A person suffering from any disturbance or abnormality in the colon, rectum and anus may be a good candidate for colorectal surgery. Apart from this, the following reasons also make a good candidate for this surgery:
- Anal lumps
- Rectal bleeding
- Suffering from anal fissure
- rectal or colon cancer
- Severe abdominal pain
- Anal pain
The following reasons may not make a good candidate for colorectal surgery:
- Prior abdominal surgery
- Weak immune system
- Heart condition
- History of medical conditions
- Bleeding disorder, anaemia or any other chronic illness
Colorectal surgeries are major surgical procedures. The doctor may perform several tests and scans. These may include blood and urine tests, EKG (electrocardiogram), X-ray, ultrasound, and more. The doctor will advise stopping taking over-the-counter medications, such as aspirin.
One also need to prepare for bowel by taking laxatives before the surgery. The goal behind this is to clear the lower digestive tract to give the surgeon a clear and clean surgical field. This also prevents post-operative infections. Apart from this, other preparations for abdominal surgery may require the following:
- Avoid taking anti-inflammatory drugs
- Wear loose clothing
- Leave all the jewellery at home before going to the hospital
- Stop taking blood-thinning medications for two weeks before the surgery
- Not to eat or drink after midnight before the surgery
- Pre-arranging a ride home after the surgery
Colorectal surgery is generally performed under local anaesthesia, intravenous sedation or general anaesthesia. The surgery begins by making incisions around the abdomen. There are several ways to perform colorectal surgery, depending on the conditions that need to be treated. Some of the most often used techniques are as follows:
Colectomy: The surgery is done to remove part of all of the colon. The surgery can be performed as open or laparoscopic. The surgeon makes an incision in the abdomen during the procedure and cuts a part or entire colon. The surgeon then reconnects the digestive system by rejoining the remaining portion or connecting the intestine to an opening created in the abdomen.
Colostomy: The surgical procedure involves creating a hole in the abdomen and pulling one end of the colon through it. Colostomy can be temporary or permanent, depending on the condition. The surgeon makes an incision in the abdomen during the procedure and pulls the colon. The surgeon then attaches a colostomy bag to collect the stool.
Laparoscopic surgery: This type of surgery is performed in the abdomen to minimize pain and enable speedy recovery. The surgeon makes a small incision in the abdomen during the procedure and inserts a tube with a camera attached to it. Once the surgery is completed, the surgeon then sutures the small incisions.
Anoplasty: The surgery is performed to reconstruct the anus and is often done in case of anal stenosis.
Hemorrhoidectomy: This surgical procedure is done to remove haemorrhoids. During the procedure, the surgeon makes incisions around the haemorrhoid and ties off the swollen vein inside it. The surgeon then removes the haemorrhoid and sutures the incision site.
Ileal pouch-anal anastomosis: Also known as IPPA or J-pouch procedure, the surgery removes the entire colon and rectum. The surgeon then creates a pouch from the small intestine’s end and attaches it to the anus. The surgeon then makes a temporary opening in the abdominal wall to eliminate waste. Once the J-pouch is healed, the surgeon performs the second procedure to close the opening and allow the waste to pass normally.
Lateral internal sphincterotomy: This surgical procedure is performed to treat chronic anal fissures. In this procedure, the surgeon cuts a small portion of the anal sphincter muscle, which reduces spams and pain. This allows anal fissures to heal.
Rectopexy: The surgery is done to repair rectal prolapse. During the procedure, the surgeon restores the rectum to its normal position in the pelvis so that it can no longer protrude. The surgeon then stitches around the rectum to secure it in place.
Like any other major surgery, there are some risks associated with colorectal surgery, including bleeding, infection, and reaction to anaesthesia. Other complications may include:
- Blood clots
- Bleeding from the incision site
- Infection at the surgical site
- Leaks at the connection site
- Paralytic ileus
- Swelling around the incision
- Damage to an organ or blood vessel
Depending on the type of surgery, patients may need to stay in the hospital for one or two days. The recovery time for colorectal surgery is approximately six to eight weeks, though it may be longer in some cases. The doctor will provide a post-operative care package to ensure minimal complications and faster recovery. The doctor may also ask to come back on the fifth or seventh day to monitor the progress. Apart from this, other post-operative care includes:
- Avoid indulging in strenuous physical activities for four to six weeks
- Take proper rest
- Take all the medications in a timely manner as prescribed by the doctor
- Try to walk after the surgery
- Don’t drive for a few weeks
- Keep the incision area clean and covered with a dressing
- Take vitamin A and vitamin C supplements
- Follow a strict diet and exercise regime
- Maintain a healthy lifestyle
- Avoid alcohol or smoking for a few weeks
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