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Colectomy

 

What is a colectomy?

Colectomy is a surgical procedure to remove a section of the colon. The colon is a part of the large intestine and comprises the last segment of the gastrointestinal tract. The colon’s role in digestion is largely the reabsorption of water. Many patients undergo colectomy without significant impact upon their digestion or overall health.

What are causes for a colectomy?

Common indications for colectomy may include:

What are risk factors of a colectomy?

Colectomy carries several potential risks - as with any major surgical procedure. These risks can vary depending on factors such as the patient's overall health, the reason for the surgery, and the specific type of colectomy performed. Here are some common risks associated with colectomy:

  • Infection: Any surgical procedure carries a risk of infection. Infections can occur at the site of the incision or within the abdominal cavity (intra-abdominal infection). Antibiotics are typically administered before and after surgery to reduce this risk.
  • Bleeding: Bleeding can occur during or after surgery. In some cases, additional surgery may be required to control bleeding.
  • Blood clots: Blood clots can form in the legs (deep vein thrombosis) or travel to the lungs (pulmonary embolism). Measures such as compression stockings, blood thinners, and early mobilization are often used to reduce this risk.
  • Anastomotic leak: When the remaining portions of the colon are reconnected (anastomosis), there is a risk of leakage at the site of the connection. A variety of well-established techniques and assessments are used to minimize this risk.
  • Damage to surrounding organs: The colon lays adjacent to several nearby organs. Often, these nearby organs and tissues must be carefully preserved during the procedure.  Your Colorectal Surgeons have unique training and experience to minimize risk of injury to nearby organs.
  • Changes in bowel function: Following colectomy, some patients may experience changes in bowel habits, including diarrhea, constipation, or increased frequency of bowel movements.
  • Impaired wound healing: Factors such as poor circulation, diabetes, or smoking can increase the risk of delayed wound healing or wound infection.
  • Adverse reaction to anesthesia: Some individuals may experience allergic reactions or other complications related to anesthesia administration.

It's important for patients to discuss these risks with your surgeon prior to surgery.

How do you prepare for a colectomy?

Prior to your colectomy, your Surgeon will perform a pre-operative evaluation of your overall health. This may include collaboration with your Primary Care Provider and established care team. Coordinating with your care team helps provide the best care and minimizes risk of complications during or after surgery.

For most colectomy procedures, a bowel prep is beneficial to reduce the risk of infection and facilitate a safe minimally invasive technique. Often, this involves clear liquids, laxative medication, and antibiotics taken the day prior to surgery. Your Colorectal Surgeon will provide clear instructions to help ensure your bowel prep is completed appropriately.

On the day prior to surgery, you will receive a call from the hospital with arrival time and final instructions prior to surgery. This will likely include instructions regarding when to stop eating food and when to stop drinking liquids.

What should you expect after a colectomy?

Recovery following colectomy can vary widely depending on factors such as the reason for the surgery, the extent of the procedure, the patient's overall health, and any complications that may arise during or after surgery. However, here's a general overview of what to expect during the recovery process:

  • Hospital Stay: Most patients will spend several days in the hospital after colectomy surgery. The length of the hospital stay can vary but is typically around 3 to 7 days. During this time, the Colorectal Surgery team will monitor each patient’s condition, manage pain, and ensure that they are recovering well.
  • Pain Management: Our Colorectal Surgeons utilize minimally invasive surgical techniques like Laparoscopy and Robotic Surgery whenever possible. These techniques minimize pain during and after surgery. Spinal anesthesia is utilized in combination with general anesthesia when possible, to minimize the amount of anesthesia medication required. Non-narcotic pain medications are employed to minimize the adverse effects of narcotic pain medications. Through minimally invasive technique and multi-modal pain management, many patients are able to recover without the need for narcotics.
  • Dietary Changes: Initially, patients may be placed on a liquid diet and gradually transition to solid foods as tolerated. It's common for patients to experience temporary changes in bowel habits and digestion following colectomy, so dietary adjustments may be necessary.
  • Activity Level: While it's important to rest and allow the body to heal after surgery, early mobilization is also encouraged to prevent complications such as blood clots and to promote recovery. Patients will be encouraged to start walking on the day of surgery and gradually increase activity levels as tolerated.
  • Wound Care: Patients will receive instructions on how to care for their incisions and any drains or tubes that may have been placed during surgery. Keeping the incisions clean and dry, and following any specific wound care instructions provided by healthcare providers, is important to prevent infection and promote healing.
  • Follow-up Care: Most patients recover very well following surgery. Our Surgeons routinely meet with patients 2-4 weeks after surgery to ensure they are healing well without complication. This visit may include further dietary guidance, medication adjustments, and recommendations for resuming normal activities. Additional visits with our Surgeons are provided for any questions or concerns.
  • Return to Normal Activities: The time it takes to fully recover and return to normal activities can vary widely depending on individual factors and the extent of the surgery. Some patients may be able to return to work and other normal activities within a few weeks, while others may require several months to fully recover. Fatigue is very normal after surgery – often lasting up to 6 weeks while the body continues to heal and recover.

It's important for patients to follow their healthcare provider's recommendations closely during the recovery period and to communicate any concerns or unexpected symptoms promptly. With proper care and follow-up, most patients can expect to gradually resume their normal activities and enjoy an improved quality of life following colectomy surgery.