Abstract
Introduction The cecum is the first part of the large bowel. Cecectomy is a sufficient treatment
for some patients, avoiding overtreatment by ileocolic resection.
Purpose The goal of this study was to review a surgeon's experience with laparoscopic cecectomy
and provide a technical video demonstration of this uncommon operation.
Methods A retrospective chart review was conducted of all consecutive patients treated with
laparoscopic cecectomy over a 16-year period. All operations were performed using
a 3-trocar technique. The cecum was transected with 1 to 2 firings of a 60 millimeters
linear stapler, preserving the ileocecal valve and ascending colon.
Results 19 patients were identified including 12 females (63.2%). Median age was 42 years
(range 16-84). Indication for surgery included appendiceal pathology in 12 patients
(63.2%) and cecal abnormality in 7 (38.9%). There was no conversion to open surgery.
Median intraoperative blood loss was 25 ml (range 0-150 ml) and no patient received
a blood transfusion. No intraoperative or postoperative complication was noted. The
median length stay was 1 day (range 0-6). Readmission rate was 0%. Final appendiceal
histopathology revealed acute/chronic appendicitis in 5 patients, mucinous cystadenoma
in 4 patients. Cecal histopathology revealed adenoma in 4 patients. Median follow-up
was 16 months (range 4-53).
Conclusions Laparoscopic cecectomy is a sufficient treatment for some patients with benign conditions
of the appendix and cecum. It carries minimal morbidity. It should be considered as
an alternative to segmental bowel resection in a select group of patients.
Keywords
cecum - cecectomy - appendicitis - appendiceal tumors - cecal diverticulum - cecal
polyp
