A colectomy is a major surgical surgery that calls for a significant amount of time spent both getting ready for the operation and recovering afterward.
Colectomies are often carried out using a technique known as laparoscopy, which involves making a series of very small incisions in the patient’s belly through which a video camera and long, thin instruments are placed to carry out the procedure.
This technique is frequently used since it lessens the likelihood of an infection occurring and shortens the amount of time necessary for recuperation.
During the process, the patient is often sedated, and any tissue that is taken is afterward sent to a laboratory for additional evaluation. Depending on the type of colectomy that is performed, the surgeon may remove all or part of the large intestine. Additionally, the surgeon may need to remove other organs such as the rectum, appendix, and/or small intestine.
What is the Colon?
The last portion of the digestive system is called the colon, also known as the big intestine. The colon is the organ that oversees absorbing fluids and electrolytes from the food that we eat and subsequently expelling the waste products from the body in the form of stool. It is responsible for this process.
The colon is a muscular tube that ranges in length from about five to six feet and is composed of four pieces. These sections are the cecum, the ascending colon, the transverse colon, and the descending colon.
In addition to storing waste products and eliminating them from the body, its primary activities include the absorption of water, electrolytes, and vitamins from the food that is being digested.
Why does one undergo a colectomy?
A major surgery known as a colectomy can be used to treat a wide range of medical disorders, including:
- Colon Cancer: Colon cancer, or colorectal cancer, is a malignant tumor that begins in the large intestine. People over the age of 50 have an increased risk of developing this third most frequent kind of cancer worldwide. Colon cancer symptoms consist of a change in bowel habits, pain in the abdomen, and rectal bleeding. Surgery, chemotherapy, and radiation therapy are just some of the options that can be available, depending on the size and stage of the tumor.
- Precancerous Colon Condition: Colon precancers are a group of disorders marked by alterations in colon cells that raise the risk of the development of colon cancer. Mutations in the genetic code, environmental circumstances, and even a symbiotic relationship between the two can all contribute to the development of these diseases. Adenomatous polyps, growths on the lining of the colon that are usually harmless but can develop into cancer, are the most prevalent form of the precancerous disease. Precancerous alterations in the colon are normally treated by keeping a close eye on the situation and having any polyps removed.
- Ulcerative Colitis: Ulcerative colitis is a disease of the large intestine (colon) that causes inflammation of the intestinal lining. Colon inflammation and ulceration are hallmarks of this condition, which can also cause exhaustion, weight loss, bloody diarrhea, and other gastrointestinal symptoms. Although the origin of ulcerative colitis is still a mystery, scientists suspect a mix of genetic and environmental factors. Medications to reduce inflammation, antibiotics to cure an infection, and in extreme situations, surgery to remove the colon are all common treatments for ulcerative colitis.
- Large bowel obstruction: It is another potential cause for surgical removal of the colon. This is the result when the colon is blocked, whether by a tumor, foreign item, or waste build-up. Constipation, nausea, and vomiting are also symptoms of a major intestinal obstruction, along with abdominal pain. A section of the colon may need to be surgically removed if the obstruction is severe enough.
- Diverticulitis: When pouches, or diverticula, form in the lining of the colon, a person can develop diverticulitis. Abdominal pain, fever, and diarrhea are just some of the symptoms that can result from inflammation or infection of these organs. Antibiotics and rest are the usual treatments for diverticulitis, while surgery may be necessary in severe cases. If the diverticula are producing an obstruction in the colon or the infection is very serious, a colectomy may be required.
- Uncontrolled Colon Bleeding: The existence of polyps, tumors, or ulcers in the colon are just some of the potential causes of uncontrolled colon bleeding, a potentially life-threatening medical disease. When the colon is torn, either by trauma or surgical intervention, bleeding can occur. Abdominal pain, exhaustion, and tarry or black stools are some signs of uncontrolled bleeding. Medication to reduce bleeding and/or surgical intervention to either halt the bleeding or remove the cause of the bleeding are common treatments for this problem.
- Inflammatory bowel disease (IBD): Diseases that cause inflammation of the intestines are grouped together under the umbrella term “inflammatory bowel disease.” Abdominal discomfort, diarrhea, fever, and weight loss are just a few of the symptoms that can occur because of inflammatory bowel diseases including Crohn’s disease and ulcerative colitis. Medications to minimize inflammation, antibiotics to cure an infection, and, in severe situations, surgical removal of the damaged section of the intestine may all be part of the treatment plan. It is possible that removing all or part of the colon, known as a colectomy, will be necessary for extreme circumstances.
In addition to this, it can be utilized to remove a section of the large intestine that is either infected or obstructed in some way.
The extent of the problem that has to be treated will determine whether the entire colon or only a portion of it needs to be removed during the surgical procedure.
Depending on the type of colectomy that is performed, it may be necessary in some instances to remove additional organs along with the colostomy bag, including the rectum, appendix, and/or small intestine.
Is a colectomy a significant operation?
According to Dr. Valeria Simone MD, an experienced general surgeon at Southlake General Surgery, Texas, USA, a colectomy may entail the removal of a portion or the entirety of the patient’s colon. Because of this, it is classified as a significant surgical procedure.
Open surgery involves making a major incision in the belly; laparoscopic surgery, on the other hand, involves making a few smaller incisions and using a camera to carry out the process through a series of these smaller incisions. The procedure can be carried out either way.
The healing period following an open colectomy is typically around six weeks, but the recovery period following a laparoscopic colectomy might be as little as four weeks. In either scenario, the most important thing you can do to ensure a speedy and thorough recovery is to carefully carry out the recommendations given to you by your physician.
Difference between Colectomy and Colostomy
A colostomy is a surgical technique in which the end of the colon is diverted outside the body and a bag is placed over it to collect wastes. This differs from a colectomy, which is the removal of part or all of the colon. A colectomy can be performed. Colectomies are often carried out to treat diseases such as severe infections, uncontrolled colon bleeding, and conditions that place the colon in a precancerous state.
If the colon needs to be bypassed because of an injury or disease, or if a colectomy has been performed and the end of the colon cannot be reattached, then a colostomy may be necessary. In either scenario, it is essential to carry out your doctor’s recommendations exactly as they have been laid out to maximize the likelihood of a positive outcome.
Open colectomies and laparoscopic colectomies are both considered major surgeries, with the normal recovery period for the former being approximately six weeks and the latter being around four weeks.
Patients who are suffering from a wide variety of digestive diseases may benefit from life-saving treatments such as colostomies and colectomies. To make an educated decision about which treatment is best for you, it is essential to have a thorough understanding of the potential drawbacks as well as the advantages of each possible course of action.
The patient may decide to go with an alternative course of therapy if they feel that the potential drawbacks are too great relative to the potential gains. In some circumstances, the patient may conclude that a colectomy or colostomy is the best way to treat their condition since the potential advantages are greater than the potential hazards.
Preparing for a Colectomy
The first step in getting ready for a colectomy is having an in-depth conversation with your physician about whether the procedure is in your best interest. To assess the full scope of your problem, you will also need to take part in a few diagnostic examinations, such as:
- Blood tests
- Imaging scans
- Urinalysis
- Electrocardiogram (EKG) test
- Colonoscopy
In addition, you should get ready for a period after the operation during which you will need to sleep and recover, as well as for any alterations to your lifestyle that may be required after the procedure. For you to be ready for the treatment in the most effective manner, your doctor will most likely give you specific instructions regarding the drugs, foods, and activities that you should engage in prior to the procedure.
Furthermore, patients need to make sure that they have someone to drive them home after their operation. During the period of recovery, it is essential to prepare for time away from work as well as for any other activities that may be necessary.
What happens during a colectomy?
Colectomy is normally carried out under either general or regional anesthesia, depending on the specifics of the treatment that is being carried out.
During the operation, the surgeon will disconnect the two ends of the colon and then re-join them if it is necessary to do so. The surgeon may remove all or part of the affected section of the colon.
It is possible that the patient will have to remain in the hospital for anywhere between three days and a week after the surgery, but this will be determined by the specific nature of the procedure.
Open colectomy vs Laparoscopic colectomy
Open colectomy: In circumstances where a laparoscopic colectomy is not a viable choice, an open colectomy may be the only viable option. A colon can be removed and reconnected if necessary, via an open colectomy, which involves making a wide incision in the abdomen and removing the diseased section of the colon. To achieve a positive outcome after an open colectomy, it is crucial to carefully adhere to your doctor’s postoperative care instructions, which may be more time-consuming and demanding than those for laparoscopic treatment. After the procedure, patients may need to relax for a few weeks and follow a limited diet.
Laparoscopic colectomy: A laparoscopic colectomy is a surgery that is minimally invasive because it only requires a few small incisions to be made across the patient’s abdomen. The patient’s health and the nature of the operation both have a role in determining whether anesthesia will be administered during the treatment. During the surgical procedure, the diseased portion of the colon is removed, and then the two ends are reconnected. The recovery period following a laparoscopic colectomy is typically shorter than the recovery period following an open colectomy. However, it is essential to carefully follow the instructions given by your doctor and to allow plenty of time for rest and recovery to increase the likelihood of a successful outcome.
Colon Resection Variations
Different types of resections call for different approaches to the colectomy operation. There are various terms for colon resection surgeries that remove specific segments.
Total Colectomy
The term “total colectomy” refers to an invasive surgical surgery that removes the entire colon as well as the rectum. This procedure is also often referred to as “proctocolectomy.”
To treat illnesses such as diverticulitis, colon cancer, and chronic inflammation of the colon, a technique like this one is frequently performed. A laparoscopic total colectomy is a sort of minimally invasive surgery that involves making only a few tiny incisions in the abdomen and using a camera to carry out the process.
An open colectomy is a more traditional form of surgical surgery that requires a bigger incision to be made in the abdominal region to access the colon.
Partial or Subtotal Colectomy
A partial or subtotal colectomy is a surgical procedure that removes a portion of the colon and rectum. This is typically done as a treatment for cancer or precancerous diseases, although it can also be done to cure obstructions or other disorders. In addition, a partial colectomy might be required for certain patients who suffer from conditions like diverticular disease or Crohn’s disease.
The Partial Colectomy procedure is further sub-divided into three parts:
- Sigmoid colectomy: The sigmoid colon, or the bottom part of the large intestine, can be removed through a surgical procedure called a sigmoid colectomy. This procedure removes the lower segment of the large intestine. This surgery is frequently carried out in order to treat conditions such as diverticulitis, inflammatory bowel disease, and colon cancer. It is possible to carry out the procedure either through laparoscopic surgery or open surgery, depending on the requirements of the patient. The length of time needed for recovery and the possible complications that could arise are both contingent on the specific treatment that was performed as well as the patient’s general state of health.
- Hemicolectomy: In a hemicolectomy, surgeons remove the lower section of the colon. Large tumors or precancerous growths are the usual prospects for this treatment, while it may also be used for severe infections or uncontrolled bleeding. The diseased section of the colon is dissected out and the healthy sections are stitched back together during the operation. Patients should adhere to their doctor’s recommendation about medication, nutrition, and activity during the recommended six-week recovery period.
- Proctocolectomy: In a proctocolectomy, both the colon and rectum are surgically removed. Most often, it is used to treat advanced cases of colon cancer, inflammatory bowel disease, or familial polyposis. The surgery entails detaching the small intestine at both ends and gently reattaching it to the anus after the colon and rectum have been removed. A successful outcome from this treatment demands that you adhere to your doctor’s advice for medications, diet, and activity for the duration of the recovery period (usually 8-10 weeks).
Use of Anastomosis or ostomy
When the colon is removed during a colectomy, the two ends may need to be reunited using an anastomosis.
An ostomy is a surgical procedure in which a tiny hole is cut into the abdomen to redirect waste. Follow-up visits to the doctor are necessary for both anastomosis and ostomy patients to ensure the health of the surgical site, monitor the patient’s recovery, and prevent problems.
Moreover, individuals thinking about either treatment should think about their way of life and quality of life and talk about any concerns they have with their doctor.
- Anastomosis: Reconnecting two ends of the colon requires a surgical procedure known as an anastomosis. After a colectomy, this surgery is performed to reconnect the two sections of the colon. A surgeon will perform the surgery to reattach the two ends of the colon by stitching them together. Colectomy patients do not necessarily require anastomosis, and whether one is performed depends on the specifics of each case.
- Colostomy / Ileostomy: When a person undergoes surgery to produce a colostomy or ileostomy, an artificial opening is made in the abdominal wall for waste to exit the body. In cases where the anastomosis is not feasible due to the patient’s condition or the complexity of the operation, this treatment is routinely employed as a temporary alternative. The stoma, the man-made incision, is attached to a pouch that holds the waste. Patients should be given detailed information on how to clean and maintain the stoma to reduce the risk of infection.
- Ileal pouch: As an alternative to ileostomy or colostomy, the small intestine (ileum) can be used to create a pouch called an ileal pouch. When this pouch is linked to the rectal muscles, waste can be collected and eliminated in a more normal manner. Patients who are not good candidates for an ileostomy or colostomy, or who are unable to undergo an anastomosis, may be candidates for the ileal pouch operation. To ensure proper healing and prevent any complications, the surgery necessitates follow-up appointments with a doctor over the course of several months.
What can we expect after Colectomy?
Patients who have undergone colectomy surgery often go through a period of recovery that can last anywhere from a few weeks to several months, depending on the patient and the specific procedure that was carried out.
To hasten the process of recovery during this time, patients should adhere to the recommendations of their treating physicians on diet and exercise.
In addition, individuals who have undergone a colostomy, ileostomy, or ileal pouch procedure may be required to adhere to specific care instructions for their stoma or an ileal pouch. These instructions may be given by their doctor. After having a colectomy, most people can make a full recovery if they take the necessary precautions and maintain regular follow-up appointments with their surgeon.
What are the risks and complications of Colectomy?
A colectomy, like any other surgical surgery, exposes the patient to the possibility of experiencing adverse effects and problems. Among these include the potential for infection, bleeding, the formation of blood clots, and the formation of adhesions.
In addition, the excision of a significant amount of the colon might result in changes in digestion, which may necessitate adjustments to one’s way of life, such as the adoption of an unusual diet or the consumption of vitamin supplements.
Through meticulous pre-surgery preparation and careful monitoring at all stages of the treatment, most of these risks can be mitigated to a significant extent.
Recovery After Colectomy
The length of time necessary to make a full recovery after undergoing a colectomy procedure varies from person to person and is directly proportional to the extent of the procedure.
In most cases, it takes between four and eight weeks for the body to heal, but it can take as long as six months until all the adverse effects have subsided, and the patient is back to feeling normal.
To improve their chances of making a full recovery, patients should pay close attention to the prescriptions, nutrition, and activities recommended by their doctors throughout this time.
In addition, as part of the recovery process, physical therapy may be advised to assist strengthen muscles and minimize discomfort.
Diet After Colectomy
It is essential to adhere to a diet that is both healthy and well-balanced after having a colectomy, as this will assist the body in recovering as quickly as possible.
Consuming a wide variety of healthful foods can assist in the restoration of strength, the promotion of healing, and the reduction of discomfort. Your doctor may recommend that you maintain a low-fiber diet for the first few weeks following surgery and then gradually introduce foods that are high in fiber, such as fruits and vegetables.
This recommendation will depend on the degree of the procedure. In addition, it is essential to consume enough fluids to provide optimal hydration and contribute to the maintenance of a healthy body.
Prognosis
Even though the risks and amount of time needed for recovery after a colectomy can be intimidating, the prognosis for many patients is favorable.
The operation is usually successful in addressing the underlying disease, and many patients can anticipate making a full recovery if they receive the appropriate care and monitoring after the procedure.
In addition, adaptations to one’s lifestyle, such as consuming a special diet or taking vitamin supplements, may be able to mitigate the potential adverse effects of the treatment on one’s digestive system. A patient should be able to return to their usual life in a short amount of time if they are dedicated and committed to following the directions given to them by their doctor.
Appointment
For more information on Colectomy or consultation with Dr. Valeria Simone MD at Southlake General Surgery, Texas, USA. You can contact our healthcare expert today at +1(817) 748-0200.