This procedure involves removing a portion of the large intestine and creating an ileostomy to redirect human waste. People will likely need to adjust their diet after surgery.
People with colon disease may require surgery. The type of surgery a surgeon performs depends on the extent of the colon disease.
Colon diseases that affect a part of the colon may require a subtotal colectomy with end ileostomy.
This article discusses in detail the process of subtotal colectomy with end ileostomy and when the surgery might be necessary.
Subtotal colectomy involves surgically removing part of the large intestine up to the lower segment of the left descending colon and creating an opening in the abdominal wall for the small intestine to empty called an ileostomy.
An ileostomy connects the end of the small bowel, also known as the ileum, to a surgical opening in the abdominal wall to allow digestive waste to leave the body.
Surgeons perform a subtotal colectomy with end ileostomy to remove diseased portions of the large colon and encourage healing of the remaining segment of colon. Over time, as healing occurs, the surgeon may be able to reconnect the ileum to the large intestine and close the ostomy.
Total colectomy is the removal of the entire large intestine or colon. Subtotal colectomy is the removal of part of the colon up to the lower part of the left descending colon.
After the surgical removal of a diseased segment of the colon, the surgeon typically joins the small bowel to the remaining healthy portion of the colon, a reconnection procedure called an anastomosis. Following an anastomosis, digestive waste continues to follow the familiar pathway to the rectum for elimination.
Depending on clinical circumstances, the surgeon may be unable to perform an immediate anastomosis and will need to redirect digestive waste directly from the ileum through a surgically created hole in the abdominal wall (ileostomy). This could be a temporary or permanent situation.
Surgeons can perform open surgery or use minimally invasive surgical techniques to perform total and subtotal colectomy.
- inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis
- colon cancer
- bowel obstruction
Several factors, such as the risks and benefits of the surgical procedure, the person’s general health, and the stage of the disease, can influence whether a surgeon decides to perform subtotal colectomy with end ileostomy.
On the day of the surgery, the person typically receives general anesthesia before the procedure starts. Then the surgeon gains access to the abdomen via an incision on the abdominal wall.
The surgeon can choose to use a wide incision for open surgery or a small incision for a minimally invasive laparoscopic procedure.
The surgeon locates the colon through the incision. They then explore and identify the diseased segment of the colon that needs to be removed.
Next, the surgeon creates a special opening on the abdominal wall and connects the lower end of the small bowel to the opening, forming a stoma. The surgery ends with the closure of the abdominal incision.
After surgery, the person will be kept under close observation.
Recovery after subtotal colectomy with end ileostomy depends on multiple factors and varies for each person.
A person’s health status and the surgical method could influence the length of hospital stay. For example, people who undergo laparoscopic procedures
Some people may experience the following adverse effects of general anesthesia:
- confusion lasting for a few days
- sore throat due to the breathing tube.
- postoperative delirium, or cognitive dysfunction, which can result in long-term memory and learning problems in some people
- malignant hyperthermia, which causes a high fever and rapid muscle contractions
- breathing difficulties during and after surgery
- inflammation of the rectal stump
- necessary diet changes
- mental health conditions such as anxiety and depression
- anastomosis leak and infection
After a subtotal colectomy procedure, a person may need follow-ups with a healthcare professional for wound care.
Additionally, people may need to adjust their diet and lifestyle to help promote bowel healing.
Subtotal colectomy with end ileostomy involves surgically removing part of the large intestine and introducing a special opening on the small bowel called an ileostomy.
Surgeons typically perform this procedure to treat conditions such as inflammatory bowel disease and colon cancer.
The recovery period and long-term effects of surgery vary, but most people retain a good quality of life.