Colectomy is a surgical procedure for removal of colon (large intestine), either completely or partially.
Colectomy may be of following types:
Total colectomy: entire colon is removed
Partial colectomy: colon is partially removed
Hemicolectomy: half of the colon is removed (right or left)
Proctocolectomy: the entire colon and the rectum are removed
After colectomy, your surgeon will perform another procedure to reattach the remaining portions of your digestive system and allow waste to flow out of your body.
Colectomy is required in cases of:
injury/trauma to the colon
diverticulitis of colon (formation of diverticula/out pouching of the colon mucosa)
inflammation of colon as in ulcerative colitis
formation of polyps on colon lining
It may be performed as a preventive surgery in patients with high risk/strong family history of colon cancer.
There are certain pre-requisites for Colectomy.
On the advice of the treating doctor, the medications that can increase the risk of complications will have to be stopped 2 weeks prior to the surgery.
Colonoscopy is done to examine the colon.
You should not eat or drink anything for 8 to 10 hours prior to the surgery.
You will be given a laxative solution to completely clear the bowels, prior to the surgery.
Colectomy may be performed as an open invasive surgery or minimally invasive laparoscopic surgery. Both are performed under general anaesthesia by gastrointestinal surgeon.
Open technique: a long incision is made on the abdomen. The colon is separated from surrounding tissues and is removed.
Laparoscopic technique: a small incision is given on the abdomen near the navel. A laparoscope is inserted through this incision. The camera attached to the laparoscope projects the images of the colon and surrounding structures on a monitor. After placing the laparoscope, a few more small incisions are made for placing the small instruments. Then the colon is removed, partially or completely as required. The remaining parts of the digestive system are stitched together.
When the colon is partially removed, remaining portions of the healthy colon are stitched together (anastomosis).
An incision is made on the abdominal wall and an opening/stoma is formed on the remaining healthy end of the colon, the intestinal waste is then collected in the colostomy bag worn outside. This procedure is called as colostomy.
When the entire colon and rectum are removed, the small intestine/ileum is attached to the anus (ileoanal anastomosis).
Recovery period is longer with open surgery than with laparoscopic surgery.
Hospital stay of few days is generally required. The patient will initially be on IV fluids, then clear liquids are started and gradually semi solids and solids will be given as and when the healing occurs. The patient is sent home on a soft diet.
If you have a colostomy, the nurse will explain how to take care of the stoma and how to change the colostomy bag.
Risk and Complications
As with other procedures, certain complications and risk are also associated with colectomy. In general,
There is risk of bleeding, infection and formation of clots in the legs and lungs.
There is also risk of injury to organs like small intestine and urinary bladder.
When anastomosis is done, there is risk of breaking/dehiscence of the stitches and this may lead to inflammation of the peritoneal cavity causing sepsis and even death.
It is also called a colon resection.
Most of the colon resections are performed using the minimally invasive approach.
The surgery may begin as a minimally invasive surgery but may have to be converted to open surgery.
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