Colectomy

When medicine alone does not adequately treat inflammatory bowel disease (IBD), surgery may be necessary. The 2 main forms of IBD, Crohn’s disease (CD) and ulcerative colitis (UC), can both affect the colon, or large intestine. (CD can also affect other parts of the digestive tract, like the mouth and small intestine.)

A colectomy is a type of surgery that may be recommended for these people if their disease does not affect the rectum or anus. It is a surgical procedure used to remove all or part of the large intestine. After it has been removed, the colorectal surgeon attaches the end of the remaining part of the intestine to the rectum. This means that the patient will still be able to pass stool through the anus.^1,2

There are 4 types of colectomy surgeries:²

• Total colectomy – removal of the entire colon
• Partial colectomy – removal of part of the colon
• Hemicolectomy – removal of the right or left side of the colon
• Proctocolectomy – removal of both the entire colon and the rectum

What happens during a colectomy?

There are 2 different ways that a colorectal surgeon may perform a colectomy:^1,2

• Open colectomy
• Laparoscopic colectomy

An open colectomy is a more invasive surgery than a laparoscopic colectomy. During an open colectomy, a colorectal surgeon will make a long incision in the abdomen and use surgical tools to manually cut out the affected parts of the colon, or in the case of a total colectomy, the entire colon.²

Laparoscopic colectomy is a less invasive surgery. During a laparoscopic colectomy, a surgeon will make several tiny incisions in the abdomen. Then, a small video camera will be inserted into the colon. The surgeon will use the camera to bring the colon outside of the body through 1 of the small incisions. This allows the surgeon to operate on the colon outside of the body. Once the necessary portion of the colon has been removed, the surgeon will reinsert the colon through the incision.²

After either procedure, the surgeon will connect the remaining part of the intestine to the rectum so the body is able to pass stool through the anus.²

What happens after a colectomy?

People who have undergone a colectomy will typically stay in the hospital to recover for 3 to 7 days. During recovery, the patient will slowly reintroduce liquids. Once the bowels begin to work again, you will be able to reintroduce soft foods. Most people who have had a colectomy will recover fully and will be able to return to most of the activities they were doing before surgery.^1,2

Healthcare providers will advise you about how to care for yourself well during and after the recovery process. For example, you may be advised to adjust your diet or take supplements to ensure that your body is receiving enough nutrients following a colectomy. You may also be advised not to do any heavy lifting or intense exercising during the recovery period, or until your healthcare advisor advises you that it is safe to do so.^2,3

What are the possible risks?

Risks associated with colectomy include common risks associated with any surgery, such as:^2,3

• Infection
• Adverse reaction to anesthesia
• Tears in sutures
• Blood clots

Some risks specific to a colectomy include:^2,3

• Bleeding in the belly
• Damage to nearby organs
• Scarring of the connection between the intestine and the rectum, which can cause a blockage

This is not a complete list of risks associated with colectomy.