Colectomy

Colectomy is a surgical procedure to remove all or part of your colon to treat or prevent diseases and conditions that affect your colon.

Some facts about Colectomy:

• Colon is a part of your large intestine, that is a long tubelike organ at the end of your digestive tract.
• Other procedures are also required to reattach the remaining portions of your digestive system and permit waste to leave your body during a colectomy surgery.
• Surgery may be required to remove the affected portion of the colon if severe bleeding occurs from the colon.
• Total or partial colectomy is required for a bowel obstruction, depending on the situation.
• A small section of the colon will be removed during colectomy for early-stage cancers. More of the colon has to be removed for cancers at a later stage.
• You may get temporary relief from signs and symptoms of Crohn's disease by removing the affected part of your colon if medications aren't helping you.
• Colectomy may also be done if precancerous changes are found during colonoscopy which is a test to examine the colon.
• A total colectomy or proctocolectomy may be recommended by your doctor if medications aren't helping to control your signs and symptoms of Ulcerative colitis.
• Proctocolectomy may also be recommended by the doctor if precancerous changes are found during a colonoscopy.
• The affected portion of the colon will be removed if your diverticulitis recurs or if you experience complications of diverticulitis.
• Total colectomy can be done to prevent cancer in the future if you have a very high risk of colon cancer due to the formation of multiple precancerous colon polyps.
• Colectomy may also be an option for people with inherited genetic conditions that increase the risk of colon cancer, such as familial adenomatous polyposis or Lynch syndrome.
• Bleeding, Deep vein thrombosis, Pulmonary embolism, Infection, Injury to organs near your colon, such as the bladder and small intestines and tears in the sutures that reconnect the remaining parts of your digestive system are some of the common risk associated with Colectomy.
• However, your risk of complications depends on your general health, the type of colectomy you undergo and the approach used by your surgeon to perform the operation.

Types of Colectomy:

Various types of colectomy operations are:

• Total colectomy: The entire colon will be removed in a total colectomy.
• Partial colectomy: Some part of the colon will be removed and may also be called subtotal colectomy
• Hemicolectomy: This procedure involves removing the right or left portion of the colon.
• Proctocolectomy: Both the colon and rectum will be removed in proctocolectomy.

Preparation for Colectomy:

• You must inform  about the medicines you are taking and your use of caffeine, alcohol or other drugs to your doctor before surgery as you may need to make changes to your medications or avoid certain substances to help with healing and recovery after surgery.
• You need to quit smoking before surgery if you are smoking as it increases the risk of developing problems after surgery.
• You will receive specific instructions on how to prepare for the procedure when you schedule your surgery.
• You are not allowed to eat anything after midnight before the scheduled surgery. The instructions about eating food and drinking liquids will be provided prior to reporting to the hospital.
• A laxative solution will be prescribed by your doctor that you mix with water at home that causes diarrhea to help empty your colon. You should drink the solution over several hours, following the directions.
• Enemas may also be recommended by your doctor.
• Antibiotics may also be recommended to suppress the bacteria found naturally in your colon and to help prevent infection.

Procedure for Colectomy:

• Your health care team will take you to a preparation room and your blood pressure and breathing will be monitored on the day of your surgery.
• An antibiotic medication may be given through a vein in your arm.
• You will then be taken to an operating room and a general anesthesia medication will be given to help you relax during the procedure.
• Colon surgery may be performed as Open colectomy or Laparoscopic colectomy.
• A longer incision will be made in your abdomen to access your colon during an open surgery. Surgical tools will be used by the surgeon to free your colon from the surrounding tissue and cuts out either a portion of the colon or the entire colon.
• Several small incisions will be made in your abdomen during Laparoscopic colectomy, also called minimally invasive colectomy. A tiny video camera will be passed through one incision and special surgical tools through the other incisions.
• A video screen will be watched by the surgeon in the operating room as the tools are used to free the colon from the surrounding tissue which allows the surgeon to operate on the colon outside of your body.
• The surgeon reinserts the colon through the incision once repairs are made to the colon.
• The type of operation you undergo depends on your health condition and the expertise of your surgeon.
• The pain and recovery time after surgery is less in Laparoscopic colectomy.
• Your surgeon will reconnect your digestive system to allow your body to expel waste after the colon has been repaired or removed.
• An anastomosis may be created in which the surgeon may stitch the remaining portions of your colon together or attach your colon to your small intestine. Stool will leaves your body as before in this case.
• Your colon or small intestine will be attached to an opening created in your abdomen which allows waste to leave your body through the opening (stoma). You will have wear a bag on the outside of the stoma to collect stool which can be permanent or temporary.
• A portion of your small intestine will be used to create a pouch that is attached to your anus after removing both the colon and the rectum. Though you may have several watery bowel movements each day, this  allows you to expel waste normally. You may undergo a temporary ileostomy as part of this procedure.
• Your options will be discussed by the surgeon with you before your operation.

Recovery from Colectomy:

• You will have to stay in the hospital until you regain bowel function which may take a couple of days to a week.
• Liquid nutrition will be given through a vein and then transition will be made to drinking clear liquids. you can eventually add solid foods as  your intestines recover.
• You will meet with an ostomy nurse if a colostomy or ileostomy is involved your surgery to attach your intestine to the outside of your abdomen. She will show you how to care for your stoma and explain how to change the ostomy bag that will collect waste.
• A couple of weeks of recovery is expected at home.