Did your doctor talk to you about a stomach ache or a bowel problem? He may have also told you about a surgery called a 'Colectomy'. Hearing this name can be a bit scary. But if we know exactly what it is, that fear can be largely eliminated. This is a surgery that removes a diseased part of the colon. Let's see in simple terms what it means, why it is done, and how to deal with it.
Simply put, what is Colectomy?
Colectomy is the surgical removal of part or all of your large intestine (colon). The large intestine is a very important part of our digestive system. However, some diseases can damage this large intestine. Then it cannot function properly. That is when doctors decide to remove this damaged part.
What medical conditions lead to this surgery?
A doctor will only recommend such a major surgery if there is a serious reason. There are usually several main reasons for undergoing a colectomy.
| Medical condition | A simple explanation |
|---|---|
| Colon cancer | This surgery is performed to remove the part of the intestine that contains cancer cells and stop the cancer from spreading. |
| Diverticulitis | As a treatment for severe conditions caused by small pouches forming in the walls of the intestine and becoming infected. |
| Gastrointestinal bleeding | If bleeding continues from a part of the intestine that cannot be controlled by other methods. |
| Large bowel obstruction | If the intestine is completely blocked due to a tumor or other cause, that part will have to be removed. |
| Inflammatory bowel disease | Conditions such as Crohn's disease or ulcerative colitis that are too severe to be controlled with medication. |
Additionally, some people have hereditary conditions, such as Lynch syndrome or Familial adenomatous polyposis (FAP). These conditions increase the risk of developing colon cancer in the future. In such cases, doctors may recommend this surgery as a preventive measure before the disease develops .
What types of colectomy surgeries are there?
This surgery is divided into several types depending on the amount of intestine removed.
- Total colectomy: In this, your entire large intestine is removed.
- Partial colectomy: In this, only part of the large intestine is removed. There are several other subtypes of this.
| Type of surgery | The part to be removed |
|---|---|
| Hemicolectomy | Removal of part of the right or left side of the large intestine. |
| Proctocolectomy | Removal of both the large intestine and rectum. |
| Sigmoid colectomy | Removing the sigmoid section, the last bend of the large intestine, which connects to the rectum. |
How do you prepare before surgery?
Since this is a major surgery, it requires careful preparation. Your gastrointestinal surgeon will meet with you and explain all the details about the surgery you are going to have and how it will be performed.
In addition, you will undergo several tests to see if you can withstand surgery.
- Blood tests
- Colonoscopy
- EKG (Electrocardiogram) to check the heart's function
- Imaging tests such as CT scan or MRI scan
The doctor will also give you instructions on what you need to do a few days before the surgery.
1. Someone to take you home: Arrange in advance for someone to take you home from the hospital after surgery.
2. Liquid diet: You will be asked to eat only clear liquid foods for a few days before surgery. For example, things like soup water and orange juice.
3. Bowel cleansing: Before surgery, your intestines need to be completely emptied and cleaned. You will be given a special liquid (bowel prep) to drink. This can be a bit uncomfortable, but it is very important for the surgery to be successful.
4. Fasting: You are advised not to eat or drink anything from midnight the day before the surgery.
What happens during the surgery?
You won't feel anything during the surgery because the surgery will begin after you are completely anesthetized (general anesthesia) and sound asleep.
Simply put, this is what happens:
- Your anesthesiologist will put you under general anesthesia.
- The surgeon makes one long incision in your abdomen (open colectomy) or several small incisions (laparoscopic colectomy or robotic colectomy). The recovery is faster with laparoscopic surgery.
- Then, the damaged or diseased part of the intestine is identified and cut out.
- Next, the two ends of the remaining healthy intestine are joined together.
- Sometimes there are times when these two ends cannot be connected together. In those cases, a different method is followed (we'll talk about that).
- Finally, the incisions are closed with stitches.
This entire surgery can usually take about one to four hours.
What is Anastomosis and Ostomy? This is very important.
After a section of the intestine is removed, it is very important to know what happens to the remaining two parts. There are two main methods here. Your doctor will choose the method that is best for you.
This change can have a big impact on your life, so it's important to understand it well.
| Method | Description |
|---|---|
| Anastomosis (reconnection) | This involves sewing the two ends of the healthy intestine that are left after the section that was removed is reconnected. If this is successful, your bowel movements will return to normal. |
| Ostomy (creating a passageway from the stomach to the outside) | Sometimes the two ends of the intestine cannot be connected at once (for example, due to an infection). In this case, an opening is made so that the end of the upper part of the intestine comes to the surface of the skin of the abdomen. This is called a stoma. Stool comes out of this opening, and a special bag (ostomy bag) must be worn to collect it. This can be temporary or permanent. |
It's normal to feel scared and anxious when you're told you'll have to live with an ostomy. But the doctors and nursing staff will teach you the best way to get used to it, how to use the bag, and how to live a normal life with it.
What are the possible risks of this surgery?
Like any major surgery, colectomy surgery carries some risks, but doctors do their best to minimize these risks.
- Anastomotic leak: Leakage of stool into the abdominal cavity from the site of intestinal connection.
- Excessive bleeding: Excessive bleeding during or after surgery.
- Infections: Infections in the surgical wound or inside the abdomen.
- Damage to nearby organs: There is a small risk of damage to nearby organs, such as the bladder and small intestine.
What happens after the surgery?
After the surgery, you will need to stay in the hospital for a few days, possibly up to a week. During this time:
- Until your intestines start working again, you will first be given intravenous fluids, then oral fluids and a soft diet.
- The nursing staff regularly checks to see if the surgical wound is healing well and if there are any signs of infection.
- You will be given detailed instructions on how to care for the wound after you go home.
- If you have an ostomy, you will be given special training on how to care for the stoma and how to change the bag.
- After you go home, they will give you advice on what foods to eat and small activities you can do (like walking).
During this time, you have to remember a lot of things at once. So it's a good idea to have a family member or friend with you while the doctor is talking.
How long does it take to heal?
It can take up to six weeks to fully recover after going home. However, most people can resume most of their normal activities within two weeks. But don't rush it. Listen to your body. If you feel tired, rest.
What should I eat after surgery?
Usually, for the first month or so, you should eat low-fiber foods . Because they are easier for the intestines to digest. You can eat things like white rice, well-cooked lentils, well-cooked vegetables, fish, and chicken. The doctor advises you to stop eating high-fiber foods like leafy green vegetables and whole grains for a while.
When should you talk to the doctor?
Be very careful about your body after you go home. If you have any of the following symptoms, call your surgeon immediately .
| Danger symptoms - tell the doctor immediately! | |
|---|---|
| Stomach pain | A severe stomach ache that gets worse over time. |
| Signs of infection | Fever, redness, swelling, pain, or pus from the surgical wound. |
| Difficulty defecating | Inability to defecate or persistent diarrhea. |
Surgery like this is a life-changing experience. It may relieve your painful symptoms, cure you of cancer, or give you a longer life. Living with an ostomy can be a big change. But there are many people who can help you adjust to it. So be open about your questions, fears, and concerns with your doctor.
Take-Home Message
- Colectomy is a surgery to remove a diseased part or all of the colon.
- This is done as a treatment for serious conditions such as cancer, intestinal obstructions, and severe infections.
- Follow the doctor's instructions (diet, bowel cleansing) exactly before surgery.
- It takes time to heal after surgery, so be patient and give your body plenty of rest.
- Sometimes, an opening (ostomy) may need to be created on the surface of the skin on your abdomen to allow stool to pass through, and the medical staff will help you get used to it.
- If you notice any danger signs such as fever, severe stomach pain, or pus draining from the wound, call your doctor immediately.
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