Colectomy surgery removes either the entire or part of the large intestine.
It has several variations depending upon the surgical approach taken-Open or Laparoscopic and also depending upon the extent of the colon removed it can be further classified into Hemicolectomy;Partial colectomy or Segmental resection.
If the indication for colectomy is the treatment for Colorectal cancer then small part of adjacent healthy colon is also resected to ensure complete removal of cancer.
Surrounding lymph nodes are simultaenously removed. This procedure,referred to as Lymphaedenectomy, is carried out to stage the cancer and check the spread of the cancer.
A1. Colon, also known as Large intestine is the last part of the digestive tract that serves the function of absorption of water from the food waste produced as a result of absorption of nutrients from the small intestine. Solid food waste is then expelled from the body by way of small opening called anus.
A2. Cancer that originates from the large intestine or colon is termed as Colon cancer. It usually begins as a non cancerous growth on the inner lining of the large intestine, often called polyps in simple terms.
If these benign growths are left unattended they have the potential to change into malignant or cancerous growths over time. Like any other cancer, this too will slowly and gradually invade the normal healthy tissue surrounding the growth initially and later spread via blood or lymphatic system to distant places causing damage there as well (Metastasis)and may result in inevitable complications.
A3. No, they are actually not. Most often the colon and the rectal cancer co-exist and hence the term used for such kind of cancer is Colorectal cancer. Also referred to as Bowel cancer.
A4. Colonoscopy is a procedure that is carried out by the specialist to examine the inner lining of the large intestine. A thin flexible tube is passed through the anal opening that has a light and tiny camera at its tip. This tube is called a colonoscope. It helps in the screening of the colorectal cancer. Colonoscopy is done not only to examine, evaluate, diagnose several gastrointestinal disorders but it is also used for the treatment which can be carried out at the same time.
The polyps are generally removed and biopsy done, if required, at the same time.
The conditions that are usually investigated through colonoscopy are change in bowel habits, bleeding through anus, bowel obstruction,unexplained weight loss, pain in abdomen, presence of ulcers, colon cancer, polyps, Inflammatory bowel conditions and Diverticulosis amongst others. The duration of colonoscopy is 30 to 60 minutes and it is done as an outpatient procedure.
A5. Cancer in the rectum is referred to as rectal cancer. Rectum is the part of the large intestine,with length of few inches, immediately above the anus.
A6. The chief complaints that the patient may present with, are the following:
• Unexplained weight loss
• Always feeling tired.
• Anemia
• Change in the bowel habits (Alternating diarrhea or constipation)
• Blood in the feces
• Pain, cramping or flatulence in the abdomen
• Urge to defecate frequently
• Pain during defecation
• Stool consistency changes
Besides the above, depending upon the distant site or organ of metastasis i.e. the other places where the cancer has spread, the related additional sign and symptoms will also occur.
A7 Surgery is the mainstay of treatment in case of early stage Colon cancer. The type of surgery performed depends upon the factors such as the extent of spread,precise location of cancer and above all what you wish to achieve through the surgery.
A8 Conventional Open colectomy involves a large incision in the abdominal wall to access the large intestine.The recovery time is longer.
Laparoscopic assisted colectomy,like other laparoscopic procedures,involves few small key hole size incisions to access the colon. It is minimally invasive procedure. Through one of the small incision a thin flexible tube with light and video camera is passed to see the surgical site on the high definition video monitor and through rest of the incisions tiny surgical instruments are inserted to carry out the surgery.
Colectomy surgery is often accompanied by other surgeries to rejoin the remaining healthy ends of the digestive tract and allow the expulsion of waste out of the body.
A9. The conditions for which colectomy surgery is generally recommended are:
Precancerous Colon Polyps, they have high potential of changing into cancer eventually.
Colon Cancer
Familial Adenomatour polyposis
Inflammatory bowel disease (Ulcerative Colitis and Crohn's disease)
Uncontrolled bleeding
Large Intestine Obstruction or Perforation, these are emergency conditions.
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Dr Harit Chaturvedi
MBBS,MS, MCh(Surgical Oncology)
Chairman,Cancercare, Director and Chief Consultant Surgical Oncology
Max Super Specialty Hospital Saket,New Delhi
Dr Adarsh Choudhary
MBBS,MS(General Surgery)
Chairman, Division of GI Surgery, GI Oncology, Minimal Access and Bariatric Surgery
Medanta The Medicity, Gurgaon,Delhi-NCR
Dr Pawan Gupta
MBBS,MS(Surgery),MCh(Surgical Oncology)
Fellowship from Royal College of Surgeons, Glasgow, UK.
Active Member,International Society of Surgery (ISS/SIC).
Additional Director,Institute of Cancer Care
Jaypee Hospital, Noida, Delhi-NCR
MBBS,MS, FACS, DNB (Surgical Gastroenterology)
Senior Director and HOD, Surgical Gastroenterology
Max Super Specialty Hospital, Saket, Delhi
MBBS, MS, FICS
Director, Institute of Digestive and Liver Diseases
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