Colectomy (Bowel Resection Surgery)

What is a colectomy?

A colectomy is surgery to remove part or all of your colon in your large intestine. You may have a colectomy if you have a condition that damages your colon. The damage may affect your gastrointestinal tract so it can’t work like it should.

Healthcare providers may do colectomies to treat the following conditions:

• Colon cancer
• Diverticulitis
• Gastrointestinal bleeding
• Large bowel obstruction
• Severe inflammatory bowel disease

There are inherited disorders, like Lynch syndrome, that increase colon cancer risk. Familial adenomatous polyposis (FAP) is another example. If you have these conditions, a preventive colectomy may reduce your risk.

Colectomy types

A total colectomy removes your entire colon. A partial colectomy removes certain sections of your colon. There are different types of partial colectomies:

• Hemicolectomy removes one side of your colon
• Proctocolectomy removes your colon and rectum
• Proctosigmoidectomy removes the last part of your colon (sigmoid colon), which connects to your rectum. It may involve removing part of your rectum
• Sigmoid colectomy (sigmoidectomy) removes your sigmoid colon

How should I prepare for a colectomy?

A colectomy is major surgery. There’s a lot that goes into preparing for it. First, you’ll meet with your gastrointestinal surgeon. They’ll discuss the specific type of colectomy you’ll have and the method they’ll use.

Your healthcare team will do tests to confirm you’re able to have surgery. You may have tests like:

• Blood tests
• Colonoscopy
• Electrocardiogram (EKG)
• Imaging tests like CT scans or MRI scans

They’ll also explain what you should do during the few days before your surgery. General guidelines are:

• Arrange for someone to take you home from the hospital after your surgery.
• Start a clear liquid diet a few days before your surgery.
• Use a bowel prep to clear out your intestines before surgery.
• Don’t eat or drink anything after midnight the day of your surgery.

What happens during a colectomy?

Here’s what happens during a colectomy:

1. Your anesthesiologist gives you general anesthesia. You’re asleep during surgery.
2. Your surgeon makes one long incision (open colectomy) or several small incisions (laparoscopic colectomy or robotic colectomy) in your belly.
3. They divide your colon and remove the diseased or damaged part.
4. Your surgeon connects the healthy ends of your colon together. They’ll do a colostomy or ileostomy if they can’t reconnect the two sections of your colon.
5. They’ll use sutures to close your incision.

A colectomy may take between one and four hours to complete.

Anastomosis vs. ostomy

Having a colectomy may change the way poop leaves your body. Normally, digested food moves through your colon on its way to becoming poop. Removing part or all of your colon can disrupt that process.

Surgery to remove damaged sections of your colon divides it into two sections. Your surgeon may be able to connect the two sections (anastomosis). This lets poop continue to move through your colon.

But sometimes, that’s not possible. In that case, your surgeon will do an ostomy as part of your colectomy surgery.

What are the potential risks of a colectomy?

Like all major surgeries, colectomies may cause complications. Potential complications include:

• Anastomotic leak
• Excessing bleeding
• Infection
• Injury to nearby organs

What happens after a colectomy?

You’ll stay in the hospital for a few days up to a week. Your intestines can’t process food right after surgery, so you’ll be on a liquid or soft diet for few days. Your healthcare team will check the surgery site for any issues.

Your team will explain how to care for your incision. If you have an ostomy, your care team will explain how to care for it and how to adjust to life with an ostomy bag.

They’ll also explain what you can eat as your intestines recover from surgery. They may have suggestions for activities that you can do once you get home, like walking.

This is a lot of information to take in at any time, especially when you’re just starting to recover from surgery. You may want to have a family member or friend sit in on these conversations.

What is the recovery time?

Recovery at home may take up to six weeks. Many people get back to most of their usual routines within two weeks after surgery. But your recovery time may be different. Try to be extra gentle with yourself. Resist the urge to race back to your routine.

What can I eat after a colectomy?

In general, you should stick to low-fiber foods for the first month after surgery. Low-fiber foods are easier for your colon to process.

When should I call my healthcare provider?

Contact your surgeon if you have:

• Belly pain that gets worse over time
• Fever or other signs of infection like redness, pain or pus at the incision site
• Issues pooping or you don’t poop
• Pain around your belly that gets worse over time

What is the life expectancy after you have a colectomy?

A colectomy is treatment for several conditions. Some of them, like colon cancer, can have an impact on how long you live. Other conditions, like diverticulitis, cause painful symptoms but aren’t life-threatening. And colectomy may be just one part of your treatment. You’re unique, and your life expectancy may be different from that of other people. Ask your healthcare provider about life expectancy. They know you and your situation. They’re your best source of accurate information.