Colectomy -- Open Surgery
(Total Colectomy; Partial Colectomy; Colon Removal)
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Reasons for Procedure
- Colorectal cancer
- Inflammatory intestinal diseases such as ulcerative colitis and Crohn’s disease
- Intestinal blockage
- Trauma to the intestine
- Diverticular disease —small pouches in the wall of the colon
- Precancerous polyps, especially those seen in familial polyposis
- A hole in the bowel wall, or a dead piece of bowel
- Bleeding from the colon
- Damage to other organs or structures
- Hernia forming at the incision site
- Blood clots
- Complications from general anesthesia
What to Expect
Prior to Procedure
- A special diet.
- Your colon must be completely cleaned out. A number of cleansing methods may be used. This may include enemas, laxatives, and a clear-liquid diet. You may be asked to drink a large container of solution. It will aid in the complete emptying of the colon. This preparation may start several days before the procedure.
- Antibiotics. It is important to take them as directed.
- A shower the night before your procedure using antibacterial soap.
- Wearing comfortable clothing.
- Arranging for a ride to and from the hospital.
- Arranging for help at home for the first days after your procedure.
Description of Procedure
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Immediately After Procedure
How Long Will It Take
How Much Will It Hurt?
Average Hospital Stay
- You may need antibiotics. You may also need medication for nausea and pain.
- You may require a nasogastric (NG) tube for a few days. The tube enters through your nose and goes to your stomach. It is used to help decompress your intestines.
- Your intestine will require some time to heal before it will function properly again. At first, you will get nutrition through an IV. As you improve, you will be slowly advanced through liquid and soft diets to a regular diet.
- If you had a colostomy or ileostomy, a pouch will be attached on the outside of your body. Waste material will be collected in it. You will receive instructions about diet and activity. During the first few days after surgery, you may be restricted from eating.
- You will wear boots or special socks to help prevent blood clots.
- You will be asked to walk often after surgery.
- You may be asked to use an incentive spirometer, to breathe deeply, and to cough frequently. This will improve lung function.
- Your incision will be examined often for signs of infection.
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
- Washing your hands often and reminding your healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incision
- You will need to take it easy for 1-2 months.
- A specialized nurse will teach you how to care for the stoma site and change the ostomy bag .
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
- You will progress from a clear liquid, to a bland, low-fiber diet, to your regular diet after about 6-8 weeks.
- Alert your physicians and pharmacist that you cannot take medications that are considered time-released or time-sustained.
- Do not use laxatives, because postcolostomy stools are usually quite liquid.
- Drink plenty of liquid daily as extra fluids will be lost in your stool.
- You will need to practice good skin care of the area around the stoma. This will help to prevent inflammation and infection.
- You may wish to join a support group or seek counseling to help you adjust to your colostomy.
Call Your Doctor
- Redness, swelling, increasing pain, excessive bleeding, warmth, drainage, or bulging at the incision site
- Nausea and/or vomiting that you cannot control with the medications you were given after surgery
- Severe abdominal pain
- Signs of infection, including fever and chills
- Cough, shortness of breath, or chest pain
- Pain and/or swelling in your feet, calves, or legs
- Pain, burning, urgency, frequency of urination, or persistent bleeding in the urine
- Not passing any stool
- Blood in your stool, or black, tarry stools
- Feeling weak or lightheaded
- Not collecting stool in the ostomy pouch
- The skin around the stoma appears irritated, moist, red, swollen, or develops sores
American Cancer Society http://www.cancer.org
National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov
Canadian Society of Colon and Rectal Surgeons http://cscrs.ca
Health Canada http://www.hc-sc.gc.ca
A patient guide to colostomy care. Northwestern Memorial Hospital website. Available at: http://www.nmh.org/ccurl/580/761/colostomy-care-guide-09-07.pdf. Published September 2007. Accessed June 27, 2013.
Alves A, Panis Y, et al. Postoperative mortality and morbidity in French patients undergoing colorectal surgery: Results of a prospective multicenter study. Archives of Surgery. 2005;140:278-283.
Colorectal cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003096-pdf.pdf. Accessed June 27, 2013.
Colorectal cancer. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 12, 2013. Accessed June 27, 2013.
Colorectal cancer prevention and treatment. American Gastroenterological Association website. Available at: http://www.gastro.org/patient-center/digestive-conditions/colorectal-cancer. Updated June 2013. Accessed June 27, 2013.
Crohn’s disease. National Digestive Diseases Information Clearinghouse website. Available at: http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/crohns-disease/Pages/facts.aspx. Updated January 18, 2011. Accessed June 27, 2013.
Diverticulitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 13, 2013. Accessed June 27, 2013.
Feo CV, Zerbinati A, Giacometti M, et al. The ideal length of hospital stay in the surgical treatment of colorectal cancer. Ann Ital Chir. 2002;73:13-16.
Inflammatory bowel disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Accessed June 27, 2013.
- Reviewer: Daus Mahnke, MD
- Review Date: 01/2015 -
- Update Date: 05/08/2014 -