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What is colectomy?

Colon is also known as large intestine. Colectomy is advised in order to treat and prevent any condition or disease that are affecting the large intestine. This is also the treatment option for those suffering with colon cancer. 

Colon cancer may begin from polyps in the large intestine or inside the rectum.Early detection may leads to complete cure. In advance stage, it leads to metastasis in the body i.e. cancer spreads in other parts of the body and thus leads to serious complications.  

There are various types of colectomy surgeries:

• Partial or subtotal colectomy
• Hemicolectomy
• Total colectomy
• Total proctocolectomy

Why colectomy is done?

Colectomy is done in various medical conditions to treat and prevent that affects colon like:

• Colon cancer
• Crohn’s disease
• Ulcerative colitis
• Bowel obstruction

What happens before surgery?

Surgery is only recommended after taking medical history of patients including current or past illness if any, any medication if patient is taking etc. and some test and examinations like colonoscopy are also done. The test which is required before surgery includes

• Blood Test
• Abdominal or chest X-rays
• CT scans
• Ultrasound 
• Urinalysis

What happens during colectomy?

Colectomies take place under general anesthetic, which may be either open surgery or laparoscopic-assisted.

Open surgery

In open colectomy, the section of the colon that is diseased or damaged are removed through an incision in the abdomen. They may also remove some of the surrounding healthy tissue.The ends are stitch or staple together, known as anastomosis, or create a stoma.

If the procedure is for the cancer treatment, some of the lymph nodes near the colon are removed for microscopic examination to check for cancer.

Laparoscopic-assisted surgery

During laparoscopic colectomy, a tiny flexible ports or tubes are inserted through incisions in the abdomen and through these ports or tubes, lights and other surgical tools are inserted by a surgeon. The diseased or damaged portion of the colon are removed through this procedure and either the two ends together are sewed or create a stoma.Procedure type

The surgical procedure during colectomy depend on how much of the colon requires removal. This include:

• Right hemicolectomy: Removal of the right, or ascending, colon.
• Left hemicolectomy: Removal of the left, or descending, colon.
• Segmental resection: Removal of short segments of the colon.
• Total colectomy: Removal of the entire colon. A surgeon will then attach the small intestine to the rectum.
• Transverse colectomy:  Removal of the middle bowel, or the transverse colon.
• Sigmoidectomy: Removal of the sigmoid colon, which is the curved portion of the descending colon that connects to the rectum.
• Low anterior resections: Removal of the upper rectum.
• Abdominal perineal resection: Removal of the rectum, anus, and sigmoid colon and the attachment of permanent colostomy.
• Total proctocolectomy: Removal of all or part of the colon and the rectum.

Risks of colectomy

Risks and complications that are commonly associated with colectomy include:

• Leakage of the colon contents into the abdomen and postoperative bleeding
• Infections, organ or tissue adhesions
• Pneumonia and other lung problems
• Blood clots in veins or the lungs, stroke or heart attack
• Gastrointestinal fistula or an unusual connection between two body parts

Medical advice: People who underwent colectomy, should seek medical advice when they experience any of the following symptoms after surgery: 

• Continuous nausea, fever and vomiting
• Any leakage or drainage from the wound or a bad smell coming from it
• Severe pain, abdominal cramping, swollen abdomen or blood in the stool
• Increased swelling or flushing around or over the incision
• No bowel movements for 2–3 days

Recovery Time post-surgery

Most people stay in the hospital for 3–4 days after laparoscopic-assisted or open colectomies and may return to normal routine. If anyone experience complications like vomiting, nausea, or an inability to pass urine, may need to stay in the hospital for a longer duration.

Many people return to their regular activities 1–2 weeks after laparoscopic-assisted surgery and 2–3 weeks after open surgery.

Summary

Colectomy refers to a type of surgery to remove all or some of a diseased or damaged colon. In one study, 84% of people reported an improvement in their quality of life after surgery. On the other hand, the same study shows 81% people experienced many symptoms like weight reduction, anxiety, depression and overall reduced work productivity.