Other surgical procedures include duodenopexy, cecopexy
, and adhesiolysis (8).
In the current surgical perspective, surgical procedures in cecal volvulus are hemocolectomy, detorsion, cecopexy
and cecostomy operations performed with open or laparoscopic methods.
If a patient with mobile cecum syndrome has recurrent symptoms or volvulus, the treatment of choice is cecopexy using lateral peritoneal flap (1,3).
Laparoscopic cecopexy for mobile cecum syndrome manifesting as cecal volvulus: report of a case.
(18%), right Hemicolectomy with primary anastomosis (63.63%) and Ileostomy with mucous fistula (18%) were offered.
Options for the management of cecal volvulus include endoscopic decompression, surgical detorsion alone, cecopexy, cecostomy, and right colectomy with primary or delayed anastomosis or proximal stoma--all through open or minimally invasive approaches.
With increasing use of minimally invasive techniques, the morbidity associated with cecopexy may decrease, although its effect on long-term recurrence remains to be seen. Cecostomy has been associated with even higher complication rates more than 50% in some series and has largely been abandoned. More often, surgical resection with primary anastomosis has become the mainstay of therapy, with low morbidity and mortality and recurrence rates <10%.
Conservative management is not recommended because of the high risk of ischemia, and surgical detorsion alone carries a high rate of recurrence (20%-75%). Retrospective case series have shown the lowest morbidity and recurrence with surgical cecal resection, as opposed to alternative procedures such as cecopexy and cecostomy. Early surgery is the rule.
, cecostomy, and resection are all surgical options.
The options for the management of the cecocolic volvulus include: endoscopic decompression, surgical detorsion alone, cecopexy, cecostomy, and right colectomy with primary anastomosis or stoma formation with delayed anastomosis--through open or minimally invasive approaches.
Laparoscopic cecopexy for mobile cecal syndrome manifesting as cecal volvulus: report of a case.