Popazu Constantin, Toma Alexandra, Mihalache Daniela, Duca Oana-Monica, Firescu Dorel, Voicu Dragoș F
Faculty of Medicine and Pharmacy, "Dunărea de Jos" University of Galați, 800201 Galați, Romania.
Emergency Clinical County Hospital of Brăila, 810325 Brăila, Romania.
Life (Basel). 2025 Jan 15;15(1):101. doi: 10.3390/life15010101.
Colonic obstructions present a serious medical emergency that requires prompt surgical intervention to prevent life-threatening complications. Cecostomy, a procedure involving the creation of an opening in the cecum to decompress the colon, serves as one surgical approach for managing these obstructions. The aim of this review is to evaluate the effectiveness and benefits of cecostomies in emergency surgical settings, with a focus on recent clinical studies and case reports. Cecostomy is highlighted as a bridge procedure in cases such as obstructive carcinomas, providing data on success rates, relative survival, and clinical effectiveness. The importance of the patient's condition and surgeon expertise in selecting cecostomy as a procedure is emphasized. Further comparative research is suggested to optimize the selection criteria, providing a strong, clinically oriented conclusion.
A comprehensive literature review was conducted to identify studies and case reports focusing on the application of cecostomies in cases of acute colonic obstruction. Articles were selected based on their relevance to emergency surgery, the effectiveness of cecostomies, and patient outcomes in various clinical scenarios, including obstructive carcinomas and colonic pseudo-obstructions.
The analysis reveals that cecostomies provide rapid decompression and effective relief from colonic obstruction, particularly when immediate intervention is needed to prevent bowel perforation or ischemia. In several cases, cecostomies act as a bridge to more definitive surgical treatments, such as resection and anastomosis, and are associated with reduced morbidity and mortality. The selection of cecostomy as a preferred procedure depends on the patient's condition, location of the obstruction, and surgeon expertise.
Cecostomies play a crucial role in the emergency management of colonic obstructions, offering a viable and sometimes lifesaving alternative for rapid decompression. Understanding the indications and appropriate use of cecostomies can enhance patient outcomes and provide surgeons with effective strategies for managing acute colonic obstructions. Further research is warranted to refine selection criteria and to compare outcomes between cecostomies and other decompressive techniques in emergency settings.
结肠梗阻是一种严重的医疗急症，需要迅速进行手术干预以防止危及生命的并发症。盲肠造口术是一种在盲肠上开口以减压结肠的手术，是处理这些梗阻的一种手术方法。本综述的目的是评估盲肠造口术在急诊手术中的有效性和益处，重点关注近期的临床研究和病例报告。盲肠造口术在诸如梗阻性癌等病例中被视为一种过渡性手术，并提供了成功率、相对生存率和临床有效性的数据。强调了患者病情和外科医生专业知识在选择盲肠造口术作为手术方法时的重要性。建议进行进一步的比较研究以优化选择标准，从而得出有力的、以临床为导向的结论。
进行了全面的文献综述，以确定关注盲肠造口术在急性结肠梗阻病例中应用的研究和病例报告。根据文章与急诊手术的相关性、盲肠造口术的有效性以及在各种临床场景（包括梗阻性癌和结肠假性梗阻）中的患者结局来选择文章。
分析表明，盲肠造口术可实现快速减压并有效缓解结肠梗阻，尤其是在需要立即干预以防止肠穿孔或缺血时。在一些病例中，盲肠造口术可作为更确定性手术治疗（如切除和吻合术）的过渡，且与发病率和死亡率降低相关。选择盲肠造口术作为首选手术方法取决于患者病情、梗阻部位和外科医生的专业知识。
盲肠造口术在结肠梗阻的急诊处理中起着关键作用，为快速减压提供了一种可行且有时能挽救生命的替代方法。了解盲肠造口术的适应症和正确使用方法可改善患者结局，并为外科医生提供处理急性结肠梗阻的有效策略。有必要进行进一步研究以完善选择标准，并比较急诊情况下盲肠造口术与其他减压技术的结局。
