Total abdominal colectomy
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.
Ileorectal anastomosis; Subtotal colectomy
You will receive general anesthesia before your surgery. This will make you sleep and pain free.
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:
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.
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.
Araghizadeh F. Ileostomy, colostomy, and pouches. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 117.
Mahmoud NM, Bleier JIS, Aarons CB, Paulson EC, Shanmugan S, Fry RD. Colon and rectum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 51.
Review Date: 9/3/2018
Reviewed By: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. 03-13-19: Editorial update.
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