Large bowel resection Health Article

Definition

Large bowel resection is surgery to remove part of your large bowel. The large bowel connects the small intestine to the anus. It is also called the large intestine or colon.

Alternative Names

Large intestine surgery; Colon resection; Resection of part of large intestine; Colectomy; Proctocolectomy

Description

In most cases, your bowel is cleaned before the surgery with enemas and medication.

The surgery is performed while you are under general anesthesia. This means you are unconscious and pain-free. A cut is made in your abdomen. The diseased part of the large bowel is removed and the two healthy ends of the bowel are sewn back together (resected). The cut is closed. If the entire colon and rectum is removed, it is called a proctocolectomy.

A bowel resection may be performed as a traditional "open" procedure or as a minimally invasive laparoscopic procedure.

To help your bowel heal, a temporary opening of the colon through the abdominal wall may be created. This is called a colostomy. The end of the bowel near the small intestine is then passed through the abdominal wall, and stitched in place. A drainage bag (stoma appliance) is placed around the opening.

In most cases, the colostomy is temporary and can be closed with another operation at a later date. If a large portion of the bowel is removed, the colostomy may be permanent.

The large bowel absorbs a significant amount of water from digested food. When the colon is bypassed by a colostomy, loose or liquid stool (feces) will collect in the drainage bag. Careful skin care and a well-fitting colostomy bag are necessary to reduce skin irritation around the colostomy.

Indications

Large bowel resection is used to treat a variety of conditions, including:

• Colon cancer
• Diverticular disease
• A block in the intestine due to scar tissue

Other reasons to perform bowel resection include:

• Ulcerative colitis  
• Traumatic injuries
• Precancerous polyps
• Familial polyposis

Risks

Risks for any anesthesia include the following:

• Reactions to medications
• Problems breathing

Risks for any surgery include the following:

• Bleeding
• Infection

Additional risks include the following:

• Bulging through the incision (incisional hernia)
• Narrowing (stricture) of the stoma
• Blockage of the intestine from scar tissue
• Leakage from the reconnection of the intestine

Some cases may result in the permanent need for a colostomy bag.

Expectations after surgery

The outcome depends on the disease. Most patients have relief of their symptoms.

Convalescence

Most patients will stay in the hospital for 5 to 7 days. Complete recovery from surgery may take 2 months. During the first few days after surgery, eating is restricted.

Laparoscopic bowel resection for colon cancer may result in a faster recovery time than traditional open surgery.