Tube cecostomy revisited.

A retrospective review of 59 tube cecostomies, performed between 1971 and 1981, was undertaken to evaluate current operative indications, outcome and associated morbidity. Tube cecostomy was performed as a complementary procedure in 81.4% of cases; in the other 18.6%, it represented either the only operative intervention or the initial stage of a two-stage procedure. Complications included local infection in 32% of cases, peri-catheter leak in 25%, skin excoriation in 24% and pain in 12%. Catheters remained in place an average of 14 days, but function was adequate in only 40% of cases. Cecal drainage persisted from 24 hours to 90 days after the tube was removed. Two additional procedures were required to close persistent cecal fistulas. The authors conclude that the high morbidity associated with this procedure militates against its routine use. Decompression by cecostomy may be inadequate for treating acute colonic obstruction.