[Cecostomy can not be recommended as a routine method in the treatment of acute left-sided obstructive colon cancer]

During a period of 17 years, 135 patients with acute left-sided obstructive cancer of the colon were admitted to two hospitals in the County of Copenhagen. Primary decompression by means of coecostomy was performed. The plan was to perform resection of the tumour after some weeks and colocolic anastomosis and closure of the coecostomy either spontaneously or operatively after some months. The total mortality was 24%. A total of 84 patients (62%) completed the planned therapeutic course, 21 without complications. Eighteen patients survived with permanent coecostomies. The mortality in this material was similar to those in materials where other therapeutic regimes were employed. The prolonged therapeutic programme and considerable morbidity thus do not result in reduction in the mortality. The authors cannot therefore recommend primary decompressive coecostomy. This method can only be recommended as an emergency measure under local anaesthesia for patients in such poor general condition that other forms of treatment are not possible.