Colectomy

A loyalty program applies to surgical interventions in the inpatient department, making treatment even more affordable.

Colectomy is a surgical operation during which part or all of the large intestine is removed. The extent of the intervention depends on the nature of the disease, the extent of the pathological process, and the patient's general condition.

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 surgical department is equipped with modern expert-class equipment, which makes it possible to perform complex surgical interventions.

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, if necessary, develop an individual surgical treatment plan.

Doctors at Oxford Medical explain that after partial resection of the colon, the preserved sections of the intestine are connected to each other whenever possible. Such a connection is called an anastomosis. If its formation is impossible or associated with a high risk of complications, a temporary or permanent stoma may be required — a special opening in the anterior abdominal wall through which intestinal contents are discharged into an ostomy bag.

Resection of the large intestine is performed using two main methods — laparoscopic or laparotomic (open). The choice of surgical approach depends on the diagnosis, the extent of the disease, and the presence of complications.

To perform the operation, the following methods are used:

• Laparoscopic method. This is a minimally invasive intervention performed through several small incisions in the abdominal wall. Through them, the surgeon inserts a laparoscope with a video camera and special instruments. An enlarged image of the internal organs is transmitted to a monitor, allowing the doctor to perform the necessary manipulations precisely. To remove the affected section of the intestine, one of the incisions is usually enlarged.

• Laparotomic method. This is an open operation during which the surgeon makes an incision in the abdominal wall for direct access to the intestine. This approach may be necessary in cases of extensive involvement of the organ, large neoplasms, or emergency conditions, particularly intestinal perforation and peritonitis.

According to Cleveland Clinic, the laparoscopic method is usually accompanied by less postoperative pain, a shorter hospital stay, and faster recovery compared with open surgery. At the same time, open access allows the surgeon to directly examine the abdominal organs and perform the necessary extent of intervention when the clinical situation requires it.

Before colectomy, the patient undergoes a comprehensive examination. It may include:

• general and biochemical blood tests, a coagulogram, and other laboratory tests;

• electrocardiography (ECG) to assess heart function;

• colonoscopy with biopsy if indicated;

• computed tomography (CT) of the abdominal and pelvic organs;

• consultation with an anesthesiologist to assess risks and plan anesthesia.

Preparation for planned surgery may also involve a special diet and bowel cleansing. 2–3 days before the intervention, the doctor may recommend limiting foods high in fiber: raw vegetables, fruits with skin, legumes, nuts, seeds, and whole-grain products. During this period, white rice, pasta, eggs, lean meat, and fish can be consumed.

One day before the operation, it may be recommended to consume only clear drinks and liquid products without solid particles: water, tea without milk, clear strained broth. If necessary, special preparations for bowel cleansing and antibiotics are prescribed to reduce the risk of infectious complications.

Before anesthesia, it is usually necessary to abstain from solid food for at least 6 hours. Clear liquids, in the absence of contraindications, may be permitted up to 2 hours before the start of anesthesia. The exact regimen of eating, drinking, and bowel cleansing is determined by the doctor according to the planned operation.

Doctors at Oxford Medical note that it is necessary to inform the surgeon in advance about chronic diseases, allergic reactions, and all medications you are taking. It is especially important to report medications that affect blood clotting, as well as medications for controlling diabetes mellitus. If necessary, the doctor will adjust the regimen for taking them before the operation.

Colectomy is performed under general anesthesia, so during the intervention, the patient is asleep and does not feel pain. The duration of the operation depends on the extent of resection, the chosen surgical approach, and the complexity of the disease.

The main stages of the operation:

• Surgical access. The doctor makes several small incisions during laparoscopic surgery or one larger incision during open surgery.

• Removal of the affected section. The surgeon separates the necessary part of the intestine from the surrounding tissues, ligates the corresponding blood vessels, and removes it. In cases of oncological diseases, regional lymph nodes are sometimes removed along with the section of the intestine.

• Restoration of intestinal continuity. If possible, the doctor connects the preserved sections of the intestine, forming an anastomosis. When such a connection is inadvisable or dangerous, the creation of a temporary or permanent stoma may be necessary — bringing the intestine out onto the anterior abdominal wall to divert intestinal contents.

• Completion of the operation. The surgeon checks the condition of the operated tissues, makes sure there is no bleeding, and closes the surgical incisions. If indicated, a drain is placed.

After completion of the intervention, the patient is transferred to the postoperative observation ward, where medical staff monitor the patient's condition and recovery from anesthesia. With stable indicators, the patient continues recovery in comfortable single or double rooms of the surgical inpatient department.

For several hours after the operation, the patient remains in the postoperative ward. There, the heart rate, breathing, and other vital body functions are monitored. After that, if the patient's condition is stable, he is transferred to a single or double ward of a surgical hospital.

On the day of the operation, the patient is usually recommended to adhere to bed rest. You can get up only after the doctor's permission. From the 2nd-3rd day, moderate physical activity is recommended. It helps prevent the formation of adhesions and the development of postoperative pneumonia.

The duration of hospitalization depends on the complexity of the operation and the patient's well-being. On average, in the absence of complications, it is 3-7 days.

The recovery period after surgery is also purely individual. It may include drug therapy, recommendations on nutrition and physical activity.

Adhering to the recommended regimen and diet after rectal resection allows for normal healing, reduces the risk of postoperative complications, and supports the body in the recovery process.

On the day of surgery, the patient may be allowed to drink only clean, still water. Nutrition is provided parenterally - the body is supplied with nutrients through a dropper.

On the second day, it is possible to eat liquid dishes. It is important that they are warm, but not hot or cold.

On the 4th day, easily digestible dishes of a soft consistency are added. It is recommended to eat in small portions 5-6 times a day.

After 2 weeks after surgery, the menu is gradually expanded, and in the case of an anastomosis, over time, they are allowed to return to a full diet. At the same time, it should remain regular and balanced, and exclude foods that are harmful to health: fried, smoked, spicy, salty foods, spices, fresh milk, coffee, alcohol and foods that contribute to gas formation, constipation or diarrhea.

In the case of colostomy formation, nutritional recommendations may vary. In particular, the patient may be advised to eat foods with a mild laxative effect, minimize fat intake and drink up to 2 liters of water per day.

Violation of the recommended diet can provoke the development of complications.

Colectomy, like any surgical intervention, is associated with certain risks. The likelihood of complications depends on the extent of the operation, the patient's general condition, and the presence of concomitant diseases.

Possible complications include:

• postoperative bleeding;

• infection of the surgical wound;

• anastomotic failure (loss of the integrity of the intestinal connection);

• temporary impairment of intestinal motility;

• formation of adhesions and intestinal obstruction;

• thromboembolic complications.

At Oxford Medical clinic, special attention is paid to minimizing surgical risks. The surgeons' many years of experience, expert-class equipment, thorough preoperative preparation, and medical supervision in the inpatient department help reduce the likelihood of complications and ensure monitoring of the patient's condition during recovery.

One of the possible consequences of the operation is the formation of a stoma — a special opening in the anterior abdominal wall for the discharge of intestinal contents into an ostomy bag. If part of the large intestine is brought out, this is called a colostomy; if part of the small intestine is brought out, it is called an ileostomy. A stoma may be temporary, when restoration of the natural route of bowel emptying is planned later, or permanent, if such restoration is impossible.

The cost of colectomy at the Oxford Medical medical center depends on the complexity of the surgical intervention.

The price of the operation is influenced by:

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

• the extent of colon removal;

• the need to remove regional lymph nodes;

• the need to create a temporary or permanent stoma.

The doctor can determine the final cost of treatment after the examination and selection of the surgical approach. You can familiarize yourself with the prices for medical services in advance here.

To schedule a consultation with a surgeon at Oxford Medical, call the contact center or fill out the online appointment form on the website.

The information is for informational purposes only and does not replace a doctor's consultation.

Sources:

• American College of Surgeons

• National Cancer Institute (NCI)

• American Society of Colon and Rectal Surgeons (ASCRS)