Colectomy
What is Colectomy ?
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Why do you need Colectomy?
Colectomy is indicated for:
- Colorectal cancer: Tumors in the colon or rectum requiring resection to prevent spread.
- Inflammatory bowel disease (IBD): Severe ulcerative colitis or Crohn’s disease unresponsive to medical therapy.
- Diverticulitis: Recurrent or complicated diverticular disease causing abscesses or perforation.
- Bowel obstruction: Due to tumors, volvulus, or strictures.
- Familial adenomatous polyposis (FAP): A genetic condition with multiple colon polyps predisposing to cancer.
- Severe trauma or ischemia: Damage or loss of blood supply to the colon.
The procedure aims to remove diseased tissue, restore bowel function, or create a stoma (colostomy or ileostomy) if the bowel cannot be reconnected.
Why Do Costs Vary in Philippines?
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Colectomy Procedure
The procedure is tailored to the patient’s condition, extent of disease, and surgical goals:
- Before Surgery Evaluation:
- Diagnosis is confirmed via colonoscopy with biopsy (for cancer or IBD), CT/MRI scans (to assess tumor spread or complications), and blood tests (e.g., CEA for cancer staging, liver/kidney function).
- Bowel preparation (laxatives, enemas) clears the colon for surgery.
- Nutritional status is optimized, especially for IBD patients, with possible pre-surgery IV nutrition.
- Patients receive counseling on potential stoma creation and post-operative care.
- Surgical Techniques:
- Open Colectomy:
- Performed under general anesthesia, lasting 2–4 hours.
- A midline abdominal incision provides access to the colon.
- The surgeon removes the affected colon segment (e.g., right, left, or sigmoid colectomy) or the entire colon (total colectomy).
- Lymph nodes are removed for cancer staging.
- The remaining bowel is reconnected (anastomosis) or diverted to a stoma (colostomy/ileostomy) if reconnection is not feasible.
- Laparoscopic Colectomy:
- A minimally invasive approach using 4–5 small incisions, a laparoscope (camera), and specialized instruments.
- Suitable for early-stage cancers, IBD, or diverticulitis, offering less pain, smaller scars, and faster recovery.
- Takes 2–4 hours, with conversion to open surgery possible if complications arise.
- Robotic-Assisted Colectomy:
- Uses robotic systems (e.g., da Vinci) for enhanced precision, particularly in complex cases like low rectal tumors or IBD.
- More expensive but increasingly available in centers like Apollo or Medanta.
- Types of Colectomy:
- Right hemicolectomy: Removes the right colon (cecum, ascending colon).
- Left hemicolectomy: Removes the left colon (descending colon).
- Sigmoid colectomy: Removes the sigmoid colon.
- Total colectomy: Removes the entire colon, often with ileostomy or ileoanal pouch creation.
- Proctocolectomy: Removes the colon and rectum, typically for ulcerative colitis or FAP, with a permanent ileostomy or pouch.
- Open Colectomy:
- After Surgery:
- Patients are monitored in the ICU or high-dependency unit for 1–2 days to manage pain, fluids, and bowel function.
- Hospital stay lasts 5–10 days for open colectomy or 3–7 days for laparoscopic/robotic colectomy.
- Pathology reports guide further treatment (e.g., chemotherapy for cancer, immunosuppressive therapy for IBD).
- Stoma care training is provided for patients with colostomy/ileostomy.
Recovery After Colectomy
Recovery involves physical healing, bowel function restoration, and adaptation to potential stoma:
- Hospital Stay:
- Open colectomy requires 5–10 days, including 1–2 days in the ICU.
- Laparoscopic or robotic colectomy involves 3–7 days, with 1 day in the ICU.
- Post-Surgery Care:
- Pain is managed with medications (e.g., epidural, opioids initially, then NSAIDs).
- IV fluids and gradual oral intake (clear liquids to solids) support bowel recovery, typically within 3–5 days.
- Patients with stomas receive training from an enterostomal therapist for colostomy/ileostomy care (e.g., changing bags, skin protection).
- Antibiotics prevent infection; drains (if placed) are removed once output decreases.
- Activity and Diet:
- Light walking resumes within 1–2 days to prevent blood clots and promote bowel motility.
- Strenuous activities, heavy lifting, or driving are avoided for 6–8 weeks (open surgery) or 4–6 weeks (laparoscopic/robotic).
- A low-residue diet (e.g., white rice, bananas) is followed initially, transitioning to high-fiber foods after 4–6 weeks to regulate bowel movements.
- Hydration and stoma-compatible foods (avoiding gas-producing items like beans) are emphasized for stoma patients.
- Follow-Up:
- Follow-up visits at 1–2 weeks and 4–6 weeks assess wound healing, bowel function, and stoma status.
- Imaging (CT, colonoscopy) and CEA levels monitor for cancer recurrence (every 3–6 months for 5 years).
- Stoma reversal (if temporary) is planned after 3–6 months, depending on the patient’s condition.
Most patients resume normal activities within 4–8 weeks, with laparoscopic patients recovering faster (4–6 weeks). For colorectal cancer, 5-year survival rates are 60–90% for stage I–II and 40–60% for stage III with adjuvant therapy. For IBD, colectomy often cures ulcerative colitis (with proctocolectomy) but may not fully resolve Crohn’s disease.
Risks and Complications
Colectomy is a major surgery with potential risks:
- Surgical Risks:
- Bleeding, infection, or wound dehiscence at the incision site.
- Anastomotic leaks (if bowel is reconnected), leading to peritonitis or abscesses.
- Stoma-Related Complications:
- Stoma prolapse, retraction, or blockage, requiring revision surgery.
- Skin irritation or breakdown around the stoma.
- General Risks:
- Adverse reactions to anesthesia.
- Blood clots (deep vein thrombosis or pulmonary embolism), requiring anticoagulants.
- Bowel obstruction due to adhesions, potentially needing further surgery.
- Disease-Specific Risks:
- Cancer recurrence or metastasis, requiring additional therapy.
- Persistent symptoms in Crohn’s disease patients if disease extends beyond the colon.
- Long-Term Issues:
- Altered bowel habits (e.g., diarrhea, urgency), especially after total colectomy.
- Nutritional deficiencies if extensive bowel is removed, requiring supplements.
Prompt reporting of symptoms like fever, severe pain, or no bowel output ensures timely management.
Frequently Asked Questions (FAQs)
What causes the need for a colectomy?
Common indications include colorectal cancer, ulcerative colitis, Crohn’s disease, diverticulitis, bowel obstruction, or FAP.
Can a colectomy be avoided?
Early-stage cancers or mild IBD may be managed with medication or less invasive procedures, but advanced disease or complications often require colectomy.
Will I need a permanent stoma after colectomy?
Temporary stomas are common in partial colectomy but may be reversed. Total proctocolectomy often requires a permanent stoma or ileoanal pouch.
How soon can I resume normal activities?
Laparoscopic patients resume activities in 4–6 weeks; open surgery patients take 6–8 weeks.
Is colectomy covered by insurance in India?
Most insurance plans cover colectomy for cancer, IBD, or emergencies. Confirm with your provider.
What are the signs of complications post-colectomy?
Fever, severe pain, no bowel movements, or stoma issues require immediate medical attention.
Can elderly patients undergo colectomy?
Yes, elderly patients can undergo colectomy if their health permits, with laparoscopic approaches reducing risks.
What lifestyle changes are needed post-colectomy?
Maintain a balanced diet, stay hydrated, manage stoma care (if applicable), avoid heavy lifting, and attend regular follow-ups, especially for cancer patients.
Conclusion
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Looking for Best Hospitals for Colectomy
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.