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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.

Getting Ready

Before your surgery:

  • Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.

  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.

  • Your caregiver will do tests to check if your disease has become worse. He may do a digital rectal exam by carefully placing a gloved finger inside your anus. Your caregiver may give you blood tests. He may do a colonoscopy using a special tool called a colonoscope. A colonoscope is a soft, bendable tube with a light and tiny camera on the end. It takes pictures of the inside of your colon, which may be shown on a TV-like screen. A colonoscopy may help your caregiver plan your surgery.

  • Your caregiver may do imaging studies to take pictures of your body. These tests may help measure the area of the colon that needs to be removed. Ask your caregiver for more information about these tests. Write down the date, time, and location of each test.

    • CT scan:

      • This is also called a CAT scan. A special x-ray machine uses a computer to take pictures of your colon, abdomen, or chest. It may be used to look at bones, muscles, body tissue, and blood vessels.

      • You may be given dye before the pictures are taken. The dye is usually given in an IV, which is a tube placed in your vein. The dye may help your caregiver see the pictures better. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell your caregiver if you are allergic to shellfish, or have other allergies or medical conditions.

    • Ultrasound:

      • An abdominal ultrasound is a simple test that looks inside of your abdomen. Sound waves are used to show pictures of your abdomen on a TV-like screen.


  • You may need a blood transfusion if you lose a large amount of blood during surgery. Some people are worried about getting AIDS, hepatitis, or the West Nile virus from a blood transfusion. The risk of this happening is very low. Blood banks test all donated blood for AIDS, hepatitis, and the West Nile virus. You may be able to donate your own blood before surgery. This is called autologous blood donation. This must be done no later than three days before surgery. You may also ask a family member or friend with the same blood type to donate blood for you. This is called directed blood donation.

The night before your surgery:

  • Your caregiver may want you to only drink liquids. He may also give you a special powder that is mixed with liquid. This drink is called a bowel preparation and will cause you to empty your bowels. Ask your caregiver for directions on how much and what kinds of liquids to drink.

  • You may need to have an enema to empty and clean out your bowels before surgery. During this procedure, liquid will be put into your anus through a tube. This liquid will help you have a bowel movement. Ask your caregiver for more information about an enema.

The day of your surgery:

  • Write down the correct date, time, and location of your surgery.

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.

Treatment

What will happen:

  • You will be taken on a stretcher to the room where your surgery will be done. You will be moved to a table. Your caregiver will make a cut along the middle of your abdomen. Your caregiver will look at your colon and then remove 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 some or part of your lymph nodes and other body organs that have cancer. The remaining healthy parts of your colon will be attached to other parts of your intestines. If your entire colon will be removed, your intestine will be attached to your rectum. Your rectum is the lower part of your bowel just behind your anus. Your caregiver will close your cut with stitches or staples and will cover it with bandages. Pieces of your colon, lymph nodes, or other body organs will be 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 okay. Do not get out of bed until your caregiver says it is okay.

Contact a caregiver if

  • You cannot make it to your surgery.

  • You have a fever (high body temperature).

  • You have a cold or the flu.

  • You have bleeding from your rectum or see blood in your stool.

  • You are unable to have a bowel movement.

  • You have questions about your surgery, condition, or care.

Seek Care Immediately if

  • You have bleeding that does not stop.

  • You have trouble breathing.

  • You have very bad pain in your stomach.

  • Your stomach is swollen.

  • You cannot eat without vomiting (throwing up).

© 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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