Colectomy

Colectomy

A colectomy is a surgical procedure used to treat colon diseases.

These include cancer, inflammatory disease, or diverticulitis. The surgery involves removing a portion of the colon, which is part of the large intestine.

When treating cancer, the surgeon will typically remove the portion of the colon that appears cancerous.

He or she will also remove another small portion on either side of the cancerous part and some nearby lymph nodes.

The remaining parts of the colon are then attached to each other, or a stoma (an opening to the outside of the body) is created. This is called a colostomy. 

A colectomy can be done in two ways:

• Open colectomy. The traditional procedure is an open colectomy. This involves a long, vertical incision on your stomach so that the surgeon can get to the colon.

• Laparoscopic-assisted colectomy. The newer form of colectomy is a laparoscopic-assisted colectomy. This involves only small incisions, and a tiny video camera is inserted into one of the incisions to help the surgeon see the area being worked on. This may be a choice for some cancers. People often have less pain and recover quicker from this type of surgery because of the smaller incisions. 

Reasons for the procedure

A colectomy is usually performed if colon cancer is caught in its earlier stages. Sometimes even when the cancer has progressed beyond the early stages, a more extensive colectomy can be a choice.

Your healthcare provider will recommend a colectomy if your medical team has determined that this surgery will give you the best chance of survival or improving your quality of life.

Risks of the procedure

Colectomy is generally regarded as a fairly safe procedure. Still, as with any surgery, it carries some possible risks. Be sure to discuss any concerns with your healthcare provider before the procedure.

Some possible risks of a colectomy include:

• Reactions to anesthesia

• Blood clots in the legs or lungs

• Internal bleeding

• Infection at the skin incision site or in the stomach

• Hernia

• Scar tissue (adhesions) in the stomach, which might block the intestines

• A leak where the intestines are sewn together

• Damage to nearby organs

Before the procedure

Here is what to expect before surgery:

• It is important that the bowels be empty when the surgery is performed. You must follow your healthcare provider's instructions on dietary changes and liquid intake on the days leading up to surgery.

• A day or two before the procedure, your healthcare provider may give you a bowel preparation that includes laxatives and enemas.

• The day before the procedure, you may be instructed to only drink clear liquids or broth. You may also be told not to have any food or beverages at all up to 12 hours before the procedure. 

• Your healthcare provider may ask you to stop taking certain medicines (especially any blood-thinning drugs) during the week leading up to the surgery.

Based on your medical condition, your healthcare provider may request other specific preparations.

During the procedure

Here is what to expect during surgery:

• You will receive general anesthesia before the surgery, and you will be completely asleep during the procedure.

• Your surgeon will make a long cut on your stomach if performing an open colectomy or several smaller incisions for a laparoscopic-assisted colectomy.

• The surgeon will use surgical tools to remove the targeted portion of your colon.

• The two open ends of the colon will be attached, or a stoma will be created.

• The lymph nodes near the site of the cancer will also be removed at this time. Surgeons often remove at least 12 of these lymph nodes.

• Once the surgery is complete, the stomach incision is closed.

After the procedure

A colectomy is a major surgical procedure and you will probably be in the hospital for 3 to 7 days. You'll likely also need to take pain medicine for several days. You may be allowed some limited liquids as the colon begins to recover.

After a few days, you should be able to start on solid food again. Your healthcare provider will schedule follow-up appointments to check on your progress.

Be sure you know what to look for in terms of complications or side effects after surgery, and whom you should call if you notice any problems. Watch your wounds for any sign of swelling, redness, bleeding, or discharge. Let your healthcare providers know about any increasing pain, chills or fever, or shortness of breath.