GENERAL SURGERY

Colon & Rectal Surgery

Rectal Cancer

Delta Medix Patient General Information

Total Colectomy

The colon, sometimes referred to as the large intestine, has six sections. It begins after the small intestine ends, and is divided into the cecum, ascending colon, transverse colon, descending colon, the sigmoid colon, and the rectum. The anus is not part of the colon and is where the colon ends and the stool is evacuated from the body. Removal of one or more sections of the colon may be required due to a disease process, tumor, or mass. In certain operations, after the diseased part of the colon is remaining ends will be sewn together.

A total colectomy removes most of the large intestine, leaving behind the rectum and anus. In a total colectomy, the proximal end of the small bowel, which is the ileum is typically brought out through the abdominal wall and a hole in the skin is created called a stoma. The ileum is then used to create the ostomy and is therefore referred to as an ileostomy. An ileostomy does require a drainage bag be applied over the site.

Not all total colectomies require the creation of an ileostomy. In certain cases, after the large intestine is removed, the ileum can be joined directly to the rectum during the same surgery. The rejoining of the ileum to the rectum is called an anastomosis. The ileostomy can either be permanent or temporary depending on the disease process that required the total colectomy.

If the rectum is also removed, the procedure is then referred to as a total proctocolectomy and the ileostomy is permanent. A subtotal colectomy is the resection of part of the colon or a resection of the entire colon without complete resection of the rectum.

When this surgery is performed for cancer, it is often necessary to remove some of the surrounding lymph nodes in that area.

Lymph nodes are small glands that filter bacteria, infections and cancer cells out of the blood stream. After removal, the lymph nodes are examined microscopically to see if any of the cancer has spread.

A bowel prep is necessary to clean out the entire colon, minimize the chance of infection and safely perform the surgery.

There are diseases that require a total colectomy and examples include ulcerative colitis and Crohn’s disease.