Total abdominal colectomy: Medline. Plus Medical Encyclopedia. Cima RR, Pemberton JH. Ileostomy, colostomy, and pouches. Colectomy (col-+ -ectomy) is bowel resection of the large bowel. It consists of the surgical removal of any extent of the colon, usually segmental resection (partial.Left colectomy: Open technique. Foods to Avoid After a Hemicolectomy. Diet Following a Sigmoid Colectomy. What Are Soft Foods After Oral Surgery? Colectomy is a surgical procedure to remove all or part of the colon. When only part of the colon is removed, it is called a partial colectomy. Frequently asked questions about colectomy/colon resection and laparoscopic colectomy for colorectal cancer, diverticular disease and inflammatory bowel disease. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. Philadelphia, PA: Elsevier Saunders; 2. Cunningham D, Atkin W, Lenz HJ, Lynch HT, Minsky B, Nordlinger B, et al. PMID: 2. 03. 04. 24. Fry RD, Mahmoud NN, Maron DJ, Ross HM, Rombeau J. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. Philadelphia, PA: Elsevier Saunders; 2. The goals of laparoscopic right hemicolectomy (right colectomy) performed in the setting of colon cancer are the same as those for open surgery. I am now 2-1/2 months post-op (right hemi-colectomy with removal of 32 lymph nodes and my ileo-cecal valve), and am experiencing unpredictable, watery, horrid. What is a Hemicolectomy? That would be called a colectomy because you had a piece of the colon removed. The prefix 'hemi-' means 'half' in Latin. Colectomy: Frequently Asked Questions - The University of Chicago Medicine. Q. What is a colectomy? A. A colectomy is the removal of part of the colon (partial colectomy) or the entire colon (total colectomy), also known as the large intestine. Colectomy can be used to treat a variety of diseases, including removal of colon or rectal cancer or large polyps (growths that arise on the lining of the colon), diverticular disease, inflammatory bowel disease (Crohn’s disease or ulcerative colitis), or bleeding that cannot be stopped. The portion of the colon removed depends on the nature of the disease. Top. Q. How is a colectomy performed? Colon resection can be performed in two ways: conventional open surgery or laparoscopic surgery. Conventional Open Colectomy. An open colectomy uses a long incision down the center of the abdomen. The exact same operation is performed on the inside as with an open colectomy. Surgeons at the University of Chicago Medicine have more than a decade of expertise in performing advanced laparoscopic colectomy. What are the benefits of colectomy? A. If a colectomy is recommended for a benign, or non- cancerous, growth, it is usually because that growth is symptomatic in some way (bleeding or causing a blockage) or to prevent it from progressing into a cancer. In the case of diverticulitis or inflammatory bowel disease, colectomy is used to remove a segment that is affected by severe inflammation or infection. When a colectomy is needed to treat a malignant (cancerous) tumor, the surgeon must remove both the tumor and the vascular and lymph structures supplying that portion of the colon. This operation can be curative, depending on the stage of the cancer. Patients who have a colectomy for cancer will meet with a medical oncologist soon after they have recovered from surgery to determine if further treatment such as chemotherapy is required. What are the benefits of the laparoscopic or minimally invasive approach? A. While laparoscopic surgery for colon cancer is an established and valuable option, the benefit of laparoscopy in rectal cancer surgery is still under investigation. Our surgeons at the University of Chicago Medicine are involved in the largest multicenter trial investigation on the use of laparoscopy for rectal cancer. The advantages of a laparoscopic colectomy include reduced postoperative pain due to a shorter incision and decreased exposure of the intra- abdominal viscera to air, compared to an open colectomy. Additional benefits include shorter hospital stay, smaller surgical scars, and faster return to normal activities including work. The gastrointestinal tract usually recovers more rapidly so patients can resume eating sooner. It is sometimes possible to avoid the need for narcotic pain medicines completely after a laparoscopic colectomy. What happens during a colectomy? A. During a laparoscopic colectomy, the surgeon enters the abdomen by placing a cannula or port (narrow tube- like instrument) into the abdomen through a small incision measuring less than half an inch. Carbon dioxide (CO2) gas is pumped into the abdomen through the port to create more space inside the abdomen. It is placed through the cannula to allow the surgeon to see a magnified, lighted view of the internal organs on a high- definition monitor. Up to four more ports are inserted to allow the surgeon and an assistant to use specialized instruments to work inside the abdomen. The blood vessels supplying only that segment are then sealed with a specially designed energy device and divided. The two remaining ends of the colon are then reconnected, either with a surgical stapler or sutures. When open surgery is indicated or recommended, the same principles are applied, but the surgeon works with traditional handheld instruments through a larger, single incision. Top. Q. Is laparoscopic colectomy right for me? A. Not every patient is eligible for laparoscopic colectomy. This depends on the type of disease affecting the patient and the training of the surgeon. Several other factors are considered including the patient’s body type and overall health, previous operations on the abdomen resulting in scar tissue, history of bleeding problems and pregnancy. Will I need to have a temporary or permanent stoma (ileostomy or colostomy) after the surgery? Instead of eliminating with a bowel movement, intestinal waste passes into a specially fitted low- profile appliance, also known as a pouching system or a bag. Whether or not a patient will require a stoma depends on the nature of their disease. Temporary and even permanent ileostomies are sometimes required after certain operations for inflammatory bowel disease, and for some rectal cancer operations. If the rectal cancer involves or is close to the anal sphincter mechanism, a permanent colostomy could be required. Patients who may require a stoma work closely with a team of highly experienced enterostomal nurses to learn how to manage their stoma. Patients with stomas are able to live healthy, active lives and enjoy all of the activities they used to do before they had a stoma. What happens after colon resection surgery? A. After an open or laparoscopic colectomy, the patient will be connected to IV fluids to maintain hydration. During the initial time of recovery, the patient wakes up from anesthesia while in the recovery room. The patient is then transferred to the surgical floor to spend the rest of his or her stay at the University of Chicago Medicine. Narcotic pain medications are often necessary but do slow recovery of the gastrointestinal tract. Within the University of Chicago Section of Colon and Rectal Surgery, we advise patients to self- regulate their oral intake during recovery and slow down or stop if they have nausea or feel full. This is to avoid unnecessary trauma to the healing intestinal reconnection. The long- term effects of colectomy depend on the amount of the colon removed. Even in a situation when the entire colon needs to be removed, as is often the case in ulcerative colitis, the patient will be able to return to his or her normal activities with a good quality of life despite the absence of the entire colon. However, we recommend that the patient avoid heavy lifting for approximately six weeks. Depending on the condition for which the surgery was recommended, regular checkups are scheduled either with surgeons, medical oncologists or gastroenterologists at the University of Chicago Medicine. Top. Q. What other treatments will I need in addition to colectomy? A. In cases of colectomy for cancer, very specific guidelines are followed at the University of Chicago Medicine in terms of administration of chemotherapy and/or radiation therapy. It is generally recommended that patients with Stage 3 colon cancer undergo chemotherapy after surgery. Currently, a prospective randomized trial sponsored by the American College of Surgeons Oncology Group (ACOSOG) is studying patients with Stage 2 colon cancer with markers suggesting high risk of recurrence to determine whether to treat them with chemotherapy. A multi- disciplinary team helps guide every patient through this process, including the coordination of multiple appointments. These patients will receive more treatment with chemotherapy after the operation. Several studies have shown that this treatment approach reduces the chance of cancer recurrence. For inflammatory bowel disease patients, our Section of Gastroenterology is at the forefront of innovation and new treatment modalities. Our surgeons work in close collaboration with them and offer a team approach, if needed, after surgery. Top. Q. What are the complications and risks associated with colectomy? A. The potential complications after colectomy include bleeding and infection, injury to nearby structures including the intestines, the bladder, blood vessels, and the ureter (a tube that carries urine from the kidney to the bladder). Blood clots can occur in the veins, and these can travel to the lungs. Hernia at the surgical incisions or bowel obstruction from internal scar tissue can also occur, even years later. For an operation like a colectomy, it is important to find a surgeon that has had specific training in this field and extensive experience in handling complex colorectal problems. Prior to the surgery, ask the surgeon about the volume and number of cases annually performed, the complexity of these cases, and their own overall complication rate. At the University of Chicago Medicine we provide patients with multidisciplinary, state- of- the- art care that can improve long- term outcomes. Our colon and rectal surgeons are highly trained in laparoscopy and are actively involved in national clinical trials and teaching courses.
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