Colectomy is a surgical procedure to remove all or part of the colon (large intestine). 

Colectomy may be recommended for various medical conditions affecting the colon, including:

Colon cancer: Colectomy is a common treatment for colon cancer, particularly in cases where the tumour is large or has spread to nearby tissues or lymph nodes.

Inflammatory bowel disease (IBD): In severe cases of ulcerative colitis or Crohn’s disease that do not respond to medical therapy, colectomy may be necessary to relieve symptoms and improve quality of life.

Diverticulitis: In cases of severe diverticulitis (inflammation or infection of pouches in the colon wall), colectomy may be recommended to remove the affected portion of the colon.

Bowel obstruction: Colectomy may be necessary to remove a blocked or obstructed segment of the colon caused by tumours, strictures, or other conditions.

Partial colectomy (segmental resection): Removal of a portion of the colon, with the remaining ends of the colon reconnected (anastomosed) to restore continuity of the bowel.

Total colectomy: Removal of the entire colon, including the ascending colon, transverse colon, descending colon, sigmoid colon, and rectum. After total colectomy, the small intestine is typically connected to the rectum or anus to allow for bowel movements.

Subtotal colectomy: Removal of most of the colon, leaving a small portion of the colon intact. The remaining portion of the colon may be anastomosed to the rectum or connected to a stoma (opening on the abdominal wall) to allow for bowel movements.

Colectomy can be performed using various surgical approaches, including:

Open colectomy: A traditional surgical approach involving a large abdominal incision to access the colon.

Laparoscopic colectomy: A minimally invasive surgical approach using small incisions and specialised instruments to remove the colon. Laparoscopic colectomy typically results in shorter hospital stays, faster recovery, and less postoperative pain compared to open colectomy.

Before colectomy, patients may undergo various preoperative tests, including blood tests, imaging studies (such as CT scan or colonoscopy), and bowel preparation to cleanse the colon. Bowel preparation typically involves consuming a clear liquid diet and taking laxatives or enemas to empty the colon.

After colectomy, patients typically require a period of hospitalisation for monitoring and recovery. Pain medications may be prescribed to manage discomfort, and patients are encouraged to gradually resume normal activities as tolerated. In cases of temporary stoma creation, patients may receive education and support from enterostomal therapists to manage stoma care and adjust to life with a stoma.

Although colectomy is generally safe, complications can occur, including:

• Bleeding
• Infection
• Wound complications
• Anastomotic leaks (leakage of bowel contents at the site of the anastomosis)
• Bowel obstruction or ileus (temporary paralysis of the bowel)
• Adverse reactions to anesthesia or medications

Following colectomy, some patients may experience changes in bowel habits, including alterations in stool frequency, consistency, or urgency. These changes may improve over time but can be managed with dietary modifications, medications, or lifestyle adjustments.

After colectomy, patients require regular follow-up appointments with their surgeon to monitor for any signs of complications, assess the healing process, and address any concerns related to bowel function or stoma care.

Colectomy is a major surgical procedure with significant implications for bowel function and quality of life.