Total abdominal colectomy

Definition

Total abdominal colectomy is the removal of the large intestine from the lowest part of the small intestine (ileum) to the rectum. After it is removed, the end of the small intestine is sewn to the rectum.

Alternative Names

Ileorectal anastomosis; Subtotal colectomy

Description

You will receive general anesthesia before your surgery. You will be asleep and unable to feel pain.

During the surgery:

Today, some surgeons perform this operation using a camera. The surgery is done with a few small surgical cuts, and sometimes a larger cut big enough for the surgeon to assist with the operation. The advantages of this surgery, which is called laparoscopy, are a faster recovery, less pain, and only a few small cuts.

Why the Procedure Is Performed

The procedure is done for people who have:

Risks

Total abdominal colectomy is most often safe. Your risk depends on your general overall health. Ask your health care provider about these possible complications.

Risks of anesthesia and surgery in general are:

Risks of having this surgery are:

Before the Procedure

Always tell your provider what medicines you are taking, even medicines, supplements, or herbs you bought without a prescription. Ask which medicines you should still take on the day of your surgery.

Before you have surgery, talk with your provider about the following things:

During the 2 weeks before your surgery:

The day before your surgery:

On the day of your surgery:

After the Procedure

You will be in the hospital for 3 to 7 days. By the second day, you will probably be able to drink clear liquids. You will slowly be able to add thicker fluids and then soft foods to your diet as your bowels begin to work again.

Outlook (Prognosis)

After this procedure, you can expect to have 4 to 6 bowel movements a day. You may need more surgery and an ileostomy if you have Crohn disease and it spreads to your rectum.

Most people who have this surgery recover fully. They are able to do most of the activities they were doing before their surgery. This includes most sports, travel, gardening, hiking, and other outdoor activities, and most types of work.

References

Galandiuk S, Netz U, Morpurgo E, Tosato SM, Abu-Freha N, Ellis CT. Colon and rectum. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. Philadelphia, PA: Elsevier; 2022:chap 52.

Raza A, Araghizadeh F. Ileostomies, colostomies, pouches, and anastomoses. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 117.



Review Date: 8/22/2022
Reviewed By: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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