Colectomy—Open Surgery
(Total Colectomy; Partial Colectomy; Colon Removal)
Definition
This surgery removes all or part of the colon. The colon is also called the large intestine.
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Reasons for Procedure
A colectomy may be done to treat a variety of conditions, such as:
- Colon or rectal cancer
- Ulcerative colitis and Crohn disease
- Intestinal blockage
- Injury to the intestine
- Small pouches in the colon wall— diverticular disease
- Precancerous polyps, such as familial adenomatous polyposis
- A hole in the colon wall
- Dead tissue
Possible Complications
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Blood clots
- Damage to other organs or structures
- Infection
- Hernia at the incision site
Things that may raise the risk of problems are:
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from surgery
- Tests that will need to be done before surgery, such as imaging
- Cleaning out the colon
Anesthesia
The doctor may give general anesthesia —you will be asleep.
Description of Procedure
Partial Colectomy
An incision will be made in the abdomen. The diseased portion of intestine will be removed. The ends of intestine will be sewn together. Soft tubes may be left in the abdomen. They will help drain any fluids that build up.
The incisions will be closed with stitches or staples. A bandage will be placed over the site.
Total Colectomy
An incision will be made in the abdomen. The entire colon will be removed. Sometimes, the last part of the small intestine (the ileum) is connected to the rectum. A small pouch is made from the ileum to store stool. This pouch will replace the function of the rectum.
The incisions will be closed with stitches or staples. A bandage will be placed over the site.
Colostomy
With either procedure, you may need a colostomy or ileostomy. This creates an opening in the abdomen called a stoma. One or both ends of the intestine will be attached to the stoma. The stoma allows stool to exit the intestine. It collects in a pouch called an ostomy bag. A colostomy may be temporary or permanent.
A temporary colostomy helps the intestine to rest. It will be reversed when the intestine has healed.
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How Long Will It Take
About 1 to 4 hours
Will It Hurt?
Pain and swelling are common in the first week. Medicine and home care help.
Average Hospital Stay
The usual length of stay is 5 to 6 days. If you have any problems, you may need to stay longer.
Post-procedure Care
At the Hospital
After the procedure, the staff may:
- Give you medicines to control pain or nausea
- Teach you stoma and ostomy care
- Place a tube through the nose and into the stomach to give the area time to rest
- Give you IV nutrition while your intestine heals
During your stay, the hospital staff will take steps to lower your risk of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to lower your risk of infection, such as:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others touch your incisions
At Home
Recovery may take 1 to 2 months. Physical activity will be limited during this time. A special diet will be needed for about 6 to 8 weeks.
Call Your Doctor
Call your doctor if you are not getting better or you have:
- Signs of infection, such as fever or chills
- Redness, swelling, excess bleeding, or discharge from the incision or stoma
- Lasting nausea or vomiting
- Pain that you cannot control with medicine
- Problems breathing
- Pain or swelling in your feet, calves, or legs
- Problems passing urine or stool, including bleeding
- Weakness or feeling faint
If you think you have an emergency, call for medical help right away.
RESOURCES:
American Cancer Society
https://www.cancer.org
National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov
CANADIAN RESOURCES:
Canadian Society of Colon and Rectal Surgeons
http://cscrs.ca
Health Canada
https://www.canada.ca
REFERENCES:
Colorectal cancer. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/colorectal-cancer. Accessed January 11, 2021.
Colorectal surgery considerations. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/colorectal-surgery-considerations. Accessed January 11, 2021.
Crohn disease in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/crohn-disease-in-adults. Accessed January 11, 2021.
Crohn’s disease. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/crohns-disease. Accessed January 11, 2021.
Diverticulitis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/diverticulitis. Accessed January 11, 2021.
Matsuda T, Yamashita K. Recent updates in the surgical treatment of colorectal cancer. Ann Gastroenterol Surg . 2018 Feb 15;2(2):129-136.
Surgery for colon cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/colon-rectal-cancer/treating/colon-surgery.html. Accessed January 11, 2021.
Surgery for rectal cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/colon-rectal-cancer/treating/rectal-surgery.html. Accessed January 11, 2021.
Ulcerative colitis in adults. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/ulcerative-colitis-in-adults. Accessed January 11, 2021.
Last reviewed February 2020 by EBSCO Medical Review Board Marcin Chwistek, MD Last Updated: 1/11/2021