Procedure overview

A colectomy is a surgical procedure used to treat colon cancer. The surgery involves removing a portion of the colon, or large intestine, usually about one-third to one-fourth of it. The surgeon will typically remove the portion of the colon that appears cancerous, as well as another small portion on either side of the cancerous part and some nearby lymph nodes. The remaining parts of the colon are then attached to each other.

A colectomy can be done in two ways. The traditional procedure is an open colectomy, in which a long incision is made on your abdomen to give the surgeon adequate access to the colon. The newer form of colectomy is a laparoscopic-assisted colectomy, in which only small incisions are made, and a tiny camera is inserted into one of the incisions to help the surgeon see the area being worked on. This may be an option for earlier stage cancers.

Reasons for the procedure

A colectomy is usually performed if colon cancer is caught in its earlier stages. Sometimes even when the cancer has progressed beyond the early stages, a more extensive colectomy can be an option.

Your health care provider will recommend a colectomy if your medical team has been determined that this surgery will give you the best chance of survival.

Risks of the procedure

Colectomy is generally regarded as a fairly safe procedure, and there are rarely any major complications from it. Still, as with any surgery, it carries some possible risks. Be sure to discuss any concerns with your health care provider before the procedure.

Some possible risks of a colectomy include:

• Internal bleeding
• Infection
• Hernia
• Scar tissue
• Blockage of the intestines
• A leak where the intestines are sewn together
• Damage to nearby organs

Before the procedure

• It is important that the bowels be empty when the surgery is performed. You must follow your health care provider's instructions on dietary changes and liquid intake on the days leading up to surgery.
• A day or two before the procedure, your health care provider may give you a bowel preparation that includes laxatives and enemas.
• The day before the procedure, you may be instructed to only drink clear liquids or broth; you may be told not to have any food or beverages at all up to 12 hours before the procedure.
• Your health care provider may ask you to stop taking certain medications during the week leading up to the surgery.

Based on your medical condition, your health care provider may request other specific preparations.

During the procedure

• You will receive general anesthesia before the surgery, and you will be completely asleep during the procedure.
• Your surgeon will make a long cut on your abdomen if performing an open colectomy or several smaller incisions for a laparoscopic-assisted colectomy.
• The surgeon will use surgical tools to remove the targeted portion of your colon.
• The two open ends of the colon will be attached.
• The lymph nodes near the site of the cancer will also be removed at this time. Surgeons often remove at least 12 of these lymph nodes.
• Once the surgery is complete, the abdominal incision is closed.

After the procedure

A colectomy is a major surgical procedure and you will probably be in the hospital for three to seven days. You'll likely need to take pain medication for two to three days, and you'll also receive nutrition from an IV drip. You may be allowed some limited liquids as the colon begins to recover.

After a few days, you should be able to start on solid food again. Your doctor will schedule follow-up appointments to check on your progress. Most people who have a colectomy have a good prognosis and can expect to live a normal life after their recovery.