Colectomy -- Open Surgery
(Total Colectomy; Partial Colectomy; Colon Removal)
Definition
| Colon |
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Reasons for Procedure
- Colorectal cancer
- Inflammatory intestinal diseases (eg, colitis , Crohn’s disease )
- Intestinal blockage
- Trauma to the intestine
- Diverticular disease —small pouches form in the wall of the colon
- Precancerous polyps, especially those seen in familial polyposis
- A hole in the bowel wall, or dead piece of bowel
- Bleeding from the colon
Possible Complications
- Damage to other organs or structures
- Infection
- Bleeding
- Hernia forming at the incision site
- Blood clots
- Complications from general anesthesia
- Having neurological, heart, or lung conditions
- Age: older than 70 years
- Obesity
- Smoking
- Previous abdominal surgery
- Active infection
What to Expect
Prior to Procedure
- Physical exam
- Blood tests
- Ultrasound exam of the abdomen—a test that uses sound waves to visualize the inside of the abdomen
- Barium X-ray —x-ray exam of the abdomen after swallowing a barium drink and/or receiving a barium enema
- Computed tomography (CT) Scan —a type of x-ray that uses a computer to make pictures of the inside of the body
- Magnetic resonance imaging (MRI) Scan —a test that uses magnetic waves to make pictures of the inside of the body
- Colonoscopy with biopsy samples—visual exam and removal of tissue inside the large intestine using a flexible tube with a camera on the end
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Talk to your doctor about your current medicines. Certain medicines may need to be stopped before the procedure, such as:
- Aspirin or other anti-inflammatory drugs for up to one week before surgery
- Blood-thinning drugs such as warfarin (Coumadin)
- Clopidogrel (Plavix)
- Drink at least eight, 8-ounce glasses of water daily.
- Follow a special diet, if recommended by your doctor.
- You will likely be given laxatives and other medicines to help clean out your bowels.
- Take antibiotics, if prescribed by your doctor.
- You may need to shower the night before your procedure, using antibacterial soap.
- Arrange to have someone drive you to and from the procedure and for help at home.
- The night before, eat a light meal or drink clear liquids as directed. Do not eat or drink anything after midnight unless told otherwise by your doctor.
- Wear comfortable clothing.
Anesthesia
Description of Procedure
| Colostomy Pouch |
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| Copyright © Nucleus Medical Media, Inc. |
Immediately After Procedure
How Long Will It Take
How Much Will It Hurt?
Average Hospital Stay
Post-procedure Care
- If you had a colostomy or ileostomy, a pouch will be attached on the outside of your body. Waste material will be collected in it. You will receive instructions about diet and activity. During the first few days after surgery, you may be restricted from eating.
- You will wear boots or special socks to help prevent blood clots.
- You will be encouraged to practice deep breathing to help open your lungs.
- You will need to take it easy for 1-2 months.
- A specialized nurse will teach you how to care for the stoma site and change the ostomy bag .
- You will progress from a clear liquid, to a bland, low-fiber diet, to your regular diet after about 6-8 weeks.
- Alert your physicians and pharmacist that you cannot take medicines that are considered time-released or time-sustained.
- Do not use laxatives, because postcolostomy stools are usually quite liquid.
- Drink eight, 8-ounce glasses of liquid daily as extra fluids will be lost in your stool.
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
- Be sure to follow your doctor’s instructions .
Call Your Doctor
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Nausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which persist for more than two days after discharge from the hospital
- Pain that you cannot control with the medicines you have been given
- Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
- Cough, shortness of breath, or chest pain
- Joint pain, fatigue, stiffness, rash, or other new symptoms
- Feeling weak or dizzy
- Pain or swelling in your feet, calves, or legs
- Bloody or black stools
- Diarrhea
- Lack of stool in the colostomy bag
- Severe abdominal pain
- Bleeding from the stoma
- Not collecting stool in the ostomy pouch
RESOURCES
American Cancer Society http://www.cancer.org/
American Society of Colon and Rectal Surgeons http://www.fascrs.org/
National Cancer Institute http://www.cancer.gov/
CANADIAN RESOURCES
The Canadian Association for Enterostomal Therapy http://www.caet.ca/
Colorectal Cancer Association of Canada http://www.colorectal-cancer.ca/
References
Alves A, Panis Y, Mathieu P, et al. Postoperative mortality and morbidity in French patients undergoing colorectal surgery: results of a prospective multicenter study. Archives of Surgery. 2005;140:278-283.
A patient guide to colostomy care. Northwestern Memorial Hospital website. Available at: http://www.nmh.org/ccurl/580/761/colostomy-care-guide-09-07.pdf. Accessed July 16, 2008.
Dictionary of cancer terms. National Cancer Institute website. Available at: http://www.cancer.gov/dictionary/ . Accessed July 16, 2008.
Feo CV, Zerbinati A, Giacometti M, et al. The ideal length of hospital stay in the surgical treatment of colorectal cancer. Ann Ital Chir. 2002;73:13-16.
Perioperative management. American Society of Colon and Rectal Surgeons website. Available at: http://www.fascrs.org/displaycommon.cfm?an=1&subarticlenbr=127. Accessed September 24, 2005.
What is the treatment for Crohn’s disease? National Digestive Diseases Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/#treat . Accessed July 16, 2008.
