychiatric and social disorders).…”