Colectomy is a medical procedure that is used for the removal of the whole colon or some of its parts. The part of the large intestine, the colon is a long tube-like structure at the end of the GIT. Colectomy is a necessity when there is any colon-related disease.
There are many different types of colectomy operations:
Removal of the enter colon is called total colectomy
Removal of any specific part of the colon is called partial colectomy
Removal of the right or left part of the colon is called hemicolectomy
Removal of colon and rectum both is called proctocolectomy
Typically a colectomy operation requires many other surgeries to reconnect the left portion of the body and allows waste to exit the body.
Why it is needed?
Colectomy is used for the treatment of diseases that are associated with the colon, for example:
Uncontrolled bleeding: In case of intense and nonstop bleeding from the colon may need an operation for the removal of any specific portion of the colon.
Bowel blockage: If you have a blocked or obstructed colon, it indicates an emergency condition. In this case, a partial or complete colectomy is required, depending on your health condition.
Colon Cancer: If your cancer is at a very early stage then removing only a small portion of the colon would be enough. Cancer at the later stages needs surgery that involves more portion of the colon.
Crohn’s disease: Since there is no actual cure for Crohn’s disease but if you observe that medication is not enough for you then removal of some portions or parts of the colon may relieve the symptoms. If there is evidence of precancerous during the colonoscopy then colectomy can be a better choice.
Ulcerative colitis: If medication is not working in case of ulcerative colitis then proctectomy or colectomy may be advised to control the symptoms.
Diverticulitis: Your PCP may recommend a colectomy in case of diverticulitis.
Precautionary Surgery: If you have a higher chance to develop colon cancer because of several precancerous polyps, your surgeon may advise you to have a colectomy to prevent colon cancer in the future.
What are the risks of having colectomy?
There are many risks related to colectomy. The chances for these risks and complications are dependent upon your medical condition and the type of your colectomy.
Some common risks are:
Loss of blood
Formation of blood clots in the legs (thrombosis) or the lungs (pulmonary embolism).
Damage to nearby organs, like bladder or small intestines
Cuts or tears in the sutures that rejoins the remaining parts of the digestive system
You need to stay in the hospital for few days after your surgery while your digestive system heals completely. Your healthcare experts will keep you under strict observation and they will take care of any complication following the surgery. You may require staying in the hospital for few days to a week.
How can you prepare for the colectomy?
Before some days of your colectomy, you may need to follow these guidelines:
Stop taking some specific medicines: Some medicines develop the chances of more complications during the surgery that is why the surgeon advice to quit those medicines some days before the surgery.
Don’t eat anything: You should fast before the surgery. Your surgeon will recommend you stop eating and drinking many hours before the surgery.
Use laxatives or enema: It is advised to drink laxatives mixed with plain water. It will help to cleanse the bowel completely. This will lower the chances of any complexity during the surgery.
Use specific antibiotics: You are allowed to take antibiotics some days before your surgery. This will prevent any kind of bacterial or fungal infection and lower the chances of complications.
How can you plan your stay at the hospital?
You will need to stay in the hospital to avoid any complications and for the proper healing of the digestive tract. Your stay at the hospital depends on your condition. You should arrange a person that could help you at home and the workplace.
There are some specific items that you may need during your stay at the hospitals, such as:
A robe and the slippers
Toothbrush, toothpaste, and in the case of men your shaving supplies
Casual clothes
Some magazines or books to pass your time.
What can you expect?
During the colectomy:
On the day of your colectomy, you will be taken to the preparation room. The nurse will check your blood pressure, temperature, and breathing rate. In some cases, an antibiotic is given through the arm.
Then you will be taken to Operation Theater and anesthesia will be given so that you will feel no pain.
Colon surgery can be performed in two ways:
Open colectomy: In this type of colectomy a single and long incision is made throughout the stomach till the colon. Then the surgeon removes either the whole colon or some parts of the colon using some special surgery equipment.
Laparoscopic colectomy: In this type of surgery, surgeons make small and several incisions to access the colon. Then a small camera is inserted through one incision and the other incision is used for the insertion of surgical equipment.
The camera allows the surgeon to watch the movements of surgical instruments in the abdomen. Then colon is brought out using another small incision, This type of surgery enables the surgeon to operate the colon outside the body. After the completion of the procedure, the colon is inserted back into the abdomen.
It depends on your health condition that which type of surgery will be best for you. Laparoscopic surgery saves time and lowers the pain. But not everyone is eligible for this type of surgery. In some cases, the surgeons start with laparoscopic surgery and end at open colectomy due to different situations.
The digestive system is reconnected when the colon is removed or repaired, this allows the normal expel of the bowel contents. Some options are:
Reconnecting the remaining part of the colon: your surgeon might sew the remaining part of your colon or in some cases colon can be reconnected with the small intestine, forming an anastomosis. Then your feces leaves the body just like before.
Reconnecting the intestine to an orifice formed in your abdomen: Your surgeon may perform Ostomy. This means he might bring the ileum or colon to a hole that is created in the abdomen and it is called a stoma. Then the waste leaves the body through this stoma.
Connecting the small intestine with the anus: After the removal of the colon and rectum; the surgeon involves a small intestine for the formation of a small pouch that is attached to the anus (ileoanastomosis). This will enable you to pass out the waste in a normal way, but you might experience many loose bowel movements throughout the day.
This may require a temporary ileostomy.
After the colectomy
After the surgery, you will be shifted to a rest room. You will be under strict observation until you get conscious. Then you will stay in a hospital room until you are allowed to leave.
You may not be allowed to have solid foods at once but you can start with a small portion of soft foods and then pursue the solid ones once your intestines recover.
In the case of ileostomy and colostomy, you will be introduced to an Ostomy nurse or expert. He or she will guide you about the basic care and hacks about the stoma.
You may feel weak following the surgery, but, don’t worry you will be alright within some days. In case of more queries feel free to consult your doctor.
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