Total Colectomy: aka Resection of the Bowel
What Is It?
A colectomy is a surgery that involves the surgical resection of the entire bowel or colon. There are many reasons this surgery may be necessary. An individual with colon cancer may require a colectomy; someone with other diseases may require a colectomy. Usually cancer of the bowel is the most common reason one would require a complete resection. Diverticulitis, trauma to the bowels (such as a car accident) or ulcerative colitis and similar diseases may result in problems that lead one to require a colectomy.
Normally a doctor creates an incision in the abdominal wall or laparatomy and then cuts the blood vessels and arteries connecting the bowel to the rest of the body and other organs. The surgeon can then stitch together the cut ends if there is any bowel left or may create a colostomy, which is a procedure where a small hole is made in the abdominal wall to create an opening for excretion to occur.
Alternatives to Surgery
If a doctor recommends a colectomy then in most cases surgery is the patient’s only option. They likely have a severe disease like cancer and the bowel is most likely in a diseased state and not functioning properly. This can result in the spread of disease to other parts of the body. Some patients may not require a total colectomy however. Some may require only a small portion of the colon be removed. So, in a right hemicolectomy for example, the doctor may resection the right or ascending colon only. Some doctors refer to this type of procedure as an extended hemicolectomy.
Still others may require a resection of the colon but not the rectum, which may allow for more normalized excretion following the procedure. Medications may be used as adjunct therapy to help the patient cope with pain and side effects of surgery.
Before The Operation
Before the operation the doctor will use radiograph images to find out what shape the colon is in and how much the disease has spread. The doctor will want to rule out other causes for disease and make sure a colectomy is fully necessary before scheduling the procedure.
The patient will most likely need a laxative the night before the procedure; the doctor will also likely recommend the patient not eat or drink anything for 8 to 12 hours prior to the surgery because of the general anesthesia. If the patient smokes most likely he or she will be asked to stop smoking as this dramatically increases the risk for infection. Patients will sign consent forms and talk with nurses before surgery.
After The Operation
After surgery the patient will require some time to recover in the hospital especially if a colostomy is performed with the colectomy. In cases like this the patient may need to stay in the hospital for up to two weeks. Some doctors may recommend prophylactic antibiotic therapy to reduce the risk of infection. Others may simply wait to see how the patient does with time.
It is important the patient drink plenty of fluids and get plenty of rest. The patient will feel tired and week for some time following surgery. It will take a good two to five days before the patient can and feels like eating anything. A light diet is recommended initially. If the patient had a colostomy the nurse will show the patient how to change the bags before discharge, and will check up on the patient frequently to assure they know how to do this.
As with any surgery there are potential complications. These include the risk of infection especially at the incision site. It is important to keep these areas clean and dry. If the patient lies on his or her back for too long they increase the risk of blood clots that could travel to the heart and lungs. Patients are advised to get up and move around as soon as they are able and stable to help prevent clots from forming.
Some patients may learn other parts of their bowel or the surrounding organs and tissues may become damaged following surgery. This may result in a need for additional surgeries. The psychological toll of such a major surgery may also necessitate emotional healthcare.
A colectomy is a surgical procedure that allows doctors to remove the large intestine. Usually this procedure is performed on patients with very diseased bowels from cancer, diverticulosis, ulcerative colitis, acute trauma or injury to the large intestine or for related disorders. Much in the way of alternative care will be provided before the patient has the large intestine removed.
Not all patients will require a full colectomy. Some may require that only a small part of the large intestine be removed. In cases like this the surgeon will remove the diseased tissue and reconnect the parts of the large intestine that were cut. As each person is individual and their disease unique, so too is each procedure. Some patients will have a colostomy procedure performed with a colectomy.
Estimated Costs for Colectomy
The costs of a colectomy vary and depend on the nature of the disease being treated and how much of the large intestine must be re-sectioned. The numbers provided below are estimates and averages based on statistical information available about colostomies and colectomies performed globally.