Colectomy -- Open Surgery
(Total Colectomy; Partial Colectomy; Colon Removal)
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Reasons for Procedure
- Colorectal cancer
- Inflammatory intestinal diseases such as colitis and Crohn’s disease
- Intestinal blockage
- Trauma to the intestine
- Diverticular disease —small pouches in the wall of the colon
- Precancerous polyps, especially those seen in familial polyposis
- A hole in the bowel wall, or a dead piece of bowel
- Bleeding from the colon
- Damage to other organs or structures
- Hernia forming at the incision site
- Blood clots
- Complications from general anesthesia
- Having neurological, heart, or lung conditions
- Increased age
- Previous abdominal surgery
What to Expect
Prior to Procedure
- Physical exam
- Blood tests
- Imaging tests such as ultrasound, barium x-ray, CT scan, and MRI scan
- Colonoscopy with biopsy samples—visual exam and removal of tissue inside the large intestine using a flexible tube with a camera on the end
Talk to your doctor about your current medicines. Certain medicines may need to be stopped before the procedure, such as:
- Ibuprofen or other anti-inflammatory drugs
- Blood-thinning medications
- Anti-platelet medications
- Drink plenty of water.
- Follow a special diet, if advised 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.
- Shower the night before the 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.
Description of Procedure
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Immediately After Procedure
How Long Will It Take
How Much Will It Hurt?
Average Hospital Stay
- 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.
- You will be taught how to care for the stoma site and change the ostomy bag .
- Slowly progress from a clear liquid diet, to a bland, low-fiber diet. You will slowly advance to a regular diet.
- Inform your physicians and pharmacist that you cannot take medicines that are considered time-released or time-sustained.
- Do not use laxatives, because post-colostomy stools are usually quite liquid.
- Drink plenty of fluids, since 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 medications 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 medications you have been given
- Pain, burning, urgency or frequency of urination; blood in the urine
- Cough, shortness of breath, or chest pain
- Fatigue or other new symptoms
- Pain or swelling in your feet, calves, or legs
- Bloody or black stools
- Lack of stool in the colostomy bag
- Severe abdominal pain
- Bleeding from the stoma
American Society of Colon and Rectal Surgeons http://www.fascrs.org
National Cancer Institute http://www.cancer.gov
The Canadian Association for Enterostomal Therapy http://www.caet.ca
Colorectal Cancer Association of Canada http://www.colorectal-cancer.ca
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.
Crohn’s disease. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/#treat . Updated January 18, 2011. Accessed May 28, 2013.
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.
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. Published September 2007. Accessed May 28, 2013.
- Reviewer: Marcin Chwistek, MD; Michael Woods, MD
- Review Date: 05/2013 -
- Update Date: 05/28/2013 -