Hemicolectomy

Hemicolectomy is a surgical operation during which the right or left part of the colon is removed. The extent of the intervention depends on the nature of the disease, the location and extent of the pathological process. After removal of the affected section, the preserved sections of the intestine are connected to each other whenever possible to restore the natural passage of intestinal contents.

At the Oxford Medical medical center in Kyiv, operations on the large intestine are performed by highly qualified surgeons with many years of work experience. The department is equipped with modern expert-class equipment, and comfortable conditions have been created in the surgical inpatient department for patients' stay and postoperative recovery under round-the-clock medical supervision.

To schedule a consultation with a surgeon at Oxford Medical, call the contact center or use the online appointment form on the website. Based on the examination results, the doctor will determine the indications for surgery and draw up an individual treatment plan.

In cases of malignant tumors, surgery is often the main stage of treatment. In other diseases, the decision regarding surgical intervention depends on the severity of the lesion, the presence of complications, and the effectiveness of previous therapy.

The surgeon determines the method of performing hemicolectomy after evaluating the examination results. The size and location of the affected area, the anatomical features of the intestine, the presence of adhesions after previous operations, and other factors that may affect the course of the intervention are taken into account.

Hemicolectomy can be performed:

• Laparoscopically. To access the intestine, several small incisions are made in the abdomen, through which special instruments and a camera are inserted. The surgeon works under video guidance, gradually separating the required section of the colon from the surrounding tissues. The removed part of the organ is extracted through a slightly enlarged incision.

• By laparotomy. Access to the intestine is provided through an incision in the anterior abdominal wall. This allows the surgeon to work directly with the abdominal organs, which may be necessary in cases of large tumors, extensive adhesions, or significant spread of the disease.

Laparoscopic hemicolectomy has advantages in terms of postoperative recovery: patients usually experience less pain and return to their usual activities earlier. However, minimally invasive access is not suitable in all cases. If technical difficulties or circumstances that complicate the safe performance of the operation arise during surgery, the surgeon may switch to an open intervention.

Before the operation, it is necessary to undergo an examination that will help the surgeon assess the condition of the intestine, clarify the boundaries of the affected area, and plan the intervention. The patient's general health condition is also checked to take into account possible risks during anesthesia and surgical treatment.

Preoperative diagnostics may include:

• general and biochemical blood tests, a coagulogram;

• colonoscopy with biopsy if necessary;

• computed tomography of the abdominal and pelvic organs;

• MRI of the abdominal organs if indicated, in particular to clarify the nature of detected lesions in the liver;

• electrocardiography (ECG) and consultation with an anesthesiologist.

Several days before a planned hemicolectomy, the doctor may recommend a diet with reduced fiber content. Legumes, nuts, seeds, whole-grain cereals, raw vegetables, and fruits with skin are temporarily excluded from the menu. Instead, eggs, white rice, lean meat, fish, and other easily digestible foods can be consumed.

On the day before the operation, bowel cleansing with special preparations is performed as prescribed by the surgeon. Antibiotics may also be prescribed to reduce the risk of infectious complications. The eating and drinking regimen immediately before the intervention is agreed upon with the anesthesiologist. Usually, solid food consumption is stopped at least 6 hours before anesthesia, while clear drinks, in the absence of contraindications, are permitted no later than 2 hours before anesthesia.

Doctors at Oxford Medical recommend informing the surgeon before hospitalization about all medications that the patient takes regularly, especially blood-thinning medications and medications for treating diabetes mellitus. This makes it possible to adjust medication therapy if necessary and prepare for the operation, taking into account individual health characteristics.

Hemicolectomy is performed under general anesthesia. During the intervention, the surgeon removes the right or left part of the colon and then, if possible, restores the continuity of the digestive tract. The operation usually lasts 2–4 hours, but its duration may increase depending on the complexity of the disease.

The main stages of hemicolectomy:

• Obtaining access to the intestine. Depending on the chosen technique, the surgeon makes several small incisions in the abdomen or one larger incision in the anterior abdominal wall.

• Resection of the affected section. The doctor separates the part of the colon that needs to be removed, treats the blood vessels, and excises the tissues within the planned boundaries. In cases of malignant tumors, the corresponding regional lymph nodes are also removed.

• Formation of an anastomosis. After removing the affected part of the organ, the surgeon usually connects the ends of the intestine using a special surgical stapler or sutures. For example, right-sided hemicolectomy with anastomosis involves connecting the small intestine to the preserved section of the colon.

• Completion of the intervention. The surgeon checks the blood supply to the tissues, the condition of the formed anastomosis, and the absence of bleeding, after which the surgical wound is closed.

If a safe connection of the intestine is impossible, the surgeon may create a temporary or permanent stoma to divert intestinal contents. This decision depends on the condition of the tissues, the presence of inflammation, and other features of the operation.

After hemicolectomy, the patient is transferred to the postoperative observation ward. Medical staff monitor the main vital signs, pain intensity, and general condition, after which the patient continues recovery in the surgical inpatient department.

When the operation is over, the patient is transferred to the intensive care unit. He spends 2-3 hours there. During this time, special sensors monitor the respiratory rate and heartbeat, as well as blood pressure and other vital signs. After that, if the patient's condition does not cause concern, he is transferred to a single or double ward of a surgical hospital.

During the first day, bed rest is usually recommended. To ensure comfort, innovative beds with electronic control are installed in the wards. They allow you to choose a comfortable position. Also, if necessary, the patient can call a nurse at any time.

You can sit on the bed or get up for the first time only after a doctor's examination. It is recommended to start moving gradually from the 2nd to the 3rd day. Moderate physical activity serves to prevent the formation of adhesions and the development of postoperative pneumonia.

The average hospitalization period is from 3 to 7 days. It all depends on the complexity of the operation and the patient's well-being.

The recovery period can last from 1 to several months. During this time, the patient is recommended to follow a diet, avoid heavy physical exertion and take prescribed medications. Patients with intestinal cancer may be prescribed appropriate therapy at this time.

After hemicolectomy, nutrition is resumed gradually, taking into account the patient's well-being and the functioning of the digestive system. In the absence of complications, food intake is often permitted within the first day after surgery. Initially, small portions of easily digestible dishes are recommended, and then the diet is gradually expanded.

Main dietary recommendations:

• eat small portions 5–6 times a day, chewing food thoroughly;

• during the first 1–2 weeks, on the doctor's recommendation, limit foods high in fiber, particularly raw vegetables, legumes, nuts, and whole-grain cereals;

• give preference to boiled meat, fish, eggs, white rice, mashed potatoes, and cooked vegetables without skin;

• temporarily avoid fried, very fatty, and spicy dishes, especially if they cause discomfort;

• consume sufficient fluids, especially in cases of frequent or loose bowel movements.

As intestinal function recovers, fresh vegetables, fruits, and other familiar foods are returned to the menu. It is better to introduce new dishes gradually, observing the body's reaction. The duration of dietary restrictions depends on the type of operation and individual tolerance of foods.

According to the recommendations of NHS Borders, after intestinal surgery, it is important to ensure sufficient intake of protein and other nutrients for tissue healing. If appetite is reduced or the patient is losing weight, the doctor may recommend special nutritional supplements.

After hemicolectomy, there is a risk of complications associated with surgical intervention and tissue healing. Their likelihood depends on the complexity of the operation, the presence of concomitant diseases, and the patient's general condition.

Possible complications include:

• postoperative bleeding;

• infection of the surgical wound or abdominal cavity;

• anastomotic failure — loss of the integrity of the intestinal connection;

• temporary impairment of intestinal function;

• intestinal obstruction due to the formation of adhesions;

• deep vein thrombosis and other thromboembolic complications.

Doctors at Oxford Medical explain that after hemicolectomy, in some cases, the creation of a stoma may be necessary to divert intestinal contents into an ostomy bag. With a colostomy, part of the large intestine is brought out onto the anterior abdominal wall, while with an ileostomy, part of the small intestine is brought out. A stoma may be temporary or permanent depending on the possibility of restoring the natural route of bowel emptying.

At Oxford Medical clinic, thorough preoperative preparation is carried out, expert-class equipment is used, and postoperative medical supervision is provided to reduce surgical risks. The surgeons' experience and monitoring of the patient's condition at each stage of treatment help prevent some complications and promptly detect possible abnormalities during recovery.

The cost of hemicolectomy at the Oxford Medical medical center is calculated individually, taking into account the specific features of the planned surgical intervention.

The price of the operation is influenced by:

• the type of hemicolectomy — right-sided or left-sided;

• the method of performing the operation — laparoscopic or open;

• the extent of resection and the need to remove regional lymph nodes;

• the need to form an anastomosis or a temporary or permanent stoma;

• the specific features of anesthesia management and the duration of the hospital stay.

You can find out the preliminary price of hemicolectomy here. The doctor will determine the exact cost after the examination and preparation of the treatment plan. To schedule a consultation with a surgeon at Oxford Medical, call the contact center or fill out the online appointment form on the website.