You are here: Home Colorectal Cancer Colorectal ... this content is ... Resection (also known as ...
Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.

this content is moved to A 1846

Resection (also known as "Colectomy" or "Partial Colectomy"

Next » « Previous

2/3

Colectomy is the removal of all or part of the colon in a hospital by a surgeon. With respect to removal of part of the colon, this operation is known as a Colon Resection. 

Preparation for the procedure:

  • You will be asked to put blood thinning drugs on hold for a while – and possibly other drugs as well. You will also be asked to stop smoking and to stop using recreational drugs. (For information about how to stop, click here.)
  • Specific preparation procedures vary from doctor to doctor.  As a general matter, in order that your colon be as clean as possible:
    • Enemas and laxatives, accompanied by a lot of fluids, may be given to remove fecal material – just as they were before a colonoscopy or sigmoidoscopy.
    • The day before surgery you will be asked to eat no solid foods and only drink clear liquids. (For information about what is and is not part of a clear liquid diet, click here. While the document refers to a diet before a colonoscopy, it also applies before surgery).
    • While you may want to minimize the prep, keep in mind that if your colon is not clean, the surgery may be postponed.
  • Antibiotics may be prescribed to remove bacteria from the colon. They will likely be continued as a prophylactic against infection.
  • As part of the procedure, you will be asked to sign a form known as “Informed Consent”. Generally patients first see the form right before surgery begins so there is no time to review it, much less make changes. Ask to see the form ahead of time. Make sure you understand everything in the form. Make whatever changes are necessary. For more information, click here.
  • If you have ever had a blood clot, make sure your surgeon knows.  A blood clot can be a dangerous complication of a surgery. If the doctor knows ahead of time, he or she can take steps to lessen the risk.
  • Talk with your surgeon about whether there will be blood loss during the operation and whether you may need a blood transfusion. If you do, consider reducing the already low risk involved in using some one else’s blood.  Alternatives include:
    • Banking your own blood before the operation. Banking your own blood can be expensive. If it is not used, it is thrown out.
    • Use of a machine during an operation that takes your blood, washes it, and returns it to your body.
  • In addition:
    • Check your health and disability insurance policies to find out what you have to do ahead of time, if anything and to learn about what your share of the costs will be.
    • Think about how you will pay for your share of the medical expenses.
    • Make necessary arrangements at work and at home.
    • Sign or revisit your advance healthcare directives which allow you to stay in control of your medical care if you become unable to communicate.
    • Make sure you have a valid, enforceable Will.
    • To learn more, click here. 

Just before the procedure:

  • A doctor known as an anesthesiologist administers the anesthesia. He or she will meet you with you prior to the procedure to ask questions about your health to determine which anesthesia is best suited for you. Expect questions such as:
    • Current problems such as with your heart or lungs
    • Allergies including allergies to medicines and food
    • Whether you smoke and/or drink alcohol. If so, to what degree.
    • Current medications.
  • You will likely be taken to a staging area where the anesthesiologist will insert an i.v. tube into an arm.
  • You may be given a drug to help you relax until the surgery starts.

The procedure:

  • Once in the operating room, you will be hooked up to several monitoring devices such as a heart monitor and a blood oxygen monitor. You will fall asleep immediately when the anesthesiologist starts injecting the anesthesia drug. Once asleep, a tube will be placed in your throat to keep it open during the surgery.
  • The surgery is usually performed by a colorectal or general surgeon and a surgical team including  a scrub nurse to help with the equipment and the anesthesiologist.
  • The operation involves general anesthesia so there is no pain during the procedure. 
  • What happens during the operation depends on whether the tumor is in the rectum or colon, its size, and whether it has spread.
    • The operation will remove a segment of the colon which has the cancer as well as a small length of healthy bowel around it. The two parts of the intestine are reconnected to each other (the procedure is known as an anastomosis). If the two ends of the colon cannot be sewn together, an opening (a stoma) is made which connects the bowel to the outside of the body so that waste can pass out of the body and into a bag. This is known as a colostomy. If a colostomy is required, it is not likely to be permanent.  (To learn about ostomies, click here.)
    • During the surgery:
      • biopsy is generally done  to determine whether the cancer has spread.
      • A lymph node dissection will determine if the cancer has spread to the lymph nodes.
    • If the cancer has spread to other organs (metastasized): if only a small number of metastases are present in an organ such as the liver, lungs or ovaries, they may be removed during the surgery.
  • The length of time a patient stays in the hospital depends on whether the incision is a large one or done through laparascopy. The average for an operation using laparascopy is 3 - 5 days in the hospital. For a large incision, the average stay is 5 - 7 days. The exact amount of time will be determined by your doctor.

Recovery:

  • Soon after the operation, you will be taken to the recovery room.  You will go in and out of sleep. Your throat may be sore from the tube used during the operation. You may feel cold. 
  • Don’t be surprised if there are several tubes attached to your body. For instance:
    • An intraveneous line attached to a needle in your arm which is hanging next to your bed just like in all the hospital shows on T.V.
    • A tube in your urethra. This is known as a Foley catheter and helps you urinate after surgery and is usually removed within a few days.
  • Intake of food and liquid will be restricted for a day or two to give your bowels a chance to recover.
  • Earlier than most people like, you will be asked to walk and move around.  You will also be given breathing exercises to clear your lungs.
  • Do not hesitate to ask for pain medication. Studies show that people who take pain medications after an operation do not become addicted.  Patient activists suggest that you take maximum pain relief at least initially to stay ahead of the pain. (To learn more about pain and dealing with it, see Pain 101)  (link to the topic)
  • Fatigue is normal.
  • You will be allowed to have visitors on a limited basis - usually limited by hospital policy as to what visitors and how long they can stay with you. If you want a person to visit who is not a blood relative or a legal spouse, consider executing an advance directive known as a Health Care Power of Attorney appointing that person your Health Care Proxy – the person to make medical decisions that may need to be made if you become unable to communicate. (A Health Care Proxy is recommended for everyone to have. For more information, click here).
  • When your vital signs are stabilized, you will be moved to a regular hospital room.

The hospital stay:

  • While hospitals are places of healing, mistakes happen and people can pick up infections. For tips about preparing for a stay in hospital, as well as staying safe and maximizing time in a hospital, see the documents in To Learn More.
  • No matter what study you believe, the percentage of hospital bills that are wrong is quite high. It is worth your while to take the time to review the bill – even if it is being paid for entirely by insurance. Survivorship A to Z shows you how, as well as to how to negotiate a hospital bill, in the document in “To Learn More.”  
  • The vast majority of patients get good pain control with i.v. narcotics for up to 36 hours after the operation, and pain pills by mouth thereafter.  There is no reason to be in pain in the hospital or after you get home.  
    • Patient advocates suggest that you stay ahead of the pain by taking medications as prescribed rather than waiting to feel the pain. (Also consider medications or stool softeners to counteract the constricting side effect of pain medications).  It is a myth to think that you will become addicted if you take pain medications as directed for pain. For more information about pain, see Pain 101
    •  Before you leave the hospital, remind your doctor that you do not want to be in pain and ask for a prescription for strong pain medications. (You don’t have to take them if they aren’t needed, or you take smaller doses as warranted). That way you won’t have to take time to fill the prescription after you are home. Many doctors under treat pain. 
  • Coughing: If you have an incision in your upper body, you may feel that your incision is going to break apart when you cough – especially if you have open surgery with a large incision. A time tested tip is to use a pillow for support when you cough. Where to hold the pillow depends on where the incision is. If your incision is in the front, hold the pillow against your chest or stomach. Fold your arms across the pillow. Then cough. If your incision is on your back, lean against the pillow. Then cough.

After you leave the hospital:

  • Follow the doctor’s orders – including about breathing exercise, food and liquid intake, bathing, exercise and returning to work. The norm for a return to work after major surgery is 4 – 6 weeks. It may be longer if your work involves heavy lifting or other strenuous activity..
  • Start a walking program as soon as you can and to the extent that you can.  Avoid more active movements until your doctor permits. Walking is good for your bowel function and your lungs. It also helps keep blood clots from forming.
  • Expect a change in your bowel habits that will get better over time. If the changes are uncomfortable or if they don’t get better, speak with your doctor. There are drugs and bulking agents to consider.
  • The incision:
    • If you feel more than discomfort in or near your incision, let your doctor know. There may be an infection or you may not be receiving enough pain medication.
    • Wear soft, loose clothing over the incision.
  • Contact your doctor or other health care professional immediately if something unexpected occurs or if symptoms become intolerable.

Please share how this information is useful to you. 0 Comments

 

Post a Comment Have something to add to this topic? Contact Us.

Characters remaining:

  • Allowed markup: <a> <i> <b> <em> <u> <s> <strong> <code> <pre> <p>
    All other tags will be stripped.