Abstract
We encountered 2 elderly patients aged over 90 years in whom we performed a two-stage procedure after initial decompression by cecostomy or colostomy under local anesthesia for obstructing carcinoma of the left half of the transverse colon. In the first, a 92-year-old woman, open cecostomy was performed because of unsuccessful placement of the transanal drainage tube. We performed a bypass procedure and closure of cecostomy at the second operation because of disseminated carcinoma. In the second case, a 94-year-old woman, endoscopic transanal decompression with a drainage tube was not performed in consideration of her age and general condition. Tube transversostomy was performed at the initial operation, followed by partial resection including the colostomy and anastomosis at the second. In both cases, colonic decompression was achieved by evacuation of the liquid contents by these procedures. Both patients could eat orally subsequently, and received home nursing care. In cases of unsuccessful transanal decompression who are high-risk cases for non-surgical decompression, the procedures under local anesthesia seem to be useful for successful decompression.
