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Medical Disability Advisor  >  Colon Resection

Colon Resection


Related Terms


  • Anterior Resection of the Sigmoid Colon
  • Colectomy
  • Hemicolectomy
  • Left Hemicolectomy
  • Partial Resection of the Large Intestine
  • Right Hemicolectomy
  • Segmental Resection of the Colon
  • Transverse Colectomy

Specialists


  • Colon and Rectal Surgeon
  • Gastroenterologist
  • General Surgeon

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Factors Influencing Duration


Factors that may influence the length of disability include number and severity of postoperative complications (i.e., wound infection, bleeding, abscess, or an adverse reaction to a general anesthetic), amount of blood loss during surgery and postoperatively, success of the surgery, individual's nutritional status and mental and emotional stability, and strength of the individual's support system. The type of procedure performed also influences the length of disability.

Medical Codes


ICD-9-CM:
45.7 - Partial Excision of Large Intestine
45.71 - Multiple Segmental Resection of Large Intestine; Segmental Resection for Multiple Traumatic Lesions of Small Intestine
45.72 - Cecectomy; Resection of Cecum of Terminal Ileum
45.73 - Right Hemicolectomy; Ileocolectomy; Right Radical Colectomy
45.74 - Resection of Transverse Colon
45.75 - Left Hemicolectomy
45.76 - Sigmoidectomy
45.79 - Other Partial Excision of Large Intestine; Enterocolectomy NEC

Definition


A colon resection, also known as a colectomy, is the resection of a part or all of the large intestine (colon). The colon helps remove nutrients from foods and stores the waste material (stool or feces) until it is expelled from the body.

Individuals at risk for requiring a colectomy have some type of gastrointestinal disorder, such as diverticulitis, cancer, Crohn's disease, ulcerative colitis, volvulus, or obstruction. Colon resection is also necessary for treatment of volvulus complicated by gangrene or volvulus that affects the transverse colon.

Source: Medical Disability Advisor



Reason for Procedure


Colectomy is used to treat a variety of gastrointestinal disorders. This procedure may be performed to treat small sacs on the walls of the colon that become inflamed (diverticulitis), to remove colon cancer, to treat inflammatory conditions of the bowel (Crohn's disease), or to remove an intestinal obstruction that may develop due to cancer. A colectomy is also performed for an intestinal condition where the intestine twists and causes an obstruction (volvulus), or when the intestinal tract is damaged due to trauma.

Source: Medical Disability Advisor



How Procedure is Performed


A colon resection or colectomy is performed in the hospital as an inpatient procedure using general anesthesia.

Colectomies are classified according to the portion of the colon to be removed as well as the type of procedure used. If the right side of the colon is to be removed, the procedure is called a right hemicolectomy. If the part of the colon on the individual's left side is to be removed, it is known as a left hemicolectomy. A transverse colectomy is performed when the part of the colon that crosses from the right to the left side (transverse colon) is removed. In an anterior resection of the sigmoid colon, the part of the colon next to the rectum (sigmoid colon) is removed.

There are also two types of colectomy procedures, open and laparoscopic. In either procedure, the abdomen is cleansed with an antibacterial surgical scrub solution. In open procedures, an incision is made in the middle of the abdomen (midline). The various types of colectomies are then performed through the midline incision. After removal of the diseased portion of the colon, the intestine is reconnected. Reconnecting the ends of the intestines is called an anastomosis. The anastomosis may be either hand-sewn or stapled.

In laparoscopic colon resections, surgeons create four or five small openings, each about ½ inch (1.5 cm) long in the abdomen. The laparoscopy equipment is inserted through the wounds and the procedure is performed with the help of a television monitor. In some cases, one of the small openings may be lengthened to 2 or 3 inches in order to complete the colectomy.

With either procedure, the surgeon works down through abdominal tissues to the segment of the colon to be removed. It is loosened from surrounding tissues (mobilized), and the blood supply to that part of the colon is identified. The blood supply to the diseased segment is divided from the vessels that supply the remaining segments of the colon, and the blood vessels supplying the diseased bowel segment are closed off to prevent bleeding. The diseased portion of the colon is removed. The ends of the colon that remain are usually reconnected (anastomosed). Sometimes the colon cannot be reconnected, and a colostomy is required. Drain tubes may be placed to allow drainage of any secretions that accumulate. The incision is sutured closed, and dressings are placed over the incision.

Source: Medical Disability Advisor



Prognosis


Colectomy reduces the risk of recurrence of diverticular disease. In ulcerative colitis, about half the individuals require a second surgery within 10 years of the initial surgery. Colectomy is generally curative for ulcerative colitis and for obstructions due to volvulus.

The outcome of colectomy performed for treatment of cancer varies depending on the stage and spread of the cancer at the time of diagnosis as well as individual's response to treatment. The outcome of individuals with colon cancer diagnosed in the early stage is good.

Source: Medical Disability Advisor



Complications


Complications from colectomy may include wound infection, pelvic abscess, leakage at the sites where the intestines were sutured together (anastomosis sites), development of an abnormal tube-like passage (fistula), narrowing of the intestines where the intestines were sutured together (stricture), and a recurrence of disease.

Source: Medical Disability Advisor



Return to Work (Restrictions / Accommodations)


Several weeks off work may be needed for wound healing and recovery. Light work may be resumed. Heavy lifting should be avoided until approved by the surgeon. If treatment is necessary for cancer, time off from work may be necessary for treatment and recovery.

Source: Medical Disability Advisor



General References


Becker, J. M. "Chronic Ulcerative Colitis." The Practice of General Surgery. Ed. K. I. Bland. Philadelphia: W.B. Saunders, 2002. 478-486.

Belin, B. M., and S. D. Wexner. "Crohn's Disease of the Colon." The Practice of General Surgery. Ed. K. I. Bland. Philadelphia: W.B. Saunders, 2002. 492-498.

Kaiser, A. M., and R. W. Beart. "Colon Cancer." The Practice of General Surgery. Ed. K. I. Bland. Philadelphia: W.B. Saunders, 2002. 569-577.

Kaufman, H. S., and C. J. Sunnenday. "Diverticulitis." The Practice of General Surgery. Ed. K. I. Bland. Philadelphia: W.B. Saunders, 2002. 503-508.

Source: Medical Disability Advisor






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