SURGERY FOR THE COLON AND RECTUM

When is surgery for the colon and rectum needed?

Surgery may be needed for infections, inflammations, ulcers, or obstructions in the large intestine (colon) or rectum caused by inflammatory bowel disease, Crohn's disease, bowel obstruction, bile duct conditions, bacteria, or tumours.  In order to diagnose the condition and provide accurate treatment, an endoscopy or colonoscopy may be needed.

How is it done?

The surgery will differ depending on the condition that is being treated. The following surgeries may be considered:

Colectomy or a colon resection surgery may be done to remove part of the large intestine as treatment for colon cancer, bowel disease or polyps. A Polypectomy, Segmental Colectomy or a combination of a Total Colectomy and Total Proctocolectomy may be considered depending on the condition.

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Colostomy procedure is done when a large portion of the colon or intestine is removed, and the two ends cannot be connected. When this is the issue, an opening is made thru the abdomen (a stoma) to allow waste to pass thru to a bag (colostomy bag). This may be done temporarily while the intestine heals, or as a permanent option after a portion of the colon is removed.

Endoscopic Surgery is done by inserting a thin tube with a camera attached to the end, so that the surgeon may see the internal organs. The snaring procedure is done by inserting a wire that may be looped over a tumour in the colon, tightened and cut out.

Hemorrhoidectomy to remove piles (insert hyperlink to page)

Ileal Pouch Anal Anastomosis (J-Pouch) is done by creating a pouch at the end of the small intestine which is connected to the anus. This surgery is typically done when the entire colon is removed through a colectomy, due to cancer. Functioning without a colon is possible, but to better control bowel movements, a J-pouch is inserted.  This surgery is often preferred over a colostomy procedure.

Inflammatory Bowel Disease (IBD) Surgery is most often done for colon ulcers and Crohn's disease in which a colectomy is done to remove the colon completely, thus reducing the risk of colon cancer as well.

Internal Sphincterotomy is done to treat small tears on the rectum. An incision is made into the weakened sphincter muscle to relieve the pressure, and the tears are able to heal allowing the rectum to relax and spasm less often.

Rectopexy is used to treat prolapse of the rectum. During this procedure, the intestinal organs are put back into place by lifting and reinforcing them back into position using a mesh. This surgery may be done in conjunction with a colectomy.

Resection of the colon and other parts of the intestine is done to treat tumours in the intestine or for diseased bowels. The extent of the resection will depend on the size of the tumour and how far it has spread in the bowels.

What will recovery be like?

After surgery, you will be given instructions on how to care for your wound. You will be given pain medication and antibiotics to prevent infection. Intestinal functioning should go back to normal after a few weeks until then you will be on a liquid diet. Recovery is generally quicker when the surgery is done laparoscopically or endoscopically. It is important to avoid any heavy lifting or strenuous activity during this time. Recovery should take about 4-6 weeks. It is essential to contact Dr Muthambi if you experience any of the following symptoms as emergency care may be needed:

  • High temperature or chills
  • Vomiting
  • Swelling around the incisions
  • Bleeding from the wound
  • Extreme pain

What are the risks of these surgeries?

  • Leaking from the intestine connection
  • Trouble with the stomach emptying
  • Trouble digesting some types of food
  • Changes in bowel habits
  • Weight loss

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