Colectomy – surgery of the colon

Colectomy is to remove a part of the colon that is diseased. Different terms are used to describe removal of different parts of the colon (large intestine).

Colectomy may be needed to treat:

• Cancer of the colon
• A blocked bowel
• A perforation (hole or tear) in the bowel
• Severe diverticulitis
• Pre-cancerous polyps
• A fistula (an abnormal connection between the colon and another organ such as the bladder)

The surgery involves removal of the diseased part of the colon, with a margin of healthy tissue. Usually the adjacent lymph glands are also removed, which is particularly important in treating cancer of the colon.

The remaining colon is rejoined (anastomosis). Sometimes (particularly in an emergency operation) the colon cannot be rejoined immediately. In a Hartmann’s procedure the rectum is closed and the end of the colon brought out as a colostomy. Occasionally the colon can be rejoined, but the small intestine is brought out as an ileostomy, to allow the rejoining to heal first.

Both these stomas (ileostomy or colostomy) are usually temporary, and can be rejoined several weeks later.

Colon surgery can be done open or laparoscopic, depending on the nature of the condition, if it is emergency surgery or elective surgery, and various patient factors.