Colon cancer can affect individuals across a wide age range, but it is most commonly diagnosed in people over the age of 50. In recent years, there has been a concerning rise in cases among younger individuals. India witnesses a significant influx of patients seeking treatment for colon cancer due to its world-class medical facilities and skilled healthcare professionals. The exact ratio of colon cancer patients seeking treatment in India varies, but it’s a substantial number.

Colectomy, the surgical removal of part or all of the colon, is a primary treatment method for colon cancer. It helps by eliminating cancerous growths and preventing their spread, improving patient survival rates and quality of life.

Over 300,000 colectomies are performed each year. There is some positive news as well: post-surgery survival rates are encouraging. For example, for Stages I, II, and III laparoscopic colon resections, the five-year relative survival rates are 73%, 61%, and 55%, respectively.  Furthermore, complete colectomy with ileorectal anastomosis has a high success rate of about 90%, owing to its low complication and morbidity rates.

Most patients who undergo colectomy report enhanced quality of life after surgery, and overall survival rates after 5, 10, 20, and 30 years appear extremely promising at 94.7%, 88.4%, 72.0%, and 72.0%, respectively.

This blog will discuss the procedure, recovery, and potential risks or complications of colectomy, all aimed at providing a better understanding of this medical process.

What is a Colon?

The colon is a section of your big intestine where waste from your digestion solidifies into stool. Your large intestine extends after your colon into your rectum and anus, where food waste departs your body.

What is a Colectomy?

A colectomy is a surgical procedure that removes all or part of your colon. It is also known as colon resection surgery. Since your colon is a portion of your large bowel, colectomy is a form of significant bowel resection.

Why is a Colectomy Performed?

You may need to have part or all of your colon removed for various reasons. Cancers and illnesses that cannot be treated with drugs are examples. Removing the damaged section helps to guarantee that the remainder of your gastrointestinal tract can operate normally.

What Conditions Does Colectomy Treat?

Many issues may arise that necessitate the removal of a portion of your colon.

The following conditions are typically treated by colectomy:

• Colon cancer: When cancer is discovered in your colon, it is critical to remove the cancerous area of your colon to determine the disease’s stage and prevent it from spreading.
• Cancerous circumstances: Suppose a colonoscopy finds abnormalities in your colon that have a high chance of advancing to cancer. In that case, your healthcare professional may consider removing that area of the colon as a prophylactic measure. If you have a hereditary disorder with a high risk of developing colon cancer, such as familial adenomatous polyposis (FAP) or Lynch syndrome, you may choose an elective colectomy.
• Obstruction of the large bowel: If your colon is significantly clogged and previous therapies have failed, surgery to remove the block may be necessary. A twist (volvulus) or narrowing (stricture) of the large intestine can produce a blockage.

Colectomy may be done to treat the following conditions in chronic and severe cases:

• Inflammatory bowel disease: If your colon has been extensively damaged by ulcerative colitis or Crohn’s disease, your doctor may recommend a colectomy to treat symptoms.
• Diverticulitis: A colectomy may be required when diverticulitis develops regularly, does not improve with medical treatment, or causes damage to other surrounding organs.
• Uncontrollable Bleeding: Colon injury and bleeding are challenging to treat from the outside. When gastrointestinal bleeding cannot be controlled, it becomes risky, and colectomy becomes the safer option.

Is a Colectomy a Major Surgical Procedure?

The idea that colectomy is classified as a major surgery resonates with most people. While there isn’t a universally agreed-upon definition distinguishing major and minor surgeries, a colectomy stands out due to its extended duration, often several hours.

Additionally, the recovery period for a colectomy can extend up to six weeks, which is comparatively lengthier. Furthermore, undergoing a colon resection can alter the way your digestive system works and might impact your bathroom habits in the future.

Dr. Deep Goel, a renowned GI Onco Surgeon, strongly asserts that colectomy is a major surgery—various compelling factors back his standpoint. Firstly, the considerable length of the procedure, often spanning several hours, and the subsequent recovery phase of up to six weeks unequivocally support its classification as a major surgical undertaking.

Colectomy patients typically experience extended hospital stays, a characteristic feature of major surgical procedures. Moreover, the intricate surgical techniques involved in colectomy further underline its status as a major surgery.

Dr. Goel also highlights the potential risks and complications associated with colectomies, including bleeding, infection, injury to nearby organs, and anastomotic leaks, all aligning with what is commonly seen in major surgical procedures. Therefore, Dr. Goel’s expert opinion solidifies that colectomy is a major surgery.

However, Dr. Goel additionally points out that, under favourable circumstances, colectomy surgery can be conducted using minimally invasive techniques. Patients eligible for laparoscopic or robotic surgery can benefit from shorter procedure durations and reduced recovery times.

These minimally invasive approaches involve smaller incisions than traditional open surgery, resulting in faster healing and less discomfort. The choice of procedure depends on your specific medical condition.

What is the Difference Between a Colectomy and a Colostomy?

A colectomy is a surgical procedure that removes part or all of your colon. But what happens to the rest of your intestine once the diseased tissue has been removed? This fluctuates based on several circumstances. Sometimes, the two remaining ends of your intestines can simply be stapled together during the same procedure, and your digestive tract can continue to operate normally.

But that is only sometimes achievable. In this instance, you may require an ostomy, either an ileostomy or a colostomy. The ileostomy or colostomy might be temporary or permanent.

An ostomy is another surgical treatment that establishes a new conduit for your waste to follow when the typical canal is blocked. If your system cannot transport your food waste down your rectum and out through your anus, you will require another method of faeces elimination.

A colostomy or ileostomy allows waste to exit via a hole in your abdominal wall known as a stoma. To collect excrement, an ostomy bag is attached to the exterior of the stoma.

Not all colectomies necessitate an ostomy, and not all colostomies are permanent. You may only require one while your intestines recover from the colectomy. Many ostomies are reversible after a few months, depending on your condition. You may need to return to surgery to have your intestines rejoined (anastomosis) and your stoma closed. Others could require a permanent ostomy.

How do you Prepare for a Colectomy?

Health screening

Before scheduling a colectomy, your healthcare team will evaluate your fitness for surgery. In addition to a physical exam and health history, this may include:

• Blood tests
• X-ray
• Electrocardiogram (EKG) test
• Urinalysis
• Colonoscopy

Pre-operative counselling

Your healthcare team will want to ensure you understand the procedure before signing your consent. They’ll counsel you about the following:

• Surgical risks
• Living with a colostomy, if you’re going to have one
• Options for pain management

Bowel prep

When you have surgery on your bowels, they need to be empty. You’ll need to prepare for this a couple of days in advance. Your healthcare provider may ask you to:

• Consume only a clear liquid diet
• Fast before the procedure (no food or drinks)
• Take a laxative or enema to clear your bowels, like polyethene glycol (Miralax®). These bowel preparations come with their specific instructions.

What are the Potential Risks or Complications of Colectomy?

Complications are rare, but they’re always possible. Complications of colectomy may include:

• Bleeding
• Infection
• Injury to nearby organs
• Anastomotic leak

Thus, a colectomy is a primary medical treatment for various causes, including colon cancer, inflammatory bowel disease, and intestinal blockage. Medical advances, such as less invasive treatments, have offered patients additional alternatives and faster recovery periods. Despite possible dangers and problems, overall survival statistics after colectomy are good, giving patients who undergo this procedure optimism. Talking with your healthcare team to establish the best approach for your unique problem is crucial.

While understanding colectomy from a medical perspective is crucial, hearing from someone who has undergone the procedure offers valuable insight. Patients often have concerns about surgery, recovery, and life after colectomy. Here’s a firsthand account from Rajesh S., who successfully underwent a colectomy and is now leading a healthier life:

“Undergoing a colectomy was a life-changing experience for me. I was initially anxious about the procedure, but Dr. Deep Goel and his team guided me every step of the way. The surgery was successful, and my recovery was smoother than I expected. Today, I feel healthier and more energetic, with minimal lifestyle changes. I’m grateful for the excellent care I received!”

Hearing such positive experiences reinforces that with the right medical guidance, colectomy can lead to a better quality of life.

FAQs

1. Can you still poop after a colectomy?

Yes, but your bowel movements may change depending on how much of your colon was removed. Some people experience more frequent or looser stools.

2. How long does it take to recover from a colectomy?

Full recovery typically takes 4 to 6 weeks, but it may vary based on the type of surgery and individual health.

3. Will I need a colostomy bag after a colectomy?

Not always. If your intestines can be reconnected, you won’t need a colostomy bag. However, in some cases, it may be temporary or permanent.

4. What foods should I avoid after a colectomy?

It’s best to avoid high-fiber, spicy, and fatty foods initially. Stick to a low-residue diet and gradually reintroduce solid foods as advised by your doctor.

5. How soon can I walk after a colectomy?

Most patients are encouraged to walk within 24 hours post-surgery to aid recovery and prevent complications.

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