Colectomy
all information

Colectomy

(Total Colectomy; Partial Colectomy; Colon Removal)

Pronounced: ko-LEK-tuh-mee

En Español (Spanish Version)

Definition

An operation to remove all or part of the colon. The colon, or large intestine, is the lower part of the intestines.

Colectomy

colectomy colon

© 2008 Nucleus Medical Art, Inc.

Parts of the Body Involved

  • All or part of the colon

Reasons for Procedure

Colectomy is performed to treat a variety of conditions, including the following:

Risk Factors for Complications During the Procedure

  • Having neurological, cardiovascular, or respiratory conditions
  • Age: older than 70 years
  • Obesity
  • Smoking
  • Previous abdominal surgery
  • Acute perforation or infection

What to Expect

Prior to Procedure

Your doctor will likely do the following:

  • Physical exam
  • Blood tests
  • Ultrasound exam of the abdomen—a test that uses sound waves to visualize the inside of the abdomen
  • Barium X-ray —x-ray exam of the abdomen, after swallowing a barium drink and/or receiving a barium enema
  • CT Scan —a type of x-ray that uses a computer to make pictures of the inside of the body
  • MRI Scan —a test that uses magnetic waves to make pictures of the inside of the body
  • Colonoscopy with biopsy samples—visual exam and removal of tissue inside of the large intestine using a flexible tube that is attached to a light and a viewing device

In the days leading up to your procedure:

  • Drink at least eight, 8-ounce glasses of water daily.
  • Follow a special diet, if recommended by your surgeon.
  • Follow your doctor’s instructions for cleansing your colon.
  • Take antibiotics, if prescribed by your doctor.
  • You may need to shower the night before your procedure using antibacterial soap.
  • Arrange to have someone drive you to and from the procedure, and for help at home.
  • The night before, eat a light meal or drink clear liquids as directed, and do not eat or drink anything after midnight unless told otherwise by your doctor.
  • Wear comfortable clothing.

Anesthesia

You will receive general anesthesia for the surgery.

Description of the Procedure

The surgery will be done one of two ways:

  • Open colectomy—surgeon makes a single long incision
  • Laparoscopic colectomy—several smaller incisions to allow special instruments to be used

In a partial colectomy, only part of your colon is removed. Your surgeon sews the open ends of the intestine together after the central portion has been removed.

In a total colectomy, all of your colon is removed. A colostomy or ileostomy will need to be done to create a path for waste to leave your body.

Your surgeon makes a small opening, called a stoma, in the front of your abdominal wall. The open end of your intestine is then pulled through the abdominal wall and attached to the skin. Your waste will exit your body through this opening. You will wear a pouch, or an ostomy bag, on the outside of your body, where waste material will be collected. The stoma may be either temporary or permanent.

Colostomy Pouch

colostomy pouch

© 2008 Nucleus Medical Art, Inc.

A colostomy or ileostomy may also be done if your intestine needs time to heal and rest after a partial colectomy.

Your surgeon will close the muscles and skin of the abdomen with stitches or staples, and applies a sterile dressing.

After Procedure

The removed tissue will be sent to a lab for examination.

How Long Will It Take

The procedure takes 1 to 4 hours or more.

Will It Hurt?

Anesthesia is given to prevent pain during the surgery. Pain is common during recovery. You will receive medicine to help manage the pain.

Possible Complications

  • Damage to neighboring organs or structures
  • Infection
  • Bleeding
  • Hernia at the incision site
  • Blood clots in the vein ( phlebitis ) that may travel to the lungs ( pulmonary embolism )
  • Hematoma (accumulation of blood in the wound)
  • Pneumonia and other risks of general anesthesia

Average Hospital Stay

5 to 6 days

Postoperative Care

You will receive instructions about diet and activity. During the first few days after surgery, you may be restricted from eating. You will need to take it easy for 1 to 2 months.

If you have a colostomy:

  • A specialized nurse will teach you how to care for the stoma site and change the ostomy bag
  • You will progress from a clear liquid to a bland, low-fiber diet; avoid high-fiber foods, including corn, celery, apples, nuts, popcorn, grapes, and other foods with hulls, peels, and seed
  • You will likely be able to return to your regular diet 6 to 8 weeks after surgery
  • Alert your physicians and pharmacist that you cannot take medications that are considered time-released or time-sustained
  • Do not use laxatives because postcolostomy stools are usually quite liquid
  • Drink eight, 8-ounce glasses of liquid daily because extra fluids will be lost in your stool

Outcome

The outcome varies depending on why you had the colectomy. If you have colon cancer and the entire cancerous area is removed with a colectomy, your outcome is good. A colectomy may also reduce your risk of developing colon cancer if you had it to treat a precancerous condition, including familial polyposis, ulcerative colitis , or colon polyps . Most people who have colectomies go on to live normal, active lives, and the colon adapts to return bowel activity to normal.

Call Your Doctor If Any of the Following Occurs

It is essential for you to check your recovery once you leave the hospital. Alert your doctor to any problems. If any of the following occur, call your doctor:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • Cough, shortness of breath, chest pain, or severe nausea or vomiting
  • Pain, burning, urgency, frequency of urination, or persistent bleeding in the urine
  • Pain and/or swelling in your feet, calves, or legs, or sudden shortness of breath or chest pain
  • Diarrhea
  • Blood in your stool, or black, tarry stools
  • Severe abdominal pain
  • Feeling weak or dizzy
  • Irregular urination
  • Bleeding from the stoma
  • Not collecting stool in the ostomy pouch

RESOURCES:

American Cancer Society
http://www.cancer.org

American Society of Colon and Rectal Surgeons
http://www.fascrs.org

National Cancer Institute
http://www.cancer.gov

CANADIAN RESOURCES:

The Canadian Association for Enterostomal Therapy
http://www.caet.ca/

Colorectal Cancer Association of Canada
http://www.colorectal-cancer.ca/

References:

A patient guide to colostomy care. Northwestern Memorial Hospital website. Available at: http://www.nmh.org/nmh/patientinformation/patientguidecolostomycare.htm . Accessed July 16, 2008.

Alves A, Panis Y, Mathieu P, et al. Postoperative mortality and morbidity in French patients undergoing colorectal surgery: results of a prospective multicenter study. Archives of Surgery . 2005;140:278-283.

Dictionary of cancer terms. National Cancer Institute website. Available at: http://www.cancer.gov/dictionary/ . Accessed July 16, 2008.

Feo CV, Zerbinati A, Giacometti M, et al. The ideal length of hospital stay in the surgical treatment of colorectal cancer. Ann Ital Chir . 2002;73:13-16.

Perioperative management. American Society of Colon and Rectal Surgeons website. Available at: http://www.fascrs.org/displaycommon.cfm?an=1&subarticlenbr=127 . Accessed September 24, 2005.

What is the treatment for Crohn’s disease? National Digestive Diseases Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/#treat . Accessed July 16, 2008.



Last reviewed November 2007 by Daus Mahnke, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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