Subtotal colectomy

Subtotal Colectomy is a surgical procedure involving the removal of a portion of the colon, specifically leaving behind a part of the rectum. This operation is typically performed to treat or manage various diseases of the colon, including Ulcerative Colitis, Crohn's Disease, familial adenomatous polyposis, and in some cases, Colorectal Cancer. The procedure aims to alleviate symptoms, prevent disease progression, and improve the quality of life for patients.

Indications

Subtotal colectomy is indicated in patients with:

• Severe Ulcerative Colitis that is unresponsive to medical therapy.
• Crohn's Disease affecting most of the colon.
• Familial adenomatous polyposis with a high risk of developing colon cancer.
• Multiple, large, or high-grade dysplastic polyps that cannot be removed via endoscopic procedures.
• Certain cases of Colorectal Cancer, especially when multiple sections of the colon are involved.

Procedure

The procedure can be performed using either traditional open surgery or a minimally invasive approach, such as laparoscopic surgery. The choice of technique depends on the patient's condition, the extent of the disease, and the surgeon's expertise.

During a subtotal colectomy, the surgeon removes the affected portion of the colon while preserving the rectum. The remaining parts of the colon are then reconnected to the rectum, if possible, to allow for a more natural passage of waste. In some cases, if connecting the colon to the rectum is not feasible, a temporary or permanent Ileostomy may be necessary.

Postoperative Care

Postoperative care focuses on recovery and monitoring for complications. Patients may need to stay in the hospital for several days to a week. Pain management, wound care, and gradual reintroduction to eating are critical aspects of postoperative care. Patients will also need to learn how to manage their bowel movements, which may include changes in bowel habits and consistency of stool.

Complications

Complications from subtotal colectomy can include:

• Infection
• Bleeding
• Anastomotic leak (leakage from the site where the bowel is reconnected)
• Bowel obstruction
• Changes in bowel habits, such as increased frequency or urgency

Prognosis

The prognosis after a subtotal colectomy varies depending on the underlying condition that necessitated the surgery. Many patients experience significant relief from symptoms and an improvement in quality of life. However, ongoing management may be necessary, especially for chronic conditions like Ulcerative Colitis or Crohn's Disease.

See Also

• Colectomy
• Colorectal Surgery
• Ileostomy
• Ulcerative Colitis
• Crohn's Disease