Colectomy is a crucial surgical procedure mainly to treat colon cancer. Find out when this intervention is recommended and how to prepare.
Before undergoing this surgical procedure, it is essential that the patient is well informed and understands all aspects of the procedure. Continue reading and see all the details on the subject.
What is colectomy and how is it performed?
This is a surgical procedure that involves the total or partial removal of the colon, also known as the large intestine.
This intervention is indicated in different medical conditions, such as colorectal cancer, inflammatory bowel disease, intestinal perforation, obstruction, severe diverticulitis, and large polyps.
There are different types of colectomy, depending on the portion of the colon to be removed.
Total colectomy involves the complete removal of the colon, while partial or segmental removes only a specific part of the colon.
In addition, an ileostomy or colostomy can be performed, which is the creation of an opening in the abdominal wall for the passage of feces, if it is necessary to temporarily divert the intestinal transit.
This procedure can be performed through open surgery or laparoscopic surgery.
In open surgery, an incision is made in the abdominal wall to access the colon.
In laparoscopic surgery, small incisions are made in the abdominal wall to insert a camera and special surgical instruments. Laparoscopy is less invasive and allows for a quicker recovery.
During the surgery, the surgeon removes the segment of the colon affected by the disease or medical condition.
Then, the healthy ends of the colon are joined again by sutures or surgical staples.
If a temporary ileostomy or colostomy is necessary, the surgeon creates an opening in the abdomen for the exit of feces, which will be collected in an external bag.
It is important to remember that this is a complex surgical procedure and that each case is unique.
Therefore, it is essential that the decision and performance of this procedure are discussed between the patient and the medical team, considering the risks, benefits, and specific conditions of each individual.
When is colectomy necessary to treat colon cancer?
The decision to perform a surgery like this in the treatment of colon cancer depends on several factors, including the stage of cancer, the location of the tumor, and the patient’s overall health.
Surgery is generally considered necessary when colon cancer is in more advanced stages, when the tumor has spread beyond the lining of the colon or to nearby lymph nodes.
In these mentioned situations, surgical removal of the affected colon may be the best option to stop the progression of cancer and prevent metastases to other parts of the body.
In addition, the procedure in question may be recommended in cases of large or multiple adenomatous polyps, which are pre-cancerous growths in the colon.
If the polyps are large or numerous, it may be necessary to remove the corresponding portion of the colon to reduce the risk of future development of cancer.
What are the risks and complications associated with colectomy?
Although it is a common procedure, there are risks and complications associated with this surgery, which can vary depending on the extent of the surgery and the patient’s overall health.
One of the main risks is the possibility of complications related to anesthesia, such as allergic reactions, respiratory or cardiovascular problems.
Besides that, as in any surgical procedure, there is the risk of infection at the incision site or more serious infections such as, for example, pneumonia.
Another common complication is bleeding during or after surgery. Although some bleeding is expected during the procedure, in some cases excessive bleeding may occur, requiring additional intervention, blood transfusions or, in severe cases, even the removal of the entire colon.
The formation of blood clots is another concern during and after the operation.
These clots can develop in the legs (deep vein thrombosis) and, if they migrate to the lungs (pulmonary embolism), can pose a risk to the patient’s life.
Intestinal complications can also occur after the procedure.
Adhesions, obstructions, leakage of intestinal fluid or fistulas are potential complications that may require additional surgery or medical intervention for correction.
And also, this surgery can lead to temporary or permanent changes in the pattern of bowel evacuation.
Some patients may experience frequent diarrhea or fecal incontinence, while others may face chronic constipation.
All these changes can have a significant impact on the patient’s quality of life.
It is worth mentioning that not all patients will face these complications and risks, and most cases of colectomy are successful, leading to the resolution of the underlying health problems.
However, it is essential to discuss all potential risks and complications with the surgeon and follow all pre and post-operative instructions to minimize these occurrences.
How to prepare for colectomy surgery?
This is a very important surgical procedure that requires adequate preparation to ensure the success of the intervention and a more peaceful recovery.
Here are some important steps to prepare for surgery:
1 – Medical consultation
The first step is to schedule a consultation with the responsible surgeon to discuss the need for surgery and answer all your questions.
The doctor will assess your health condition, request tests, and discuss the details of the operation.
2- Pre-operative exams
Usually, blood tests, x-rays, CT scans or MRIs will be requested to assess the state of the colon and ensure that there are no additional complications.
3- Medications
The doctor may advise you to stop certain medications before surgery, especially those that may increase the risk of bleeding or interfere with anesthesia.
Find out in advance which medications you should keep suspended and for how long.
4- Diet
In general, it is necessary to follow a special diet a few days before surgery.
This may include avoiding solid foods, but the doctor or nutritionist will provide specific guidelines for you.
5- Intestinal cleansing
Depending on the type of operation to be done, it may be necessary to perform a complete intestinal cleansing before surgery, involving the use of laxatives and special solutions to completely empty the colon.
6- Keep the doctor informed about your health
It is essential to inform the doctor about any pre-existing health conditions, allergies to medications, previous surgical history, and other relevant details.
With this action, you will help the medical team to plan the surgery properly and avoid complications.
What to expect during recovery after colectomy?
After colectomy, gradual recovery is expected.
Initial hospitalization occurs, followed by pain control with medications.
The diet is started with intravenous liquids and progressing to liquids, soft foods, and normal diet.
The incision points should be cared for and regular medical follow-up is very necessary at this time.
Possible complications can include infections, bleeding, leakage of anastomosis (local where the intestine was joined), formation of adhesions or anesthetic complications.
Therefore, it is essential to follow the specific recovery guidelines that the doctor will provide, based on the patient’s condition and the surgery performed.
Colectomy is a serious procedure that requires specialized care for effective recovery and a healthy return to quality of life.
Therefore, paying attention to medical instructions and adopting a healthy lifestyle are essential for a successful recovery in this surgery.
Image by brgfx on Freepik
Doutor em Gastroenterologia pela FM-USP.
Especialista em Cirurgia do Aparelho Digestivo (HCFMUSP), Endoscopia Digestiva (SOBED) e Gastroenterologia (FBG).
Professor do curso de Medicina da Fundação Educacional do Município de Assis - FEMA.
Médico da clínica Gastrosaúde de Marília.