Open Colon Resection

Colon resection is surgery to take out part or all of the large intestine (colon). It is also called a colectomy.

LET YOUR CAREGIVER KNOW ABOUT:

  • Any allergies.

  • All medicines you are taking, including:

  • Herbs, eyedrops, over-the-counter medicines and creams.

  • Blood thinners (anticoagulants), aspirin, or other drugs that could affect blood clotting.

  • Use of steroids (by mouth or as creams).

  • Previous problems with anesthetics, including local anesthetics.

  • Possibility of pregnancy, if this applies.

  • Any history of blood clots.

  • Any history of bleeding or other blood problems.

  • Previous surgery.

  • Smoking history.

  • Any recent symptoms of colds or infections.

  • Other health problems.

RISKS AND COMPLICATIONS

There are always risks for surgery with medicine that makes you sleep (general anesthetic). They include breathing and heart problems. However, this risk is low for people who have no other health problems. Other complications from colon resection may include:

  • An infection developing in the area where the surgery was done.

  • Problems with the incisions including:

  • Bleeding from an incision.

  • The wound reopening.

  • Tissues from inside the abdomen bulging through the incision (hernia).

  • Bleeding inside the abdomen.

  • Reopening of the colon where it was stitched or stapled together. This is a serious complication. Another procedure may be needed to fix the problem.

  • Damage to other organs in the abdomen.

  • A blood clot forming in a vein and traveling to the lungs.

  • Future blockage of the colon.

BEFORE THE PROCEDURE

  • A medical evaluation will be done. This may include:

  • A physical exam.

  • Blood tests.

  • A test to check the heart's rhythm (electrocardiogram).

  • X-rays, such as magnetic resonance imaging (MRI). This can take pictures of the colon. An MRI uses a magnet, radio waves, and a computer to create a picture of your colon.

  • Talking with the person who will be in charge of the medicine during the procedure. An open colon resection requires general anesthesia. Ask what you can expect.

  • Two weeks before the surgery, stop using aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief. This includes prescription drugs and over-the-counter drugs. Also stop taking vitamin E.

  • If you take blood thinners, ask your caregiver when you should stop taking them.

  • Do not eat or drink anything for 8 to 12 hours before the surgery. Ask your caregiver if it is okay to take any needed medicines with a sip of water.

  • Ask your caregiver if you need to arrive early before the procedure.

  • On the day of your surgery, your caregiver will need to know the last time you had anything to eat or drink. This includes water, gum, and candy.

  • Make arrangements in advance for someone to drive you home.

PROCEDURE

Colon resection can take 1 to 4 hours.

  • Small monitors will be put on your body. They are used to check your heart, blood pressure, and oxygen level.

  • You will be given an intravenous line (IV). A needle will be inserted in your arm. Medicine will be able to flow directly into your body through this needle.

  • You might be given a medicine to help you relax (sedative).

  • You will be given a general anesthetic.

  • A tube may be put in through your nose. It is called a nasogastric tube. It is used to remove stomach juices after surgery until the intestines start working again.

  • Once you are asleep, the surgeon will make an incision in the abdomen about 6 to 12 inches long.

  • Clamps are put on both ends of the diseased part of the colon.

  • The part of the intestine between the clamps is removed.

  • If possible, the ends of the healthy colon that remain will be stitched or stapled together.

  • Sometimes, a colostomy is needed. For a colostomy:

  • An opening (stoma) to the outside is made through the abdomen.

  • The end of the colon is brought through the opening. It is stitched to the skin.

  • A bag is attached to the opening. Waste will drain into this bag. The bag is removable.

  • The colostomy can be temporary or permanent. Ask your surgeon what to expect.

  • The incision from the colon resection will be closed with stitches or staples.

AFTER THE PROCEDURE

  • You will stay in a recovery area until the anesthesia has worn off. Your blood pressure and pulse will be checked every so often. Then you will be taken to a hospital room.

  • You will continue to get fluids through the IV for awhile. The IV will be taken out when the colon starts working again.

  • You will gradually go back to a normal diet.

  • Some pain is normal after a colon resection. Ask for pain medicine if the pain becomes too much.

  • You will be urged to get up and start walking after 1 or 2 days, at the most.

  • If you had a colostomy, your caregiver will explain how it works and what you will need to do.

  • Most people spend 3 to 7 days in the hospital after this surgery. Ask your caregiver what to expect.