St. David's HealthCare

St. David's HealthCare is one of the largest health systems in Texas and Austin's third-largest private employer, with more than 60 sites throughout Central Texas, including seven hospitals, four urgent care centers, four ambulatory surgery centers, and two freestanding emergency departments, with a third set to open in Bastrop this summer.

St. David's HealthCare has a long history of serving the residents of Central Texas with exceptional medical care. Our 7,500 employees touch over 858,000 lives each year with a spirit of warmth, friendliness and personal pride.

Visit our main website at www.StDavids.com
St. David's Medical Center (512) 476-7111
St. David's North Austin (512) 901-1000
St. David's South Austin (512) 447-2211
St. David's Round Rock (512) 341-1000
St. David's Georgetown (512) 943-3000
St. David's Rehabilitation (512) 544-5100
Heart Hospital of Austin (512) 407-7000

Health Library

Colectomy—Open Surgery

(Total Colectomy; Partial Colectomy; Colon Removal)

Pronounced: ko-LEK-tuh-mee—oh-pen suhr-gur-REE

This is an operation to remove all or part of the colon. The colon, or large intestine, is the lower part of the intestines.

In a partial colectomy, only part of your colon is removed. In a total colectomy, your entire colon is removed.

Colon

colectomy colon

Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure

A colectomy may be performed to treat a variety of conditions, including:

  • 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
Possible Complications

If you are planning to have a colectomy, your doctor will review a list of possible complications, which may include:

  • Damage to other organs or structures
  • Infection
  • Bleeding
  • Hernia forming at the incision site
  • Blood clots
  • Complications from general anesthesia

Factors that may increase the risk of complications include:

  • Having neurological, heart, or lung conditions
  • Increased age
  • Obesity
  • Smoking
  • Previous abdominal surgery
  • Infection
What to Expect
Prior to Procedure

Your doctor may do the following:

  • 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

Leading up to your procedure:

  • 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.
Anesthesia

You will receive general anesthesia. You will be asleep.

Description of Procedure

A single, long incision will be made in the abdomen. The section of colon will be removed through the incision. When possible, the colon on either side of the removed section will be sewn together.

In a total colectomy, a colostomy or ileostomy will need to be formed. This will create a path for waste to leave your body. A small opening called a stoma will be made in the front of your abdominal wall. The open end of your intestine will be attached at the stoma. The stoma may be either temporary or permanent. This part of the procedure may also be done if your intestine needs time to heal and rest.

Colostomy Pouch

colostomy pouch

Copyright © Nucleus Medical Media, Inc.

The surgeon will close the muscles and skin of the abdomen with stitches or staples. A sterile dressing will be placed over the incision areas.

Immediately After Procedure

The removed tissue will be sent to a lab for examination. You will be taken to the recovery room and monitored.

How Long Will It Take

About 1-4 hours or more

How Much Will It Hurt?

Anesthesia is given to prevent pain during the surgery. Pain is common during recovery. You will receive medication to help manage pain.

Average Hospital Stay

This procedure is done in a hospital setting. The usual length of stay is 5-6 days. Your doctor may choose to keep you longer if complications occur.

Post-procedure Care
At the Hospital
  • 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.
At Home

After your procedure, be sure to follow your doctor's instructions.

If you have a colostomy:

  • 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

After you leave the hospital, contact your doctor if any of the following occurs:

  • 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
  • Lightheadedness
  • Pain or swelling in your feet, calves, or legs
  • Bloody or black stools
  • Diarrhea
  • Lack of stool in the colostomy bag
  • Severe abdominal pain
  • Bleeding from the stoma

In case of an emergency, call for medical help right away.

RESOURCES:

American Society of Colon and Rectal Surgeons

http://www.fascrs.org

National Cancer Institute

http://www.cancer.gov

CANADIAN RESOURCES:

The Canadian Association for Enterostomal Therapy

http://www.caet.ca

Colorectal Cancer Association of Canada

http://www.colorectal-cancer.ca

References:

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-c...-guide-09-07.pdf. Published September 2007. Accessed May 28, 2013.

Last reviewed May 2013 by Marcin Chwistek, MD; Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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