Colectomy is a surgery typically performed to treat or prevent conditions affecting the colon and may include removal of the entire colon (total colectomy) or partial removal of the colon (partial or subtotal colectomy).
Patients undergoing colectomy will be given general anesthesia and the procedure will be done using an open approach that requires an incision of several inches or laparoscopically through a number of small incisions made in the abdomen. During the procedure, once the colon has been removed, the remaining portion of the digestive system will be reconnected or diverted in order to allow waste to leave the body. If diversion is necessary, the colon is connected to an opening in the abdomen called a stoma. The waste is then carried through the stoma to a collection bag that can be emptied as needed. The stoma may be permanent or it may be a temporary solution to allow the colon to heal.
In cases where both the colon and rectum are removed, a collection pouch may be fashioned out of the small intestine and connected to the anus. This method allows waste to be passed normally.
Why is a colectomy performed?
A colectomy may be used to treat a variety of digestive diseases, including:
- Colon or rectal cancer – partial or total removal of the colon may be required for patients with colon cancer
- Bowel obstruction – a blockage in the colon that is considered an emergency any may require a partial or total colectomy
- Crohn’s disease – if medications aren’t helping, removal of the affected area with a partial colectomy may provide temporary relief of symptoms
- Ulcerative colitis – a colectomy may be recommended if medications are not controlling signs and symptoms of ulcerative colitis
- Diverticulitis – the affected area of the colon may be removed if diverticulitis recurs or if complications arise
- Bleeding that cannot be stopped – severe bleeding from the colon may require surgery to remove the affected area
- Preventive surgery – a partial or totally colectomy may be recommended if precancerous changes or polyps (large growths in the lining of the large intestine) are found during a routine colonoscopy
Types of colectomies?
The different types of colectomy operations are typically classified as total or partial removal and then further distinguished by the portion of the colon that has been removed.
Some of the various types of colectomy operations, include:
- Right hemicolectomy – removal of the right side of the colon, also known as the ascending colon
- Left hemicolectomy – removal of the left side of the colon, also known as the descending colon
- Transverse colectomy – removal of the middle portion of the colon that connects the right and left sides
- Sigmoid colectomy – removal of the bottom portion of the colon that connects the left colon to the rectum
- Proctocolectomy – removal of the entire colon and the rectum
Until the bowel begins to heal and regular bowel movements resume, the diet should be limited to liquids. Once the bowel begins to regain function, solid foods can be reintroduced.
In some cases, colectomy is lifesaving. Although it can be hard to adjust to the idea of a stoma, many individuals with stomas continue to live full lives and participate in the same activities they enjoyed before the colectomy. The appliances come in a number of options and are very discreet, allowing them to be carefully hidden under clothing.