Jump to navigation Jump to search

Template:Interventions infobox

WikiDoc Resources for Colectomy


Most recent articles on Colectomy

Most cited articles on Colectomy

Review articles on Colectomy

Articles on Colectomy in N Eng J Med, Lancet, BMJ


Powerpoint slides on Colectomy

Images of Colectomy

Photos of Colectomy

Podcasts & MP3s on Colectomy

Videos on Colectomy

Evidence Based Medicine

Cochrane Collaboration on Colectomy

Bandolier on Colectomy

TRIP on Colectomy

Clinical Trials

Ongoing Trials on Colectomy at Clinical

Trial results on Colectomy

Clinical Trials on Colectomy at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Colectomy

NICE Guidance on Colectomy


FDA on Colectomy

CDC on Colectomy


Books on Colectomy


Colectomy in the news

Be alerted to news on Colectomy

News trends on Colectomy


Blogs on Colectomy


Definitions of Colectomy

Patient Resources / Community

Patient resources on Colectomy

Discussion groups on Colectomy

Patient Handouts on Colectomy

Directions to Hospitals Treating Colectomy

Risk calculators and risk factors for Colectomy

Healthcare Provider Resources

Symptoms of Colectomy

Causes & Risk Factors for Colectomy

Diagnostic studies for Colectomy

Treatment of Colectomy

Continuing Medical Education (CME)

CME Programs on Colectomy


Colectomy en Espanol

Colectomy en Francais


Colectomy in the Marketplace

Patents on Colectomy

Experimental / Informatics

List of terms related to Colectomy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Colectomy consists of the surgical resection of any extent of the large bowel (colon).


Some of the most common indications for colectomy are:

Basic principles

Traditionally, colectomy is performed via an abdominal incision (laparotomy), though minimally invasive colectomy, by means of laparoscopy, is growing both in scope of indications and popularity, and is a well-established procedure as of 2006 in many medical centers.

Resection of any part of the colon entails mobilization and ligation of the corresponding blood vessels. Lymphadenectomy is usually performed through excision of the fatty tissue adjacent to these vessels (mesocolon), in operations for colon cancer.

When the resection is complete, the surgeon has the option of immediately restoring the bowel, by stitching together both the cut ends (primary anastomosis), or creating a colostomy. Several factors are taken into account, including:

  • Circumstances of the operation (elective vs emergency);
  • Disease being treated;
  • Acute physiological state of the patient;
  • Impact of living with a colostomy, albeit temporarily;
  • Use of a specific preoperative regimen of low-residue diet and laxatives (so-called "bowel prep").

An anastomosis carries the risk of dehiscence (breakdown of the stitches), which can lead to contamination of the peritoneal cavity, peritonitis, sepsis and death. Colostomy is always safer, but places a societal, psychological and physical burden on the patient. The choice is by no means an easy one and is rife with controversy, being a frequent topic of heated debate among surgeons all over the world.


  • Right hemicolectomy and left hemicolectomy refer to the resection of the ascending (right) colon and the descending (left) colon, respectively. When part of the transverse colon is also resected, it may be referred to as an extended hemicolectomy
  • Transverse colectomy is also possible, though uncommon.
  • Sigmoidectomy is a resection of the sigmoid colon, sometimes including part or all of the rectum (proctosigmoidectomy). When a sigmoidectomy is followed by terminal colostomy and closure of the rectal stump, it is called a Hartmann operation; this is usually done out of impossibility to perform a "double-barrel" or Mikulicz colostomy, which is preferred because it makes "takedown" (reoperation to restore normal intestinal continuity by means of an anastomosis) considerably easier.
  • When the entire colon is removed, this is called a total colectomy. If the rectum is also removed, it is a total proctocolectomy.
  • Subtotal colectomy is resection of part of colon or a resection of all of the colon without complete resection of the rectum.[1]
  • Anterior resection is resection of the lower part of the left colon and adjacent rectum. The operation is often combined with removal of the tissue behind the rectum (mesorectum}. This extra procedure is commonly called a total mesorectal excision or TME. A TME procedure removes the rectal lymph glands.


  1. Oakley JR, Lavery IC, Fazio VW, Jagelman DG, Weakley FL, Easley K (1985). "The fate of the rectal stump after subtotal colectomy for ulcerative colitis". Dis. Colon Rectum. 28 (6): 394–6. PMID 4006633.

External links

Template:Digestive system surgical procedures

de:Kolektomie nl:Colectomie

Template:WikiDoc Sources