Hemicolectomy: Types, Considerations, Risks, Diet, Recovery and Complications

Definition:

The colon can be partially removed without affecting the way it works in your digestive system. Once the affected part is removed, the remaining ends come together with almost no impact on digestion.

A hemicolectomy is a type of surgery that is done to remove part of the large intestine called the colon. This procedure is done if your colon has been affected by a condition or has become cancerous.

Some common conditions treated by a hemicolectomy include:

  • Colon or bowel cancer.
  • Trauma or injury in the abdominal area.
  • Inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease.
  • Tissue growths in the colon that can become cancerous.
  • Diverticulitis, which occurs when the diverticula (small bags) in your colon become infected or become inflamed

Types hemicolectomies

Right hemicolectomy: The ascending colon (the part of your colon that is attached to the end of the small intestine) is removed. Then, the small intestine joins the transverse colon.

Left hemicolectomy: The descending colon is eliminated. This is the part of your colon that is attached to your rectum. After it is removed, the surgeon connects the transverse colon directly to your rectum.

Health considerations

You are likely to be a good candidate for this surgery if, in general, you are in good health, apart from the condition that may require treatment with hemicolectomy.

If you have certain conditions, you may have a higher risk of complications from the procedure. These conditions include:

  • Pregnancy.
  • Heart disease.
  • Bleeding or coagulation problems.
  • Cicatricial tissue of previous colon or abdominal surgery.
  • Being overweight or obese
  • Advanced colon cancer or other types of bowel cancer.

Be sure to talk to your doctor before surgery about the risks if you have any of these conditions.

How to prepare for surgery

Before surgery, you may need a complete physical examination. This allows your doctor to verify any condition that may cause complications during surgery.

Your doctor will inform you if you will need a stoma after the surgery. This is when the colon joins directly to your skin. The waste from your intestines is then emptied into a pouch attached to the stoma, known as a colostomy pouch.

If you are taking any medication, ask your doctor if you should stop taking them before the surgery. In general, people should stop taking anticoagulants, such as aspirin, these can increase their risk of complications during surgery.

Your doctor may ask you to take laxatives a few days before surgery. These help cleanse your digestive tract.

This step is sometimes called bowel preparation. Emptying the intestines can facilitate the procedure and reduce the risk of infection.

You may need to fast just before surgery. Your doctor can tell you not to eat or drink until 12 hours before the procedure.

Process

When you arrive for your procedure, they will register you and take you to a room where you will be asked to remove your clothes and put on a hospital gown.

Then you will lie on an operating table or bed. A doctor will administer general anesthesia, so you will not be awake or conscious during the rest of the procedure.

Then, it will be connected to an intravenous drip to give nutrients to your body and to help keep the pain in check.

A nasogastric tube will be inserted through the nose into the stomach. A catheter will be inserted into the bladder to drain urine. The surgical procedure will start soon after.

During surgery

To remove part of your colon, your surgeon will probably start by making some small incisions in your abdominal area.

This is known as laparoscopic surgery. In some cases, you may have to undergo open surgery, which means that the skin and tissue around the colon must be completely open.

After making the incisions, your surgeon will remove the affected part of your colon. They will also remove any part of your intestines connected directly to the part of your colon that is being removed, such as the end of the small intestine or part of the rectum.

They will also eliminate the lymph nodes and blood vessels that are connected to the colon.

Once the affected part of your colon is removed, your surgeon reconnects the rest of your colon. If the ascending colon was removed, they connect the colon to the end of the small intestine.

If the descending colon was removed, they will connect the rest of your colon to your rectum. This union is known as anastomosis.

In the event that your surgeon can not reattach your colon to another part of your digestive tract, you can attach your colon to your abdominal skin.

This is called a stoma and you may need to carry a bag in your abdomen to store the waste after surgery. Depending on your surgery, this solution may be temporary or permanent.

A hemicolectomy usually takes about two hours, but may take longer depending on any complications during the procedure.

Recovery

A hemicolectomy is a major surgery. You may not be able to return to normal activities for several weeks or longer.

When you wake up from surgery, you are likely to feel dizzy from anesthesia. You will not feel much pain at first due to the pain medications that you were given through an intravenous drip.

In the next few days, your doctor will follow up. They will ask you how much pain you feel and how well you can maintain the food.

Before going home from the hospital, your doctor will determine if you have any infection or complications from the surgery.

In some cases, you may need to stay in the hospital for one to two weeks to recover enough to go home, especially if you had an open hemicolectomy.

Before going home, your doctor may prescribe medications such as ibuprofen to help control your pain and docusate to help prevent constipation. Get more information on how to control constipation after surgery.

Once you have returned home, you may not be able to perform normal daily activities for another two or three weeks. You should not lift any heavy objects for at least six weeks.

Post-surgery diet

Even without a part of your colon, you may not notice any significant changes in your digestion. You may not need to change your diet.

If you notice more frequent diarrhea or stomach cramps, your doctor may recommend some of the following foods to help control your bowel movements:

  • Bananas
  • Cheese.
  • Foods rich in fiber or supplements.
  • Oatmeal or cream of wheat.
  • Pastas.
  • Papas.
  • Soft tea
  • Yoghurt.

Your doctor may also recommend drinking more water or drinks with additional electrolytes, such as Gatorade, to prevent dehydration.

Risks

There are risks associated with anesthesia and with surgery itself. Consult your doctor immediately if you notice any of the following symptoms:

  • Diarrhea or constipation that lasts several days.
  • Fever of 100˚F (37.8˚C) or more.
  • Irritation or pus around the cuts in your abdomen.
  • Pain in your abdominal area that does not stop with medication.

Other complications may include:

  • Leaks around the area where the colon was reattached.
  • Blood clots in the lungs or legs during or after surgery.
  • Infections
  • Damage to the organs that surround your colon.
  • Blockage in the colon due to scar tissue.

Get more information on how to prevent blood clots after surgery.

Panorama

After a few months, the incisions will heal and you will no longer feel pain in your intestines or abdominal area.

If your hemicolectomy was done to help treat cancer, you may need to follow up with your doctor to receive chemotherapy or other treatments to make sure the cancer does not spread.

If you need to use a colostomy bag for a stoma, your doctor will follow up with you. You can analyze how long you should use it and when you can remove it.

It is likely that you can maintain your normal diet. You should not notice any major changes in your bowel movements after a hemicolectomy.

But in some cases, you may need to make changes in your diet or lifestyle to make sure your colon stays healthy.