Surgeons carry out colectomies—the partial or complete removal of a patient’s colon, or large intestine—to treat a range of conditions and diseases, including colon cancer. A number of short-term complications are associated with the procedure, and there is always the possibility of a recurrence of the original condition or disease. With regard to the colectomy itself, however, the long-term prognosis for patients is good.
What is a Colectomy?
Colectomy is a procedure in which a surgeon removes all or part of the patient’s colon (the large intestine). Surgeons carry out various types of partial colectomy to treat conditions including colon cancer, diverticulitis and benign polyps of the colon. They most commonly carry out total colectomies to treat ulcerative colitis.
Different Means of Access
Surgeons gain access to the colon either through a single long incision in the abdomen (open colectomy) or through several small ones (the less invasive laparoscopic colectomy).
Where possible the surgeon will reconnect the two remaining ends of healthy colon to one another and the patient will continue to pass feces through the anus. In some cases, however, this is not possible: in these and temporarily in some other circumstances, the colon is ported to the outside of the body where waste collects in a colostomy bag.
The Short Term
In the short term, colectomy entails a number of serious risk. Possible complications of colectomy include bleeding, infection, injury to other organs, blood vessels, the ureter and the urinary bladder, leakage from the connection between the reconnected ends of the colon, blood clots, hernia and obstruction of the bowel. The patient may also pass very loose stools.
The Longer Term
It is important to distinguish between the long-term effects of the colectomy itself and the recurrence of the condition that resulted in the colectomy in the first place. Even after a total colectomy, a patient can expect to resume normal activities after two to three weeks, although heavy lifting should be avoided for several more weeks after that. The prognosis for patients who have undergone colectomy is generally good, and the procedure itself is unlikely to have any major side-effects other than, in some patients, continuation of loose stools and the need to pass them more frequently; and, of course, the lifestyle changes and inconveniences due to the colostomy bag. In the longer term, however, the condition that was the original reason for the procedure may recur.