Colectomy -- Laparoscopic Surgery
(Total Colectomy; Partial Colectomy; Colon Removal)
Definition
| Colon |
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Reasons for Procedure
- Colon cancer
- Inflammatory intestinal diseases (eg, colitis , Crohn’s disease )
- Intestinal blockage
- Trauma to the intestine
- Diverticular disease —small pouches form in the wall of the colon
- Precancerous polyps (eg, familial polyposis)
- A hole in the bowel wall or dead piece of bowel
- Bleeding from the colon
Possible Complications
- Damage to other organs or structures
- Infection
- Bleeding
- Hernia forming at the incision site
- Blood clots
- Complications from general anesthesia
- Neurological, heart, or lung conditions
- Age: older than 70 years
- Obesity
- Smoking
- Previous abdominal surgery
- Infection
What to Expect
Prior to Procedure
- Physical exam
- Blood tests
- Ultrasound exam of the abdomen—a test that uses sound waves to visualize the inside of the abdomen
- Barium X-ray —x-ray exam of the abdomen after swallowing a barium drink and/or receiving a barium enema
- CT Scan —a type of x-ray that uses a computer to make pictures of the inside of the body
- MRI Scan —a test that uses magnetic waves to make pictures of the inside of the body
- Colonoscopy and biopsy —exam and removal of tissue inside the large intestine using a flexible tube with a camera on the end
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Talk to your doctor about your current medicines. Certain medicines may need to be stopped before the procedure, such as:
- Aspirin or other anti-inflammatory drugs for up to one week before surgery
- Blood-thinning drugs (eg, warfarin [Coumadin])
- Clopidogrel (Plavix)
- Drink at least eight, 8-ounce glasses of water daily.
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If recommended by your doctor:
- Follow a special diet.
- Take laxatives.
- Take antibiotics.
- Shower the night before the procedure using antibacterial soap.
- Arrange to have someone drive you home and to help you at home.
- The night before, eat a light meal or drink clear liquids. Do not eat or drink anything after midnight unless told otherwise by your doctor.
Anesthesia
Description of Procedure
| Colostomy Pouch |
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| Copyright © Nucleus Medical Media, Inc. |
Immediately After Procedure
How Long Will It Take
How Much Will It Hurt?
Average Hospital Stay
Post-procedure Care
- Give you instructions about diet and activity if you have a stoma and a bag to collect waste. During the first few days after surgery, you may be restricted from eating.
- Instruct you to wear boots or special socks to prevent blood clots in your legs.
- Encourage you to do deep breathing to help prevent pneumonia.
- Limit activity for 1-2 months.
- A nurse will teach you 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.
- Tell your doctor and pharmacist that you cannot take medicines that are time-released or time-sustained.
- Do not take laxatives.
- Drink eight, 8-ounce glasses of fluid every day. Extra fluid will be lost in your stool.
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
- Follow your doctor’s instructions.
- Limit activity for 1-2 months.
- A nurse will teach you 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.
- Tell your doctor and pharmacist that you cannot take medicines that are time-released or time-sustained.
- Do not take laxatives.
- Drink eight, 8-ounce glasses of fluid every day. Extra fluid will be lost in your stool.
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
- Follow your doctor’s instructions.
Call Your Doctor
- 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 medicines you were given, or that lasts for more than two days
- Pain that you cannot control with the medicines you have been given
- Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
- Cough, shortness of breath, or chest pain
- Joint pain, fatigue, stiffness, rash, or other new symptoms
- Feeling weak or dizzy
- 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
- Not collecting stool in the ostomy pouch
RESOURCES
American Cancer Society http://www.cancer.org/
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.
A patient guide to colostomy care. Northwestern Memorial Hospital website. Available at: http://www.nmh.org/nmh/patientinformation/patientguidecolostomycare.htm . Accessed July 16, 2008.
Dictionary of cancer terms. National Cancer Institute website. Available at: http://www.cancer.gov/dictionary/ . Accessed July 16, 2008.
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.
Perioperative management. American Society of Colon and Rectal Surgeons website. Available at: http://www.fascrs.org/displaycommon.cfm?an=1&subarticlenbr=127 . Accessed September 24, 2005.
What is the treatment for Crohn’s disease? National Digestive Diseases Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/crohns/#treat . Accessed July 16, 2008.