44146 Colectomy, partial; with coloproctostomy (low pelvic anastomosis), with colostomy

Name of the Procedure:

Partial Colectomy with Coloproctostomy (Low Pelvic Anastomosis) and Colostomy

Summary

A partial colectomy with coloproctostomy (low pelvic anastomosis) and colostomy is a surgical procedure where a portion of the colon is removed, the remaining colon is connected to the rectum, and a temporary or permanent opening (stoma) is created in the abdominal wall to divert stool.

Purpose

The procedure is designed to treat conditions such as colorectal cancer, diverticulitis, or inflammatory bowel disease. It aims to remove the diseased part of the colon, allow bowel contents to be safely expelled, and promote healing.

Indications

• Colorectal cancer
• Chronic diverticulitis
• Inflammatory bowel disease (like Crohn’s disease or ulcerative colitis)
• Bowel obstruction or perforation
• Severe gastrointestinal bleeding

Preparation

• Fasting: Patients typically need to fast for at least 12 hours before surgery.
• Bowel prep: A cleansing solution is often given to empty the colon.
• Medication adjustments: Blood-thinning medications may need to be adjusted.
• Diagnostic tests: Pre-operative imaging, blood tests, and a colonoscopy may be required.

Procedure Description

1. Anesthesia: The patient is given general anesthesia to sleep through the procedure.
2. Incision: A surgical incision is made in the abdomen.
3. Colon Removal: The diseased portion of the colon is identified and removed.
4. Anastomosis: The remaining part of the colon is connected to the rectum (coloproctostomy).
5. Colostomy: A stoma is created by bringing a part of the colon to an opening in the abdominal wall.
6. Closure: The incision is closed with sutures or staples.

Duration

The procedure typically takes 3 to 4 hours, depending on complexity.

Setting

The surgery is performed in a hospital operating room.

Personnel

• Lead Surgeon
• Assistant Surgeon
• Anesthesiologist
• Surgical Nurses
• Scrub Technicians

Risks and Complications

• Infection
• Bleeding
• Damage to surrounding organs
• Leakage from the anastomosis site
• Stoma-related issues, like skin irritation
• Blood clots

Benefits

• Removal of diseased tissue
• Relief from symptoms
• Potential cure or management of colorectal cancer
• Improved quality of life

Recovery

• Hospital stay: Typically 5-7 days
• Initial recovery: 2-4 weeks of limited activity
• Full recovery: 6-8 weeks
• Follow-up: Regular check-ups and colonoscopy as recommended

Alternatives

• Endoscopic treatment (for certain conditions)
• Total colectomy (in more severe cases)
• Medications and lifestyle changes (for inflammatory conditions)
• Radiation or chemotherapy (for cancer)

Patient Experience

• May experience discomfort and pain post-surgery, managed with medication.
• Temporary or permanent uncertainty around stoma care and adjustments.
• Gradual improvement in symptoms and physical activity over weeks.
• Support from healthcare providers for stoma management and recovery.