44144 Colectomy, partial; with resection, with colostomy or ileostomy and creation of mucofistula

Name of the Procedure:

Colectomy, partial; with resection, with colostomy or ileostomy and creation of mucofistula

Summary

A partial colectomy involves surgically removing a portion of the colon. This specific procedure includes the establishment of either a colostomy or ileostomy to allow for waste elimination and the creation of a mucofistula to drain mucus from the remaining colon.

Purpose

This procedure addresses conditions such as colorectal cancer, diverticulitis, Crohn's disease, or bowel obstruction. The goals are to remove diseased or damaged sections of the colon, allow for healing, and maintain bodily function through an alternative waste removal route.

Indications

• Colorectal cancer
• Diverticulitis
• Crohn's disease
• Bowel obstruction
• Severe infection or inflammation in the colon
• Traumatic injury to the colon

Preparation

• Fasting typically starting from midnight before the surgery.
• Bowel preparation to cleanse the colon, often involving a special diet and laxatives.
• Adjusting current medications as advised by the healthcare provider.
• Preoperative tests such as blood work, imaging studies (CT scan or MRI), and colonoscopy.

Procedure Description

1. Administer general anesthesia for the patient's comfort and to render them unconscious during surgery.
2. A surgical incision is made in the abdomen to access the colon.
3. The diseased section of the colon is identified and resected.
4. The creation of a colostomy or ileostomy involves bringing the end of the remaining digestive tract through an opening in the abdominal wall to form a stoma.
5. A mucofistula is created to allow mucus from the remaining colon segments to exit the body.
6. The surgical site is closed with sutures or staples.

Duration

The procedure typically takes 2 to 4 hours, depending on the complexity and patient condition.

Setting

This surgery is performed in a hospital operating room.

Personnel

• General or colorectal surgeon
• Anesthesiologist
• Surgical nurses
• Operating room staff

Risks and Complications

• Infection
• Bleeding
• Blood clots
• Leakage from the site where the colon is stitched.
• Stoma problems such as prolapse or retraction
• Bowel obstruction
• Adverse reaction to anesthesia

Benefits

• Relief from symptoms associated with the underlying condition, such as pain and bowel blockage.
• Enhanced quality of life.
• Potentially curative for conditions like colorectal cancer.

Recovery

• Pain management with prescribed medications.
• Hospital stay for several days is typical.
• Gradual return to normal activities over 4 to 6 weeks.
• Instructions for stoma care and monitoring.
• Follow-up appointments with the surgeon.

Alternatives

• Medications and lifestyle changes to manage the condition more conservatively.
• Endoscopic procedures to remove smaller lesions.
• Total colectomy, if the condition affects a larger portion of the colon.

Patient Experience

During the procedure, the patient will be under general anesthesia and feel no pain. Post-procedure, they may experience discomfort or pain at the incision site, managed with pain relief medications. Learning to manage the stoma can be challenging initially, but patients typically adapt with time and support from healthcare professionals.