Pronounced: ko-LEK-tuh-meeEn Espaol (Spanish Version)
An operation to remove all or part of the colon. The colon, or large intestine, is the lower part of the intestines.
This procedure involves all or part of the colon.
Colectomy is performed to treat a variety of conditions, including the following:
- Having neurological, cardiovascular, or respiratory conditions
- Age: older than 70 years
- Previous abdominal surgery
- Acute perforation or infection
Your doctor will likely do the following:
- Physical exam
- Blood tests
- Ultrasound exam of the abdomena 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 samplesvisual 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 doctors instructions for cleansing your colon; this may include enemas, laxatives, drinking a special liquid preparation, and/or a clear-liquid diet.Take antibiotics, if prescribed by your doctor.If your doctor asks you 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. AnesthesiaYou will receive general anesthesia for the surgery. Description of the ProcedureThe surgeon makes a single long incision (open colectomy) or several smaller incisions (laparoscopic colectomy) in your abdomen.If only part of your colon is removed (partial colectomy), your surgeon sews the open ends of the intestine together after the central portion has been removed.If all of your colon is removed (total colectomy), or your surgeon determines your intestine needs time to heal and rest after the procedure, you may need a colostomy or ileostomy.In a colostomy or ileostomy procedure, 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.
After the procedure is complete, your surgeon closes the muscles and skin of the abdomen with stitches or staples, and applies a sterile dressing. Surgical Bowel Resection and Colostomy 2008 Nucleus Medical Art, Inc. After ProcedureThe portion of the colon that was removed will be sent to a pathologist for examination. How Long Will It TakeThe procedure takes 1 to 4 hours or more. Will It Hurt?Anesthesia prevents pain during surgery. Patients typically experience pain during recovery, but receive pain medication to relieve the discomfort. Possible ComplicationsDamage to neighboring organs or structuresInfectionBleedingHernia at the incision site Blood clots in the vein (phlebitis) that may travel to the lungs (embolism)Hematoma (accumulation of blood in the wound)Pneumonia and other risks of general anesthesia Average Hospital StayThis surgery typically requires 5 to 6 days of recovery in the hospital. Postoperative CareYou will receive instructions about when and what you can eat, and how you need to restrict your 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, as you recover from your surgery. If you have a colostomy:
A specialized nurse or your surgeon will teach you how to care for the stoma site and change the ostomy bag.In the first days after your operation, you will progress from a clear liquid to a bland, low-fiber diet. During this time, you should avoid high-fiber foods, including corn, celery, apples, nuts, popcorn, grapes, and other foods with hulls, peels, and seeds. 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 monitor your recovery once you leave the hospital. That way, you can alert your doctor to any problems immediately. If any of the following occur, call your doctor: Signs of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or discharge from the incision siteCough, shortness of breath, chest pain, or severe nausea or vomitingPain, burning, urgency, frequency of urination, or persistent bleeding in the urinePain and/or swelling in your feet, calves, or legs, or sudden shortness of breath or chest painDiarrheaBlood in your stool, or black, tarry stoolsSevere abdominal painFeeling weak or dizzyIrregular urinationBleeding from the stomaNot collecting stool in the ostomy pouch RESOURCES: American Cancer Societyhttp://www.cancer.org American Society of Colon and Rectal Surgeonshttp://www.fascrs.org National Cancer Institutehttp://www.cancer.gov CANADIAN RESOURCES: BC Health Guide, British Columbia Ministry of Healthhttp://www.bchealthguide.org Canadian Society of Colon and Rectal Surgeonshttp://www.colon-rectalsurgery.org/index.htm References: 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 September 24, 2005. 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. A patient guide to colostomy care. Northwestern Memorial Hospital website. Available at: http://www.nmh.org/nmh/patientinformation/patientguidecolostomycare.htm . Accessed September 28, 2005. 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 Crohns disease? National Digestive Diseases Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/#treat . Last reviewed November 2007 by Daus Mahnke, MDPlease 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.