Total proctocolectomy with ileostomy
Total proctocolectomy with ileostomy is surgery to remove all of the colon (large intestine) and rectum.
You will receive general anesthesia right before your surgery. This will make you be asleep and unable to feel pain.
For your proctocolectomy:
Next, your surgeon will create an ileostomy:
Some surgeons perform this operation using a camera. The surgery is done with a few small surgical cuts, and sometimes a larger cut so that the surgeon can assist by hand. 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
Total proctocolectomy with ileostomy surgery is done when other medical treatment does not help problems with your large intestine.
This surgery may also be done if you have:
Total proctocolectomy with ileostomy is most often safe. Your risk will depend 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.
Talk with your provider about these things before you have surgery:
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. You may have to stay longer if you had this surgery because of an emergency.
You may be given ice chips to ease your thirst on the same day as your surgery. By the next day, you will probably be allowed 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. You may be eating a soft diet 2 days after your surgery.
While you are in the hospital, you will learn how to care for your ileostomy.
You will have an ileostomy pouch that is fitted for you. Drainage into your pouch will be constant. You will need to wear the pouch at all times.
Most people who have this surgery are able to do most activities they were doing before their surgery. This includes most sports, travel, gardening, hiking, and other outdoor activities, and most types of work.
You may need ongoing medical treatment if you have a chronic condition, such as:
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 NN, 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.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.