Benefits and Risks of Colectomy
A colectomy is a surgical procedure that removes a section of your large intestine (partial colectomy) or the entire large intestine (total colectomy). The large intestine is also called colon or large bowel. Colectomy is performed to treat diseases like Crohn’s disease, ulcerative colitis, or colon cancer. A doctor would only recommend a colectomy in case of colon cancer or, for noncancerous conditions, if all other options have been tried but symptoms return.
For colon cancer, it is possible to cure the cancer by combining surgical removal with other cancer treatments. But there are colectomy risks still to consider. Learn about the benefits and risks of colectomy (by open surgery or laparoscopy), how colon removal surgery might help you, and possible complications related to the surgery.
A colectomy can have a significant impact on your quality of life, by relieving many of your bowel symptoms. It can also save your life, depending on your disease.
People who live with chronic bowel diseases, such as Crohn’s disease or diverticulitis, may benefit from a colectomy if medical treatment has not helped relieve symptoms, which can include severe abdominal pain, diarrhea, bloating, and more. The surgeon removes the inflamed or infected portion of the colon, leaving behind the healthy tissue. People with colon cancer may need the tumor removed before they start chemotherapy or radiation treatment.
If you have a colectomy, you may be left with a colostomy after surgery. That’s an opening in the abdomen for your stool to pass through (instead of passing through your rectum). A colostomy allows the colon to heal from surgery.
Some people may consider a colostomy a risk of colectomy. Your surgeon may not know ahead of surgery whether one will be necessary, or whether it will be temporary or permanent, so it’s important to discuss the benefits and risks of colostomy before colon surgery if possible. (This conversation may not be possible in case of emergency colectomy.)
Risks associated with colectomies are not common, but they include:
- Damage to internal organs near the intestines, such as the bladder
- Obstructions caused by scar tissue after healing
- Puncture of the parts of the bowel left behind
Open Surgery vs. Laparoscopic Colectomy Benefits and Risks
For an open surgery colectomy, your surgeon makes an incision, about 6 to 8 inches long, in your lower abdominal area. The benefit of an open surgery approach is the surgeon can easily access your intestines and other pelvic organs if there are complications or if the surgery is more complicated than anticipated. The risks of open colectomy are that of any surgery (open or laparoscopic), such as possible bleeding, infection and pain. The drawback to open colectomy is a larger scar and a longer recovery period.
With laparoscopic colectomy, the surgeon makes 3 to 5 small incisions in your lower abdomen. The surgeon inserts a camera (laparoscope) into one incision and medical instruments with long handles into the others. The scope relays images to a screen. The surgeon sees inside your abdomen on the screen and performs the surgery with the instruments. The benefits of laparoscopic surgery include less scarring and a faster recovery, but the risks are the same as with open surgery.
Life After a Colectomy
Your quality of life after a colectomy may be better because you no longer have the intestinal symptoms, or they are much improved. People with recent colectomies begin consuming fluids and slowly move to solid, but soft foods over a 6 to 8 week period. You’ll work with a dietitian to optimize your dietary and nutritional needs during that time.
You may have a colostomy if a large part of the colon is removed. Before you leave the hospital, an ostomy nurse will teach you how to manage your stoma (opening) and the bag. You may also need to meet with a dietitian to learn about the best foods with a colostomy and foods you should avoid. If you have a temporary colostomy, you will have a second operation to close it and restore normal bowel function.
It can take weeks at home to recover from the surgery. Speak with your doctor about any restrictions about lifting objects or children, as well as driving and other activities. It’s important to pace yourself and not overdo things during your healing to avoid complications, such as the incision opening, bleeding, and increased pain. It takes about 6 to 8 weeks to fully recover from colon removal surgery.