DEFINITION

The large intestine, or colon, is the lower part of the digestive tract. Diseases of the colon are common, and more than one-half million surgical procedures are performed in the United States every year to treat them.

 

INDICATIONS FOR COLON RESECTIONS

  • Colon cancer
  • Diverticular disease (diverticulitis)
  • Gastrointestinal bleeding
  • Inflammatory bowel disease (Crohn’s disease, Ulcerative colitis)
  • Intestinal polyps
  • Large bowel obstruction

During a colon resection, the diseased portion of the bowel is removed and the two healthy sections of the colon are reattached. This is called an end-to-end anastamosis. If an anastamosis is not possible because of the extent of the disease or its location, a colostomy is then created. A temporary colostomy is made when the colon is severely inflamed and needs time to heal after surgery. An anastamosis is performed once the inflammation has resolved, approximately 3-6 months.

 

REASON FOR PROCEDURE

  • Colon cancer
  • Diverticular disease (diverticulitis)
  • Gastrointestinal bleeding
  • Inflammatory bowel disease (Crohn’s disease, Ulcerative colitis)
  • Intestinal polyps
  • Large bowel obstruction
  • Symptoms
  • Fever, chills
  • Nausea, vomiting, diarrhea
  • Bloating, unable to pass flatus
  • Abdominal pain and/or distention
  • Bleeding

 

TREATMENT OPTIONS

Nonsurgical Option

A majority of colonic pathology requires surgery. For some diseases where observation is undertaken, surgery may be eminent if symptoms don’t resolved. Generally a few days of bowel rest (nothing to eat) and intravenous hydration with or without antibiotics are necessary. For those who do not resolve, or if an obstruction is due to a mass, tumor or inflammation with infection, surgery is indicated.

Surgical Option

Laparoscopic resection of the affected portion of colon or the conventional open resection.

 

RISKS ASSOCIATED WITH SURGERY

  • Infection of the skin
  • Intra-abdominal infection
  • Breakdown of colonic connection (anastomosis) or leakage of fluid from colon
  • Postoperative ileus (the intestines slow down/stop working for several days)
  • Intestinal injury

(This is only a partial list of potential complications)

 

PRE-OPERATIVE PREPARATION

May include blood work, urinalysis, abdominal x-rays, abdominal CT scan and colonoscopy.

 

AVERAGE HOSPITAL STAY

Varies amongst patients, but the average patient stays hospitalized for about 1-5 days without surgery and 4-8 days with surgery.

 

TYPE OF ANESTHESIA REQUIRED

Laparoscopic surgery requires general anesthesia which blocks pain and keeps you asleep throughout the entire surgery.

 

RECOVERY PERIOD

Once you have undergone laparoscopic surgery, your recovery period is usually shortened when compared to conventional open surgery. Most patients can usually go home within 1 to 2 days after the procedure although every case is different. You will be given pain medication along with a laxative to prevent constipation. Your activity may be limited to light lifting (no more than 20 lb) for one month.