Colon cancer is the
That may be a confusing term. This article will discuss the sigmoid colectomy procedure, the possible risks involved, and what life after the surgery might look like.
Colectomy is a medical term for the removal of part or all of your colon.
Your large bowel, or colon, has three sections:
- the ascending colon, or right side
- the transverse colon
- the descending colon, or left side
The left side of the colon includes:
- the descending colon
- the sigmoid colon
- the rectum
- the anus
When cancer or diverticulitis is found in the sigmoid colon, this section of your colon may be removed to prevent the spread of disease and prevent additional injury. Your descending colon will be connected to your rectum. This process is known as a sigmoid colectomy.
Signs and symptoms that may indicate the need for a colon removal, and should be looked at by a medical professional, include:
- pain in your abdomen
- severe bleeding from your colon
- bowel obstruction
- bowel perforation
- severe Crohn’s disease or ulcerative colitis that medications aren’t helping
- a diagnosis of colon cancer or diverticulitis
Additionally, if genetic testing reveals a high risk for colon-related cancers, or precancerous polyps are discovered, your doctor may discuss whether you wish to have a preventive colectomy.
Prior to the procedure, your doctor may request that you clean out your colon. This can require taking a laxative the day before surgery. A mark will also be placed on your stomach on the day of surgery to indicate where the stoma, an opening in the abdomen for waste to pass out, should be placed if necessary.
During surgery, the infected or damaged portion of your colon will be removed, along with the surrounding lymph nodes in the case of cancer. The remaining parts of your bowel will then be joined together.
The surgeon may not be able to rejoin your bowel during the surgery or may want to give the joined section a longer time to heal. In these cases, they can bring out a part of the small bowel onto the surface of your skin. This allows waste from your body to pass through your abdomen into a stoma bag. Follow-up surgery may be done a few months later to close up this area.
The removed section of your colon and any lymph nodes will typically be sent to pathology following the surgery.
This surgery can be performed in a variety of ways.
The more traditional way to perform this surgery is an open surgery, where an incision is made to open up your stomach. At the end of the surgery, this wound will be glued, stapled, or stitched back together.
Alternatively, the surgery can be performed in a laparoscopic or more minimally invasive manner. Your doctor may use the terms “keyhole surgery,” “minimal access surgery,” or “minimally invasive surgery” when referring to this style of surgery.
With a laparoscopic surgery, the surgeon will make a small incision in your skin and insert a laparoscope, a telescope with a light source used to light up and magnify the structures inside your abdomen. Fine instruments are then passed through a few small incisions in the skin to lift, cut, take a biopsy, and other necessary procedures.
The recovery period for sigmoid colectomy will vary depending on the type of surgery you undergo. It frequently includes a hospital stay between 3 and 10 days. If you have open surgery, your incision wound may take 10 to 14 days to heal.
Immediately following surgery, pain medication will be provided through either an epidural or intravenous (IV) drip. Fluids will also be provided through an IV until you’re able to drink freely. A catheter will drain your urine into a collection bag, and another drain will be placed in your stomach to drain fluids away from the operation site. This tubing can be present for several days.
If you have a stoma, you’ll need to show that you can handle it yourself before being discharged from the hospital. You may also receive a home visit from a nurse to check on your stoma care progress.
Your appetite may be lower in the days following surgery, and you’ll likely have to slowly build back up to your normal diet. You may also need to take medication to slow down or speed up your bowels after surgery. For some people, it can take a year for their bowels to regulate again postsurgery.
Sigmoid colectomy does carry with it some risks. These can include:
- Infections: This surgery has a particularly high risk of infection because the bowel is an organ with lots of bacteria. Infections can occur at the incision site or inside your abdomen. They may require antibiotics.
- Blood clots in your legs and lungs: The use of elastic stockings and blood thinning injections can help lower this risk.
- Excessive bleeding: This is a common risk of surgery and can occur during or after the procedure.
- Leakage at the anastomosis, or new joining in the colon: This is serious and may require antibiotics or further surgery.
- Your bowel not working: This may cause bloating of your stomach and sickness, but it’s usually temporary.
- Damage to other internal organs: Other organs that are particularly at risk of accidental injury during this procedure include your bladder and the small tubes that run to your bladder from your kidneys.
Because this procedure is done under general anesthesia, there are also anesthesia-related risks. Your anesthesiologist or doctor can discuss these with you.
People who are very overweight, smoke, or have other medical problems are at an increased risk of surgical side effects. Blood tests and a detailed medical history may be required prior to this surgery to help ensure your safety.
If you have colon cancer or diverticulitis, you may require a sigmoid colectomy. This surgical procedure removes your sigmoid colon and connects the descending colon with the anus. It can be done via open or laparoscopic surgery.
Before undergoing any surgery, it’s important to talk with a doctor about the potential risks. You’ll also want to become informed about the postsurgical recovery process.