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Colectomies: Learn About Intestinal Removal Surgery

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Colectomy Overview

A colectomy is a surgical procedure performed on the colon (a section of the lower intestine). During this procedure, the diseased area is removed by the surgeon, as well as small portions on either side of the area. The remaining tissues are then attached together.

Conditions requiring a colectomy

There are a few conditions that require a colon operation; examples of such conditions follow:

  • Colon cancer
  • Diverticulitis
  • Inflammatory disease
  • Crohn’s disease
  • Ulcerative colitis

However, colon cancer is the most common disease requiring a colectomy. When the cancerous portion of the colon is removed, the lymphs surrounding it are removed as well, so that the cancer does not spread and the colon can be healthy again. 

The most common symptoms experienced when in need of a colectomy are:

  • Diarrhea or constipation
  • Abdominal cramps
  • Nausea or loss of appetite
  • Weight loss
  • Fever or chills
  • Fatigue or weakness

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Testing for colon diseases

Colon screening is very important. The doctor will perform a physical exam and request a detailed medical history for you and your family. The doctor will also ask if are experiencing stomach pain or other notable symptoms. The doctor may also perform one or more of the following tests:

  • Abdominal ultrasound or x-ray
  • Blood or urine test
  • Colonoscopy
  • Digital rectal exam
  • CT scan or EKG

Types of colectomies

There are two ways colectomies are performed; an open colectomy and a laparoscopic-assisted colectomy.

An open colectomy requires the surgeon to make an incision in the abdomen through which the diseased portion of colon can be removed. The divided ends of the colon are sewn (or stapled) back together. If the connection is impossible, however, the colon will be taken through the abdomen and becomes a colostomy.

A laparoscopic-assisted colectomy is a minimally invasive procedure (MIS) in which a lighted camera and surgical instruments are inserted through small incisions in the abdomen. Through these tiny incisions, portions of the diseased colon or tumor are removed. This method is very simple and allows for quicker recovery time and minimal discomfort. The chances of complications or infection is very low, meaning less chance of a return visit. There is also less scarring and a quicker return to intestinal function.

Colectomy Pros and Cons

Pro: removing the diseased portions of the colon will relieve the symptoms being experiencing

Pro: It saves lives. Those with colon cancer will have the chance at a happy, healthy future

Con: As with any surgical procedure, there are risks. One of these risks is intestinal leakage or requiring the use of a colostomy bag. However, many times the colostomy issues are temporary.

Con: Potential wound infection or blood clots

Whatever the risks may be, however, the risk of not getting a colectomy when you need one is worse. Colectomies save many lives. Colon cancer can be beaten, and this procedure plays a crucial role in this.

Preparing for the procedure

Before the procedure, you will need to:

  • Provide a list  of all medications you are taking to your doctor; there is a chance your medication will need to be adjusted for surgery.
  • Let your doctor know about any allergies or conditions you might have.
  • Take a medication given to you by your doctor to help purge your intestines.

On the day of your colectomy, you will need to:

  • Not eat for four hours before the procedure
  • Not drink anything but clear liquids for two hours before the procedure
  • Thoroughly cleanse your abdomen and groin area
  • Thoroughly cleanse your mouth
  • Wear comfortable clothes
  • Bring your Insurance card
  • Wear slip-on shoes

Recovery time:

  • After undergoing a laparoscopic or open colectomy, the patient must recover in the hospital for approximately seven days. The continuation of eating what you are accustomed to and experiencing your first unassisted bowel movement takes place three to four days after the operation.

Next steps after the procedure

After the procedure, you will be kept under watch at the hospital. Your vital signs will be taken regularly to make sure you are not experiencing any post-surgery complications. Doctors advise that you get up and walk around five to six times a day to keep blood circulating and to prevent clots.

Once you are at home, it is important to maintain a healthy lifestyle to prevent readmission. Doctors recommend that for two weeks following the operation, a low fiber diet is implemented to reduce frequent bowel movements. Drinking plenty of fluids is also highly recommended. A nutritionist will advise the best plan of action for you and your body.

Normal physical activity can, in most cases, resume within one to two weeks. You can return to work or school, but keep in mind that heavy lifting or undue strain should be avoided for four to six weeks after surgery.

It is important that your hands are completely clean, when touching the site of the surgery. This way, there is little risk of infection. Long amounts of time in the water are ill advised when the stitches are still in, as is exposure to the sun. Be gentle with the wound; it will typically heal in four to six weeks, and taking care not to aggravate the area aids in this recovery.

When to contact your surgeon

You should contact your surgeon if you are experiencing any of the following symptoms after surgery:

  • Persistent or increasing pain
  • A fever of more than 101 degrees F or 38.3 degrees C
  • Persistent nausea and vomiting
  • Swollen or painful abdomen
  • Odorous discharge, redness, swelling or bleeding of the wound
  • No bowel movements after two to three days following surgery

Non-surgical treatment

Some colon conditions do not require a colectomy; some simply need antibiotics or medication assisting in the function of the immune system. It is important that you visit a doctor and discuss the correct course of action to take towards improved health.

Colectomies save lives. If you experience any issues of the colon, it is important that you visit your doctor. Early screening and diagnosis lead to quicker treatment, which means less complications and more chances of leading a long, healthy life.

Learn more about minimally invasive surgery and packages at Samitivej Sukhumvit Hospital. 

References:

  1. Colectomy, Surgical Removal of the Colon. Accessed from https://www.facs.org/~/media/files/education/patient%20ed/2015%20colectomy%20brochure%20final.ashx.  Accessed August 4, 2016.

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