What is a colectomy?
A colectomy is a surgical operation to remove part or all of your colon. It’s also called colon resection surgery. Your colon is part of your large bowel, which makes colectomy a type of large bowel resection.
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What is the colon?
Your colon is part of your large intestine, where waste from the food you’ve been digesting is gradually solidified into poop. After your colon, your large intestine continues into your rectum and anus, where food waste exits your body.
Why is colectomy done?
You may need to have part or all of your colon removed for many different reasons. This can include cancers or diseases that can't be treated with medications. Removing the affected portion helps to ensure that the rest of your gastrointestinal tract can continue to function.
What conditions does colectomy treat?
Many problems can occur that may require part of your colon to be removed.
Conditions commonly treated with colectomy include:
- Colon cancer. When cancer is found in your colon, it’s important to remove the portion of your colon with cancer to figure out the stage of cancer and help prevent it from spreading.
- Precancerous conditions. If a colonoscopy reveals changes in your colon that have a high risk of progressing to cancer, your healthcare provider may recommend removing that portion of the colon preventatively. You may also choose an elective colectomy if you have an inherited condition with a high likelihood of progressing to colon cancer, such as familial adenomatous polyposis (FAP) or Lynch syndrome.
- Large bowel obstruction. If your colon is severely blocked and other treatments haven’t worked, surgery may be required to remove the blockage. A blockage may be caused by a twist (volvulus) or narrowing (stricture) of the large intestine.
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In persistent and severe cases, colectomy may be used to treat:
- Inflammatory bowel disease. If ulcerative colitis or Crohn’s disease has severely affected your colon, your healthcare provider may suggest a colectomy to relieve symptoms.
- Diverticulitis. When diverticulitis either occurs several times repeatedly, won’t improve with medical treatment, or causes damage to other nearby organs, a colectomy may be necessary.
- Uncontrolled bleeding. Injury and bleeding in your colon are difficult to treat from the outside. When gastrointestinal bleeding can’t be stopped, it becomes increasingly dangerous, and colectomy becomes a safer alternative.
Is colectomy a major surgery?
Most people would say so. While there’s no standard definition of major vs. minor surgery, colectomy has an operating time of several hours and a recovery time of up to six weeks, both of which are on the longer side. Besides, a colon resection impacts the way your food travels through your gastrointestinal tract. Some versions of colectomy may affect the way you go to the bathroom in the future.
However, if conditions are favorable, colectomy surgery can be performed using minimally-invasive methods. If you are a candidate for laparoscopic or robotic surgery, your operation and recovery time will be shorter. These minimally-invasive surgery methods use smaller incisions than traditional open surgery, which means faster healing and less pain overall. Your condition will determine what kind of operation you have.
What is the difference between a colectomy and a colostomy?
A colectomy removes part or all of your colon. But what happens to the rest of your intestinal tract after the diseased tissue is removed? That varies, depending on several factors. Sometimes the two remaining ends of your intestines can simply be stapled together in the same surgery, and your intestinal tract can continue to function as usual. But sometimes that’s not possible. In this case, you may need an ostomy — either an ileostomy or a colostomy. The ileostomy or colostomy may be temporary or permanent.
An ostomy is another surgical procedure that creates a new pathway for your poop to follow when the usual pathway is unavailable. If your system can’t pass your food waste along to your rectum and out through your anus, you'll need another way for your poop to come out. A colostomy or ileostomy lets waste come out through a hole in your abdominal wall, called a stoma. A pouch called an ostomy bag attaches to the outside of the stoma to collect the poop.
Not all colectomies require an ostomy, and not all colostomies are permanent. You may only need one temporarily while your intestines are healing from the colectomy. After a few months, many ostomies are reversible, depending on your health. You may return to surgery to have the severed ends of your intestines reconnected (anastomosis) and your stoma closed. Others may need a permanent ostomy.
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