Colectomy

What is colectomy?

A colectomy is surgical removal or resection of all or part of the small or large intestine, or the rectum. The procedure is done to treat diseases of the colon, including colorectal cancer, Crohn's disease, inflammatory bowel disease and diverticulitis. Full removal of the intestine and rectum is called proctocolectomy. A partial colectomy involves removing part of the colon while hemicolectomy refers to removal of the right or left portion of the colon. The need for colectomy may be indicated by the results of certain diagnostic procedures such as X-ray, colonoscopy, or EKG.

At Main Line Health, 90 to 95 percent of colorectal surgeries are performed laparoscopically. Laparoscopic colectomy is a minimally invasive approach that involves use of small incisions and a tiny video camera that allows the surgeon to view the procedure on computer screen and achieve greater precision. Patients who undergo minimally invasive colectomy have faster recovery times with less pain.

What to expect from a colectomy

Your doctor will provide you with detailed instructions which may include stopping certain medications, particularly blood thinners (anticoagulants), the week before surgery. You will also be required to:

• Empty your bowels, starting several days before surgery.
• Prepare your bowels with laxatives and enemas a day or two prior.
• Drink only clear liquids or broth and refrain from eating for up to 12 hours before surgery.

During the surgery, you will be under general anesthesia so you will be asleep and won't feel anything. The surgeon will make several small incisions (cuts) if performing laparoscopic colectomy or will make large incision down the belly if performing open colectomy. The portion of colon will be removed and the open ends sewn together before the doctor closes up the incisions.

You will likely be in the hospital for three to seven days depending on your body's ability to heal. At first you will be on a liquid diet until your colon begins to recover. You may resume with solid foods after a few days. You may also need to take pain medication.

Risks of colectomy

As with any surgery, there are some colectomy risks, including:

• Anesthesia reaction
• Bleeding internally
• Infection of incision site or internally
• Leakage where the intestines are stitched together
• Scar tissue that blocks the intestines

Once you have been discharged from the hospital and returned home, you will need to watch out for any signs of infection or complications, including swelling, fever of 100.4°F or higher, shortness of breath or worsening pain.