Sigmoid Colectomy

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Sigmoid colectomy is the surgical removal of the left side of the colon which is known as sigmoid colon. It is generally performed in patients with a colon cancer or for non-cancerous conditions such as Crohns disease and diverticular disease. It is sometimes performed in patients with rectal prolapse, colon infection or one of several colon diseases.

Will there be a stoma formation after surgery?

Stoma formation is a procedure of making a small hole in the tummy and a section of the bowel is brought to the surface and stitched to the skin, the bowel waste expels out of the stoma and is collected in a bag that covers it. The risk of stoma formation is for every surgery that is performed on the left side of the bowel. Stoma formation usually does not happen after this surgery. The surgeon will decide whether stoma formation is required or not after surgery.

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Before the Treatment

Preoperative instructions

Prior to the operation-

Every patient before bowel or colon resection surgery needs appropriate bowel preparation. 3-5 days before the surgery light eating is recommended. Fibre intake must be limited and beans, bran, nuts, whole grains, raisins, raw fruits and vegetables, seeds, tomatoes, and salads must be avoided. Drinking plenty of fluids and avoiding blood thinning medications such as aspirin is recommended.

Day of surgery-

Eating or drinking is not allowed after midnight before the day of colon resection surgery. Regular medications should be taken with a sip of water. The doctor may recommend suitable enemas for the patients before surgery.

How it is Performed

Duration: It is generally two and a half hours.

Sigmoid colectomy is performed either as an open or laparoscopic procedure. In Open surgery, the surgeon makes a large incision in the abdomen and removes the affected area of the bowel. In a Laparoscopic procedure, the surgeon makes many small incisions in the abdomen and inserts specialist instruments will be guided by a camera to remove a section of the large bowel.

Both the procedures are equally effective in removing the cause of the condition and risks of complications are same. The sigmoid colon is removed during the procedure. After the surgery, the surgeon joins the remaining part of the colon and the rectum. Sutures or special staples are used for this joining. Sigmoid colectomy generally does not require the formation of a stoma i.e. ileostomy or colostomy. The portion of bowel that is removed is sent for analysis to the pathology department for examination. The results are expected within two weeks of the operation.


Post operative instructions and care

Patients can usually expect a 3-5 day hospitalization after the colon resection surgery. Whether the surgery is done laparoscopically or through an open operation, the incisions are generally closed with staples or sutures. In any case, the patient must not cover the incisions by the time they go home from the hospital. Glue or steri-strips fall off on their own within 8-10 days.

Diet- The diet is limited that advances based on the individuals. The low residue diet is continued for two weeks after surgery and gradually advanced to a high fibre diet.

Bowel movements- Some patients do have some loose stools after the function begins whereas some patients may have difficulty in moving their bowels. All of these alterations are for a short time and patients return to their normal routine within 2-4 weeks of surgery.

Benefits of surgery

  • Removal of a part of the bowel that is affected due to colon infection or colon diseases
  • Improvement in the bowel problem

Risks associated with sigmoid colectomy: Short-term complications

Ileus- It is the temporary stoppage of bowel movement. The working of bowel starts slowly and needs rest. Intravenous fluids through a drip help to replace the fluids and nasogastric tube may be inserted. This is continued until the bowel functions again.

Anastomotic leak

Sometimes the join in the bowel breaks and may cause leakage of fluids and faeces leading to severe infection. Resting of the bowel and antibiotic usage is required in this situation.

Damage to the bowel

Damage to the bowel can occur due to the surgical instruments.

Long-term complications

Bladder/ureter damage-Some patients may have difficulty in passing urine after surgery. But this complication is temporary and resolves with time.

Nerve damage and sexual dysfunction - Damage to the pelvic nerves may affect sexual function in both males and females. The surgeon will discuss these complications before the surgery.

Bowel obstruction- Bowel obstruction occurs due to obstruction of scar tissue and restricts the bowel activity. Resting the bowel for some time will help to resolve this issue.

You may also experience general complications of any major bowel surgery like

    • Urinary tract infection
    • Haemorrhage
    • Wound infection
    • Wound dehiscence
    • Incisional hernia
    • Deep vein thrombosis
  • Scar tissue

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