Efficacy of protective tube cecostomy after restorative resection for colorectal cancer: A randomized trial

Background: The construction of colostomy is associated with decreased physical and psychological wellbeing as well as decreased quality of life. Cecostomy is the creation of an opening in the cecum to provide colonic decompression. Objective: This work was conducted to evaluate the efficacy of tube cecostomy as an alternative to colostomy in the managing patients with left-sided colonic carcinoma and rectal cancer in terms of occurrence of postoperative morbidity and mortality and the functional outcome. Design and settings: A total number of 156 patients with colorectal cancer were enrolled in the study and were divided randomly into two equal groups. Patients: A group of 78 patients underwent tube cecostomy (group A) were compared with the other 78 patients who underwent loop colostomy (group B). The outcome parameters were the incidence of anastomotic leak, operative time, primary operation mortality rate, patient satisfaction and hospital stay. Results: The mean operating time and the mean hospital slay was significantly shorter in tube cecostomy group when compared with loop colostomy group (P < 0.05). The overall recorded morbidity for the primary operation was 12.8% and 29.5% for group A and B respectively [P >= 0.05] while the stoma related complications rate was 7.7% and 25.6% for each group respectively [P <= 0.05]. Conclusion: Performing tube cecostomy instead loop colostomy in managing patients with left-sided colonic carcinoma and rectal cancer can decrease the anticipated postoperative morbidity, lowers prolonged hospital stay and provides adequate functional outcome. Clinical trial registration: ACTRN12611000353998 http://www.anzctr.org.au/ACTRN12611000353998.aspx. (C) 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.