What Is a Subtotal Colectomy?

If you have serious issues with your lower digestive tract, your doctor may start a conversation about a subtotal colectomy in the near future. What is a subtotal colectomy? This specialized procedure commonly treats a wide variety of problems with the large intestine, helping reduce pain and improving your overall quality of life. While the thought of any surgery can be daunting, understanding the necessity and simplicity of the procedure and its benefits can help you feel more at ease.

By definition, a colectomy is a surgery removing either a portion or all of the colon. The colon is the end of the digestive tract and is technically a part of the large intestine. If a patient needs the entire colon removed, the surgeon performs a procedure known as a total colectomy. If the surgeon removes only part of the colon, the procedure is a subtotal colectomy.

Depending on the situation, a surgeon can perform this procedure through traditional open surgery or laparoscopic surgery. While both have their place, laparoscopic surgeries are often preferred because they are less invasive, require smaller incisions, and allow for a faster recovery time.

With a portion of the colon removed, the surgeon creates a new pathway so the digestive tract can continue expelling waste. The surgeon connects the remaining portions of the colon so that bowel movements can occur as before for most patients who undergo a subtotal colectomy. If the surgeon removes large portions or all of the colon, patients may need a colostomy, which is when the doctor creates a small opening in the abdomen to expel stool into a bag. Some patients may need a temporary colostomy after a subtotal colectomy until the surgical site heals fully.

Why Do You Need a Subtotal Colectomy?

There are many reasons a doctor may suggest this type of surgery. Total and subtotal colectomies can treat a wide variety of digestive issues.

Active Cancer

Colon cancer is one of the most prevalent types of cancer in the United States. On average, 4% of males and 3% of females develop colorectal cancer in their lifetimes. While it is treatable when caught early enough, it can still be fatal if left to progress independently. Doctors often treat early-stage colon cancer with a subtotal colectomy. However, if it continues to grow and spread, a total colectomy may be necessary.

Bowel Obstruction

Another life-threatening condition that may require the removal of part of the colon is bowel obstruction. This can happen when portions of the colon become pinched or closed, preventing waste from passing through and exiting the body. Adhesions (the growth of fibrous tissues), hernias, and tumorous growths can all lead to bowel obstructions.

Uncontrolled Abdominal Bleeding

What is a subtotal colectomy used to treat in addition to cancer and blockages? Internal bleeding is another serious issue and is often far more dangerous than external bleeding, as it can be more difficult to manage. If you experience bleeding within the colon that will not stop, your doctor may recommend a subtotal colectomy to control the hemorrhage. This serious, heavy bleeding can result from infections, bowel disease, tissue tears, and cancer.

Diverticulitis

When a person does not consume enough fiber or does not have sufficient digestive motility, it can take more time and effort for the body to expel waste. As a result, portions of the colon can become irritated and form outpouchings, a condition known as diverticulosis. If material passing through the digestive tract gets trapped in these outpouchings and leads to infection, the result is diverticulitis, a painful and sometimes serious condition. There is no cure for diverticulosis, and flare-ups can happen at any time. A subtotal colectomy can remove the affected areas for much-needed pain relief while putting an end to these chronic infections.

Inflammatory Bowel Disease

Crohn’s disease and ulcerative colitis are both considered types of inflammatory bowel disease. Crohn’s disease causes recurring or persistent inflammation of the digestive tract. Ulcerative colitis also causes inflammation, as well as ulcers or sores within the colon. Doctors typically treat mild to moderate cases with medication and dietary changes. However, severe or long-term inflammatory bowel disease can cause permanent damage to the digestive tract, requiring colon surgery.

What Happens Before and After a Subtotal Colectomy?

While a surgeon may perform an emergency colectomy, most patients have time to prepare for the procedure. You can expect your doctor to review your current medications and determine which ones (if any) you need to suspend for surgery. They may recommend antibiotics to help prevent post-operative infection, too. Patients must fast for a specific amount of time before the procedure, usually 24 hours, as well as completely empty their colons with the help of laxative solutions.

What is a subtotal colectomy recovery plan? Most patients can expect to stay in the hospital for at least a few days after the procedure. You may not eat or drink for several hours or days after, relying on intervenous nutrition instead while the surgical site heals. Your doctor determines when it’s the right time to reintroduce liquids, then solids, so your body can safely regain bowel function.

At home, you should rest and avoid strenuous activity and heavy lifting for several weeks. You may also need to follow a specific diet for a while. Each patient situation is unique, so your doctor can help you create a treatment plan for your specific needs.