The colectomy is the surgical removal or resection of a diseased part of the large intestine or colon. This surgery is recommended as a treatment for various pathological processes. Among them, the most common are cancer, diverticulitis, intestinal obstruction, ulcer activated is eased such as ulcer active col it is that does not respond to treatment, etc.
The intervention is carried out under general anesthesia. Schematically, it would consist of making an incision in the abdomen, through which the diseased part of the colon is removed. Next, the two healthy ends are sutured and the incision is closed.
When it is necessary to remove the entire colon and rectum, the operation is called a proctocolectomy. Resection of the large intestine can be performed with open surgery or by a laparoscopic procedure.
What types of colectomy exist?
- Right hemicolectomy
If the tumor is located in the cecumor in the ascending colon, aright hemicolectomy is performed.
This consists of the removal from 10-15cm. from terminal ileum to the proximal third of the transverse colon, including the corresponding blood vessels and lymph nodes. To restore intestinal transit, an ileocolicanastomos is with the manual or mechanical suture is performed.
- Left hemicolectomy
If the tumor is located in the descending colonor sigma, a left hemicolectomy is performed.
This involves the removal of the descending colon and sigma to the rectosigmoid junction, including the inferior mesenteric artery and vein. The anastomosis can be performed manually or mechanically.
Usually, it is done mechanically by means of a stapler that, from the anus, reaches the sectional area of the colon and crimps with a head that is inserted into the other end of the colon.
- Segmental colectomies
For tumors located in the transverse colon or splenic angle, it is possible to perform less extensive resections, but always with adequate margins and removing the main vascular pedicle.
It is the surgical technique used for the treatment and management of cancer and other diseases of the colon. Making very small incisions not only has aesthetic advantages, but it also reduces postoperative infections and reduces postoperative pain.
As a consequence, the fasting period, the bedtime period, the hospital admission time and the time of work leaves are shorter. The risk of hernias in the incisions is also reduced as they are smaller. Therefore the postoperative discomfort is minor and the return to normal activity very fast.
How is the recovery?
Regarding the postoperative period, the majority of patients remain in the hospital for five to seven days, while the full recovery from surgery can last from one to two months. This recovery time is generally shorter when bowel resection is treated by laparoscopic technique compared to traditional open surgery.
During the first days after surgery, food is restricted. The patient will then start with a diet first liquid and then soft.
It should be noted that, by removing all or part of the colon, bowel habits can be modified and diarrhea tendency may appear. On other occasions, constipation occurs.