A Comprehensive Guide to Total Colectomy Treatment

Total abdominal colectomy is a surgical procedure of removing the large intestine from the ileum to the rectum. It is a type of a bowel surgery used as a colon cancer surgery. It is also known as colon resection surgery. After removal, the end of the small intestine is sewn to the rectum. This procedure is also called Ileorectal anastomosis; Subtotal colectomy.

Preparation for the procedure

During the two weeks before surgery- The patient is instructed to stop the medications such as aspirin, ibuprofen, Naprosyn, and others that make the blood clot difficult. Eating high fibre food and drinking 6-8 glasses of water is recommended before the procedure.

The day before surgery: The physician instructs the patient to drink only clear liquids such as clear juice, broth, and water during the day. Solid foods are stopped after midnight and patient is advised to use enemas and laxatives to clear the intestines before surgery. On the day of surgery- The physician may prescribe drugs that must be taken with a sip of water.

Preparation for ileostomy

The physician instructs the patient to use laxatives and enemas before the procedure. Light foods and clear liquids are recommended.

After the procedure

The patient needs to be in the hospital for 3 to 7 days. By the second day, the patient is allowed to drink clear liquids. Gradually thicker fluids and then soft foods are added to the diet, and the bowel begins to work again.

Risks associated with colectomy

Bleeding inside the belly
Damage to nearby organs in the body
Formation of scar tissue in the belly that can block the small intestine
Stool leakage from the connection between the small intestine and the rectum that can cause an infection or abscess.
Wound breaking open
Wound infections

Pros and Cons:

This surgery helps to treat bowel obstruction and bowel perforation.
When conservative measures fail in Crohn's disease, removing the affected part of the colon by colectomy provides relief to the patient.
Bleeding, infection and deep vein thrombosis may occur after colectomy.
The bladder, small intestines and nearby organs may be injured.
Totel colectomy needs an ileostomy after the procedure to remove the waste materials.

Ileostomy

Ileostomy refers to a surgical opening created by bringing the loop of the intestine to the skin surface. The intestinal waste passes out through this ileostomy opening and is collected in the pouching system. Usually ileostomies are sited above the groin near the right side of the abdomen.

Reasons for having an ileostomy

An ileostomy is necessary when large intestines are not capable of removing the waste materials. This happens when the colon is removed. Diseases of the large intestine such as ulcerative colitis, Crohn's disease, familial adenomatous polyposis, and total colonic Hirschsprung's disease may require colectomy. Ileostomy is also necessary in cases of ovarian cancer and colorectal cancer.