Open Colectomy

WHAT YOU SHOULD KNOW:

  • An open colectomy is surgery to remove some or all of your colon. The colon is the long tube that connects the small bowel with the anus. The colon absorbs water from digested foods and turns the digested food into stool. It stores the stool until it passes out through your anus. Your caregiver may have told you that you need an open colectomy because you have cancer. You may also need an open colectomy if you have a bowel obstruction. You may also need an open colectomy if you have a disease that causes bleeding, infection, or swelling.



  • During your colectomy, your caregiver will cut your abdomen and remove part or all of your colon. If you have cancer, your caregiver will look at your nearby organs and body tissue. He will check to see if the cancer has spread to other parts of your body. Having an open colectomy may help you be in less pain. Your swelling may go away and you may stop bleeding. It may be easier for your stool to travel through your bowels. If you have cancer, an open colectomy may remove part or all of the cancer from your body. An open colectomy may improve the quality of your daily life.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • You may get an infection in your urinary tract (the tube used for urinating). You may develop an infection or inflammation (redness or swelling) in your lungs, like pneumonia. You may get an abscess (pus pocket) near your cuts. Your bowel may leak and cause an infection in or around your intestines. You may get a serious infection in your blood. You may get an adhesion (body tissue that joins your organs together) that may block your intestines. Your surgery may not have removed all of the disease and you may need surgery again.

  • You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.

  • Your intestines, stomach, or other organs inside may be damaged during surgery. This may cause more bleeding than expected. You may need a blood transfusion if too much bleeding occurs during surgery. Without surgery, your symptoms may get worse. You may continue to be in pain and it may be difficult for you to have a bowel movement. Your intestines may develop more blockages or holes. Cancer or other diseases may spread to other parts of your body and you may die. Call your caregiver if you have questions or concerns about your surgery, medicine, or care.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

  • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

  • Pre-op care: You are taken to the room where your surgery will be done and moved to a special table. After you are asleep, your caregiver may tilt the table upwards so your buttocks is in the air.

During your surgery:

  • Your caregiver makes a cut along the middle of your abdomen. Muscles and other tissue may need to be cut using cautery (a special tool that may use heat). Your caregiver looks at your colon and then removes the part that has disease. How much your caregiver removes depends on the location of the disease. If you have cancer, it may have spread to other body organs, such as your lymph nodes. Lymph nodes are organs made of body tissue that fight germs. Your caregiver may remove many of your nearby lymph nodes and send them to a lab for testing. Your caregiver also checks nearby organs and tissue for holes, tears, or bleeding.

  • Your caregiver may remove some or part of any body organs that also have cancer. The remaining healthy parts of your colon are attached to other parts of your intestines. If your entire colon is removed, your intestine is attached to your rectum. Your rectum is the lower part of your bowel just behind your anus. Your caregiver closes your cut with stitches or staples and covers it with bandages. Pieces of your colon, lymph nodes, or other body organs are sent to a lab for testing.

After your surgery:

You will be taken to a room where you can rest. A caregiver may remove the bandage after surgery to check your stitches. You will be taken back to your hospital room once your caregiver decides it is OK. Do not get out of bed until your caregiver says it is OK.

  • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

  • Blood sugar tests: Caregivers will monitor your blood sugar closely after surgery. This may help decrease your chance of getting an infection.

  • A Foley catheter is a tube put into your bladder to drain urine into a bag. Keep the bag below your waist. This will prevent urine from flowing back into your bladder and causing an infection or other problems. Also, keep the tube free of kinks so the urine will drain properly. Do not pull on the catheter. This can cause pain and bleeding, and may cause the catheter to come out. Caregivers will remove the catheter as soon as possible to help prevent infection.

  • Nasogastric (NG) tube: An NG tube is put into your nose, and passes down your throat until it reaches your stomach. Food and medicine may be given through an NG tube if you cannot take anything by mouth. The tube may instead be attached to suction if caregivers need to keep your stomach empty.

  • You will be able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

  • Pressure stockings: These are long, tight stockings that put pressure on your legs to promote blood flow and prevent clots. You may need to wear pressure stockings before or after surgery or if you have poor circulation (blood flow).

  • Pneumatic boots: Inflatable boots are put on your legs. The boots are connected to an air pump. The pump tightens and loosens different areas of the boots. This helps improve blood flow to prevent clots.

  • Preventing blood clots: Around the time of your surgery or procedure you may need to take medicine to thin your blood. Blood thinning medicine helps prevent blood clots from forming in your veins. This medicine makes it easier for a person to bruise and bleed. You will need regular blood tests while taking this medicine. If you have a bleeding disorder or a history of bleeding or blood clots, tell your caregiver. Talk to your caregiver about all of the medicines that you use. Physical activity helps prevent blood clots. Caregivers will help you be as active as possible after your surgery or procedure.

  • Medicines:

    • Blood thinners help prevent blood clots. Blood thinners may be given before, during, and after a surgery or procedure. Blood thinners make it more likely for you to bleed or bruise.

    • Patient controlled analgesia: You may get pain medicine through an IV or an epidural line attached to a patient controlled analgesia (PCA) pump. Caregivers set the pump to let you give yourself small amounts of pain medicine when you push a button. Your pump may also give you a constant amount of medicine, in addition to the medicine that you give yourself. Let caregivers know if your pain is still bad even with the pain medicine.

    • Stool softeners: This medicine makes it easier for you to have a bowel movement. You may need this medicine to treat or prevent constipation.

  • Treatments: If you have cancer, you may need one or both of the following:

    • Chemotherapy:

      • This medicine, often called chemo, is used to treat cancer. It works by killing tumor cells. Chemotherapy may also be used to shrink lymph nodes that have cancer in them. Once the tumor is smaller, you may need surgery to cut out the rest of the cancer.

      • Many different chemotherapy medicines are used to treat cancer. You may need blood tests often. These blood tests show how your body is doing and how much chemotherapy is needed. Chemotherapy can have many side effects. Caregivers will watch you closely and will work with you to decrease side effects. Chemotherapy can cure some cancers. Even if the chemotherapy does not cure your cancer, it may help you feel better or live longer.

    • Radiation: Radiation shrinks tumors and kills cancer cells with x-rays or gamma rays. Radiation may be given after surgery to kill cancer cells that were not removed. It may also be given alone or with chemotherapy to treat cancer.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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