Colectomy

(Hemicolectomy, partial colectomy, or segmental resection)

Procedure overview

A colectomy is a type of surgery used to treat colon diseases. These include cancer, inflammatory disease, or diverticulitis. The surgery is done by removing a portion of the colon. The colon is part of the large intestine. When treating cancer, the surgeon will often remove the part of the colon that appears to have cancer. He or she will also remove another small part on either side of the cancer area. And he or she will remove some nearby lymph nodes. The remaining parts of the colon are then attached to each other. Or an opening to the outside of the body (stoma) is created. This is called a colostomy. 

A colectomy can be done in 2 ways:

• Open colectomy. This is done through a long, vertical incision on your belly.

• Laparoscopic-assisted colectomy.This is done with small incisions. A tiny video camera is put into 1 of the incisions. This is done to help the surgeon see the colon. This surgery may be a choice for some cancers. People often have less pain and recover quicker because of the small incisions. 

Reasons for the procedure

A colectomy is usually done if colon cancer is in its earlier stages. If the cancer has grown past the early stages, a more extensive colectomy may be an option.

Your healthcare provider will advise a colectomy if your medical team believes it will give you the best chance of survival or improve your quality of life.

Risks of the procedure

All surgery has risks. Talk with your healthcare provider before the surgery if you have concerns. Risks of a colectomy include:

• Reactions to anesthesia

• Blood clots in the legs or lungs

• Internal bleeding

• Infection at the skin incision site or inside the belly

• Hernia

• Scar tissue (adhesions) in the stomach, which can block the intestines

• A leak where the intestines are sewn together

• Damage to nearby organs

Before the procedure

Before a colectomy you will need a complete evaluation by your medical team. This is done to stage your cancer and plan your surgery. This may include special X-rays, blood tests, and an EKG. You may have a colonoscopy. This is a procedure to look inside your colon and rectum. It is done with a flexible, lighted scope and a tiny video camera.

Here is what to expect before surgery:

• Your bowels must be empty for the surgery. You will need to make changes to your food and drink intake on the days before surgery. Follow all of your healthcare team’s instructions.

• You may need to do bowel prep 1 to 2 days before the procedure. This may include a laxative and enemas to clean out the bowel.

• You may be told to only drink clear liquids or broth the day before surgery. You may also be told not to have any food or drinks at all up to 12 hours before the procedure. 

• You may need to stop taking some medicines in the week before the surgery. This includes any medicines that thin the blood.

Your healthcare provider may give you other instructions.

During the procedure

Here is what to expect during surgery:

• You will have general anesthesia for the surgery. This is medicine that causes you to sleep during the procedure.

• For an open colectomy, the surgeon will make a long cut (incision) on your stomach. For a laparoscopic-assisted colectomy, he or she will make several smaller incisions.

• The surgeon will remove part of your colon.

• The 2 open ends of the colon will be attached. Or a stoma will be created.

• The lymph nodes near the site of the cancer will be removed. Surgeons often remove at least 12 of these lymph nodes.

• Once the surgery is done, the incision is closed.

After the procedure

You will likely be in the hospital for 3 to 7 days. You'll likely also need to take pain medicine for several days. You may be allowed some liquids as your colon begins to recover.

After a few days, you may be able to eat some solid food again. Your healthcare provider will schedule follow-up appointments to check on your progress.

Before leaving the hospital, make sure you know what problems or side effects to watch for. Watch your wounds for signs of problems, such as swelling. Ask what number to call if you have problems. 

When to call your healthcare provider

Call your healthcare provider if you have any of the below:

• Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

• Swelling, redness, bleeding, or fluid leaking from the incision

• Pain that gets worse

• Shortness of breath