Bowel surgery has to do with the removal of both benign and cancerous lesions of the small and large intestines. Small bowel surgery usually deals with malignant tumors, but occasionally benign tumors may grow enough to cause obstruction, bleeding, or even perforation.
More commonly are the lesions of the large intestines or colon. Most non-cancerous lesions of the large intestines or colon are related to diverticular disease. Diverticula are out-pouchings of the colon. They occur most frequently in weak areas where blood vessels enter. Patients with diverticula are said to have diverticulosis. Diverticulosis may be the cause of significant lower gastrointestinal bleeding. If the diverticula get inflamed and infected, this is then called diverticulitis. There is significant pain primarily in the left lower abdomen caused by diverticulitis. Patients with severe complications (recurrent episodes, perforations, and those non responsive to medical treatment) are deemed to be surgical candidates. Patients with severe, unrelenting bleeding from diverticulosis are also considered surgical candidates.
Polyps are common growths of the large intestines (colon). Most of these can be removed by colonoscopy. Some polyps may be too large or too sessile (flat) to remove. These may require surgical intervention to remove the polyp and the portion of the colon involved.
The type of surgery for disorders of the colon depends upon the situation. For acute perforations or obstructions, either from malignant or benign causes, a temporary colostomy and removal of the offending portion of the colon is required. The colostomy, in most situations, can be reversed after a few months. In most situations that are not acute, colon resection with reanastomosis (reconnecting the colon back together) is feasible. Prior to surgery a bowel prep is indicated to try and decrease the bacteria count to make surgery safer.
Frequently Asked Questions
- Following colon surgery, how long is my recuperation time?
- It is important to remember people may recover at different rates. Most patients will be able to go home after 5-7 days of hospitalization. No heavy lifting (over 10 lbs.) for about 6-8 weeks to allow the incision to heal and prevent an incisional hernia. Most often, activities are comfort related, that is, do what you are comfortable doing.
- How much pain will I experience after colon surgery?
- With open abdominal surgery there will certainly be post-operative pain. Your physician will want you to be walking very soon after surgery. Therefore, they will provide enough pain medication so you can accomplish that task. This is usually administered through the IV until taking food. As you begin to eat, this medication would be switched to an oral route.
- I need surgery for colon cancer. How long will I be in the hospital?
- Most patients are able to be safely discharged in 5-7 days. Prior to going home, a patient should be up and around, eating regular food, and having bowel movements. It may take 3-6 months for your bowel movements to normalize. Initially they may be loose, but with time they will become more formed.
- I need surgery for colon cancer. Will I need to wear a bag (colostomy)?
- Most patients requiring colon surgery do not need a colostomy. The exception would be obstructing cancers, perforated cancers, or cancers lying very low or distal in the rectum.