[Cecostomy in the treatment of large intestine ileus]

Large bowel decompression by simple coecostomy is not generally accepted. As this procedure is our method of choice in all suitable cases, we have checked the results. From 1.11.1971 to 31.3.1979 a coecostomy was performed in 44 patients presenting with uncomplicated colonic obstruction. The operation was done through an ileocoecal muscle split incision without an exploratory laparotomy. The coecum was primarily opened and sutured to the skin. There were 38 carcinomas, one actinic sigmoid stenosis and one pancreatitic stenosis. In four cases further investigations did not show any mechanical bowel obstruction. In 37 patients there was a secondary laparotomy. In 34 patients the stenotic area was resectable. The coecostomy could be closed in 39 cases and was removed with the resected specimen in one case. Overall-lethality was 4/44, the lethality of mechanical large bowel obstruction was 4/40 or 10% respectively. Three patients died of metastatic carcinomas, one patient of thromboembolic complications. The coecostomy always was successful in decompressing the dilated bowel. The morbidity was negligible (one abscess after closure of the stoma with cicatricial herniation later on.