Hemicolectomy

What Is a Hemicolectomy?

A hemicolectomy is an operation that removes a part of your colon, which is also called the large intestine. You may have cancer or another disease that affects only a section of this organ. If so, your surgeon can sew the healthy parts of your colon together after they remove the damaged part.

Early-stage colon cancer is the most common reason you might have a hemicolectomy.

You might also need one if you have:

Talk to your doctor if you have long-term symptoms like throwing up, belly pain, diarrhea, or you have a hard time with bowel movements. They can look in your colon with a camera (a colonoscopy) or run tests like blood work, X-rays, or other scans to find out if this surgery is right for you.

Types

There are two types:

  • Right hemicolectomy: Removes the right, or ascending, part of your colon. The surgeon may also take out some other areas, like your appendix and part or all of your middle large intestine. They'll connect what's left of your colon to your small intestine.
  • Left hemicolectomy: Removes the left, or descending, part of your colon. The surgeon will attach the right and middle parts to your rectum. This is the last place your bowel movements pass through on their way out.

It isn’t likely, but sometimes your colon can’t be sewn back together right away. If that happens, your doctor will connect your intestines to a hole in your belly, called a stoma. Your waste collects in a bag outside of your body. You empty it when it gets full. After you heal, your doctor will do another operation a few months later so you can pass stool the normal way.

Methods

A hemicolectomy can be done in one of two ways:

  1. Open colectomy: Your doctor makes one long, vertical cut in your belly to get to your colon. It could be 6-8 inches long. They will look inside to find the parts they need to take out.
  2. Laparoscopy: A surgeon makes three to five small cuts in your belly. To find your colon, they use a tube with a camera and light on the end. They take out the damaged part through the other cuts. Because the cuts are small, it's easier on your body than the open kind. That usually means a quicker recovery, smaller scars, and less pain. Your doctor will decide if this type is right for you.

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How to Prepare

You can’t have anything in your intestines during the procedure. Your doctor will have you do a “bowel prep” 1 or 2 days in advance.

Your doctor might ask you to:

  • Drink clear liquids the day before.
  • Don't eat or drink 12 hours before surgery.
  • Stop taking certain medicines like aspirin, blood thinners, or anti-inflammatory drugs.
  • Take laxatives or enemas to empty your bowels.
  • Take antibiotics.

Recovery

Expect to stay in the hospital for at least few days after surgery. But you could be there for up to a week. IV fluids will keep you hydrated right after the operation. You'll be on a liquid diet for 1-3 days. Medicine will help with pain, but you probably won’t want to do normal activities for a couple of weeks. If you have the open kind, it might take longer. Your doctor will probably tell you not to lift anything heavy for 6 weeks.

You should be able to eat and go to the bathroom like normal after you recover. But everyone heals at their own pace, so take it easy until you feel better. Ask your doctor what to expect.

Call your doctor if:

  • You have a fever of 100.4 F or higher.
  • Your cuts swell or leak blood, fluid, or pus.
  • Your pain gets worse.
  • You have a hard time breathing.
  • You can’t stop throwing up.
  • You still haven’t pooped 3 days after surgery.
  • There is blood in your stool.

What to Eat After Surgery

Ask your doctor when it’s safe to eat solid meals. It will take some time for your intestines and gut bacteria to digest food like normal. As you recover, your colon may also have trouble absorbing water. Make sure to drink 8-10 glasses of water or fluid a day.

You might have:

To give your gut a rest, your doctor may have you follow a low-residue diet for about 4-6 weeks. This will make you have smaller bowel movements and go less often. It cuts out most fiber as well as some dairy. Some “low-residue” foods include:

  • Applesauce
  • Bananas
  • Bread or toast
  • Peanut butter
  • Yogurt
  • Potatoes
  • White rice
  • Cheese
  • Pasta
  • Tofu or meat that is easy to eat

Some foods you should avoid include:

  • Processed meat like hot dogs or sausage
  • Nuts
  • Beans, peas, lentils, legumes

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Complications

A hemicolectomy has some of the same risks as other surgeries. You doctor will give you anesthesia to put you to sleep. It’s safe for most people, but you could have a reaction that makes you feel sick for a few days. It’s rare, but some people may feel confused for a week or so.

You could also get blood clots in your legs or lungs. To lessen the chances of this, a doctor or nurse will get you to walk around every hour or so in your hospital room.

Other possible problems include:

  • Infection
  • Scar tissue that can block your intestines
  • Leakage where the intestines are reconnected
  • Hernia
  • Injury to nearby organs
  • Internal bleeding

After Care

Your doctor will want to see how you are doing after surgery. Talk to them about when you should come back. They may want you to visit within a couple of weeks. But your checkup schedule could be different depending on why you had to have the procedure.

WebMD Medical Reference Reviewed by Carol DerSarkissian on May 30, 2019

Sources

SOURCES:

Cedars-Sinai: “Hemicolectomy.”

Baylor College of Medicine: “Colon Resection.”

University of Chicago Medicine: “Colectomy.”

Health Direct (Australia): “Hemicolectomy.”

Mayo Clinic: “Colectomy,” “Right colectomy,” “Left colectomy.” 

American College of Surgeons: “Colectomy.”

Northwestern Medicine: “Colectomy.”

Canadian Cancer Society: “Bowel Resection.”

University Hospitals Birmingham, NHS (UK): “Right Hemicolectomy – Your operation explained.”

American Cancer Society: “Surgery for Colon Cancer.”

World Journal of Gastroenterology: “Laparoscopic vs open extended right hemicolectomy for colon cancer.”

Society of American Gastrointestinal and Endoscopic Surgeons: “Laparoscopic Colon Resection Surgery Patient Information From SAGES.”

American Society of Anesthesiologists: “Effects of Anesthesia.” 

Canadian Society of Intestinal Research: "Low Residue Diet."

University of Michigan: “Colectomy Diet.”

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