Total abdominal colectomy is the removal of the large intestine from the lowest part of the small intestine (ileum) to the rectum. After it is removed, the end of the small intestine is sewn to the rectum.
Ileorectal anastomosis; Subtotal colectomy
You will receive general anesthesia before your surgery. This will make you asleep and unable to feel pain.
During the surgery:
Your surgeon will make a surgical cut in your belly.
The surgeon will remove your large intestine. Your rectum and anus will be left in place.
Your surgeon will sew the end of your small intestine to your rectum.
Always let your provider know about any cold, flu, fever, herpes breakout, or other illnesses you may have before your surgery.
Eat high fiber foods and drink 6 to 8 glasses of water every day.
The day before your surgery:
Follow your provider's instruction about what to eat and drink. You may be asked to drink only clear liquids such as broth, clear juice, and water at some point during the day.
You will be told when to stop eating and drinking. You may be asked to stop eating solid food after midnight, but you might be able to have clear liquids up until two hours before surgery.
Your provider may ask you to use enemas or laxatives to clear out your intestines. You will get instructions on how to use them.
On the day of your surgery:
Take the drugs you were told to take with a small sip of water.
You will be told when to arrive at the hospital.
After the Procedure
You will be in the hospital for 3 to 7 days. By the second day, you will probably be able to drink clear liquids. You will slowly be able to add thicker fluids and then soft foods to your diet as your bowels begin to work again.
After this procedure, you can expect to have 4 to 6 bowel movements a day. You may need more surgery and an ileostomy if you have Crohn disease and it spreads to your rectum.
Most people who have a total abdominal colectomy recover fully. They are able to do most of the activities they were doing before their surgery. This includes most sports, travel, gardening, hiking, and other outdoor activities, and most types of work.
Fry RD, Mahmoud NN, Maron DJ, Ross HM, Rombeau J. Colon and rectum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 52.
Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.