SIGMOID COLON REMOVAL

General Information

DEFINITION-Removal of the sigmoid colon.

BODY PARTS INVOLVED-Sigmoid colon, the part of the large intestine (colon) that extends from the descending colon to the rectum.

REASONS FOR SURGERY

• Diverticulitis with bleeding and infection.
• Diverticulitis with ruptured diverticula and peritonitis from infection caused by perforations.
• Cancer or precancerous polyps.

SURGICAL RISK INCREASES WITH

• Adults over 60 years.
• Obesity; smoking; stress.
• Poor nutrition.
• Newborns and infants.
• Excess alcohol consumption.
• Chronic illness.
• Recent illness such as acute, recurrent diverticulitis.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES-General surgeon.

WHERE PERFORMED-Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; x-rays of upper and lower gastrointestinal tract; ECG; endoscopy (See Glossary for both).
• After surgery: Blood studies.

ANESTHESIA-General anesthesia by injection and inhalation with an airway tube placed in the windpipe (trachea).

DESCRIPTION OF OPERATION

• An incision is made in the abdomen, and the abdominal muscles are opened.
• The sigmoid colon is isolated and clamps are placed at each end.
• All of the diseased sigmoid colon is cut free and removed. The two healthy ends are brought back together and joined.
• The abdominal contents are replaced into the abdomen, and the muscles are closed. The skin is closed with sutures or skin clips, which usually can be removed about 1 week after surgery.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Deep-vein blood clots.
• Leaking from the repair area that can result in peritonitis or incisional hernia. If surgery is performed to treat infection or tumor, a temporary colostomy (see Surgery section) may be necessary.

AVERAGE HOSPITAL STAY-7 to 10 days.

PROBABLE OUTCOME-Expect complete healing without complications. Allow 6 weeks for recovery from surgery.

Postoperative Care

GENERAL MEASURES

• A hard ridge should form along the incision. As it heals, the ridge will recede gradually.
• Use an electric heating pad, a heat lamp or a warm compress to relieve incisional pain.

MEDICATION--

Your doctor may prescribe:

• Pain relievers. Don't take prescription pain medication longer than 4 to 7 days. Use only as much as you need. > Stool softeners to prevent constipation. > Antibiotics to fight infection.

† To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Resume driving about 3 weeks after returning home. > Resume sexual relations when able.

DIET-Nasogastric suction is used initially, followed by clear liquid diet until the gastrointestinal tract functions again. Then eat a well--balanced diet to promote healing. After recovery, eat a normal diet with adequate bulk.

Call Your Doctor If

† You develop signs of leaking in the surgical area: fever, fast pulse or abdominal swelling and pain.

• Pain, swelling, redness, drainage or bleeding increases in the surgical area.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.