Total proctocolectomy with ileostomy

Total proctocolectomy with ileostomy is surgery to remove all of the colon (part of the large intestine), rectum, and anus.

Description of Procedure

You will receive general anesthesia right before your surgery. This will make you unconscious and unable to feel pain.

For your proctocolectomy:

• Your surgeon will make surgical cut about 6 inches long in your lower belly.
• Then your surgeon will remove your large intestine and rectum.
• Your surgeon may also look at your lymph nodes and may remove some of them, if needed.

Next your surgeon will create an ileostomy:

• Your surgeon will make a small surgical cut in your belly. Usually this is made in the lower right part of your belly.
• The last part of your small intestine (ileum) is pulled through this surgical cut, and sewn onto your belly.
• This opening in your belly formed by your ileum is called the stoma. Stool will come out of this opening and collect in a drainage bag that will be attached to you.

Risks of Total proctocolectomy with ileostomy

Total proctocolectomy with ileostomy is usually safe. Your risk will depend on your general overall health. Ask your doctor about these possible complications:

Risks for any surgery are:

• Wound infections
• Blood clots in the legs that may travel to the lungs
• Breathing problems
• Heart attack or stroke

Risks for this surgery are:

• Bleeding inside your belly
• Damage to nearby organs in the body and to the nerves in the pelvis
• Infection, including in the lungs, urinary tract, and belly
• Scar tissue may form in your belly and causes blockage of your intestines.
• Your wound may break open.
• Poor healing of your wound in your perineum (where the rectum was removed)
• Poor absorption of nutrients from food because of your ileostomy
• Phantom rectum, a sensation that your rectum is still there (similar to people who have amputation of a limb)

Review Date: 11/23/2010
Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California.

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