Tube cecostomy and staged resection for obstructing carcinoma of the left colon

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Abstract
Over a 17-yr period, all patients presenting with acute obstruction of the left colon due to carcinoma were treated by emergency tube cecostomy. There were 57 patients aged between 35-93 yr. After the decompressive procedure, 8 died, 34 had complications and 8 were left with permanent cecostomies. Patients (41) underwent secondary procedures, of which 35 had resections. Seven patients died postoperatively; 15 had complications. Of the 34 survivors, in 23 the cecostomy closed spontaneously; 11 had operative cecostomy closure. Of the latter, 4 died postoperatively; 9 had complications. Thus, 30 survived the entire treatment program. Reasons for the high morbidity and mortality are discussed. Comparison is made with other forms of treatment in the literature. A treatment program is suggested, using tube cecostomy for poor-risk patients and primary resection without anastomosis for patients in better condition.

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