Large Bowel Resection
A large bowel resection is also known as a colectomy. The goal of this surgery is for your surgeon to remove diseased sections of your large bowel. Another name for the large bowel is the large intestine. The large intestine consists of several parts, including the colon.
During this surgery, your surgeon removes the diseased parts of the bowel and then reconnects the healthy parts. Your surgeon may remove all or part of your bowel.
Your surgeon may perform a colostomy if there’s not enough healthy intestine after surgery. During a colostomy, your surgeon moves one end of your large intestine to the outside of your abdominal wall and attaches a colostomy bag to your abdomen. When stool passes through your large intestine, it drains into the bag. The stool that goes into the bag is usually soft or liquid.
A colostomy is often temporary. You’ll have the bag until your intestines heal. During a new operation, your surgeon can then remove the colostomy. In some cases, the colostomy is permanent.
Why Do I Need a Large Bowel Resection?
A large bowel resection may be necessary to treat conditions such as:
- colon cancer
- intestinal blockages caused by scar tissue or tumors
- diverticulitis, which is a disease of the large bowel
- precancerous polyps
- bleeding in the intestines
- volvulus, which is an abnormal twisting of the bowel
- ulcerative colitis, which is a type of bowel inflammation
- intussusception, which occurs when one part of your intestine slides into another part of your intestine
What Are the Risks Associated with a Large Bowel Resection?
All types of surgery carry some risk. These risks can include:
- difficulty breathing
- heart attack or stroke
- blood clots
The risks that are specific to a lower bowel resection include:
- bleeding inside the abdomen
- an incisional hernia, which occurs when tissue comes through the surgical cut
- damage to the bladder or other nearby organs
- scar tissue
- dehiscence, which is an opening of a surgical wound
- problems with the colostomy, such as skin irritation
There are also risks associated with general anesthesia. These include reactions to medication and breathing difficulties.
How Do I Prepare for a Large Bowel Resection?
At least two weeks before surgery, tell your doctor about all the medications you’re taking. You should include supplements such as vitamins and herbs. You should also inform them about any recent illnesses including any colds, flus, or herpes breakouts.
Before surgery, your doctor may need you to:
- stop taking blood-thinning drugs, such as aspirin, ibuprofen, naproxen, or warfarin
- stop smoking
- drink plenty of water
- eat foods high in fiber
A few days before you have a large bowel resection, you may need to:
- take laxatives to help you defecate
- have an enema to clear your colon
- drink only clear liquids, such as water, clear juice, and broth
On the day of your surgery, follow your doctor’s instructions. You may need to refrain from eating or drinking anything for 12 hours before the surgery.
How Is a Large Bowel Resection Performed?
You’ll receive general anesthesia before the surgery begins. This will keep you asleep during the surgery. It will also keep you from feeling pain. Your surgeon may do a laparoscopic or open colectomy.
In a laparoscopic colectomy, your surgeon uses a camera to get a clear view of your intestines. The surgery is performed through a series of small incisions. It’s less invasive than open surgery.
In an open colectomy, your surgeon makes a large incision in your abdomen to see the bowel directly.
The basic structure of both surgeries is the same. The surgeon accesses your bowel using one or more incisions and removes the diseased or damaged bowel. The remaining bowel is stapled or sewn together. This is known as an anastomosis. Your surgeon will also perform a colostomy if needed. They’ll then stitch the incision closed.
In some cases, your surgeon may also need to remove other organs during the surgery.
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What Happens After a Large Bowel Resection?
You’ll generally stay in the hospital for three to seven days. You may need to stay in the hospital longer if you develop complications. You may also need to stay longer if you have a more serious underlying health problem.
You’ll have to follow specific instructions about how to eat after your surgery. You’re generally able to drink clear liquids by the second or third day. As you heal, you’ll be able to drink thicker fluids and eat soft foods.
A full recovery may take about two months.
What Is the Long-Term Outlook?
Most people who have a large bowel resection make a full recovery. You may have to use a colostomy bag temporarily. You may also need a permanent colostomy. A colostomy doesn’t usually prevent you from doing the activities you enjoy.
You may need ongoing medical care if you have a chronic bowel condition, such as cancer, Crohn’s disease, or ulcerative colitis.