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Understanding Colectomy

A colectomy is a surgical procedure to remove all or a part of your large intestine (colon). More than 300,000 colectomies are performed each year in the United States. Beaumont surgeons perform about 1,000 colectomies each year. 

Reasons for a Colectomy

When you have a disease or a problem in your colon, the colon can lose its ability to work properly, leading to changes in your bowel habits: this means you may experience watery or loose bowel movements (diarrhea), fewer bowel movements (constipation) or a combination of both. You may also feel pain or cramping, have a fever or experience bleeding.

When medical therapy doesn’t work or isn’t appropriate, a person with colorectal disease may require a colectomy. The surgery can be done in two ways: open or minimally invasive (laparoscopic). In an open procedure, the surgeon makes one incision, usually several inches long, on the abdomen and directly accesses the colon through the wound. In a minimally invasive procedure, the surgeon makes smaller incisions and inserts surgical tools, such as a camera that allows him or her to see, and various instruments that help to cut, seal, staple or suction, etc.

In both cases, the goal of the surgeon is to remove the diseased portion of the colon. Most of the time, the healthy portions of the colon can be sewn together, resulting in a shorter but intact colon.

However, sometimes, it is necessary for the surgeon to create an ostomy (stoma), attaching the colon to the abdominal wall so that waste can empty into an attached appliance (bag) that can be emptied as needed. The ostomy may be temporary, which will require at least one more surgery to reconnect or close the ostomy, or it may be permanent.

Types of Colectomy

There are four different types of colectomy surgery:

  1. total colectomy- your surgeon will remove the entire colon
  2. partial colectomy- your surgeon will remove part of the colon
  3. hemicolectomy- the right or left portion of the colon is removed
  4. proctocolectomy- both the colon and rectum are removed

The surgery you receive depends on your condition.

Generally, colectomies are done under general anesthesia. This is medication that will make you unconscious during your surgery so that you do not feel pain. Epidural anesthesia, which is delivered to the spine, is used sparingly in colectomy patients at Beaumont.

Risks and Benefits of Colectomy

As with any surgery, there are risks involved with colectomy. Primarily, the risks include: 

  • bleeding 
  • blood clots in the legs or lungs
  • leaks in the reconnected bowel
  • infections
  • injuries to other abdominal organs

During your stay in the hospital, you will be monitored by your health care team for signs of these complications. The benefits of a colectomy depend on the condition with which you were diagnosed. For the most part, this means:

  • the relief of pain due to obstruction (blockage)
  • stopping bleeding
  • removing of sections affected by inflammation or infection
  • removal of pre-cancerous or malignant tumors