What is colon surgery?
Colon surgery, also known as colorectal surgery, refers to surgical procedures performed on the large intestine (colon) and rectum. Some common reasons for colon surgery include:
- Removing polyps or early-stage colorectal cancers
- Reconnecting parts of the colon after injury or disease (bowel resection)
- Treating diverticulitis or inflammatory bowel disease
- Repairing bowel obstructions or fistulas
- Controlling rectal bleeding
- Treating hemorrhoids
The colon, or large intestine, is an important part of the digestive system. It is responsible for absorbing water and forming stool. So when disease or injury affects this organ, surgery may be required. Some colon surgeries can be done through small incisions using laparoscopic techniques. Other more complex procedures require open surgery through larger abdominal incisions.
How serious is colon surgery?
Like any major surgery, colon surgery does carry risks of complications. However, when performed by an experienced colon and rectal surgeon, most patients tolerate the procedures well and recover quickly. Here are some factors to consider regarding the seriousness and risks of colon surgery:
- Type of procedure – Some colon surgeries like simple polyp removal are low risk. Large bowel resections or surgeries for colon cancer are more complex.
- Degree of invasiveness – Laparoscopic techniques allow many colon operations to be done through small incisions. This leads to quicker recovery than open surgery.
- Patient health – Age, weight, diabetes, smoking, and other health factors affect surgical risks.
- Reason for surgery – Elective surgeries tend to have lower risks than emergency procedures.
- Extent of resection – Removing larger portions of the colon is associated with more complications.
- Surgeon experience – Outcomes are better when colon surgery is done by surgeons with specific training and expertise.
Let’s look more closely at the risks and seriousness of some common colon surgery procedures:
Polypectomy
Removing precancerous colon polyps through a colonoscope is generally low risk. Complications occur in less than 5% of cases and include:
- Bleeding at the polyp site
- Perforation or tear in the colon wall
For most patients, polypectomy does not require hospitalization and allows quick recovery.
Laparoscopic colon resection
This minimally invasive surgery to remove parts of the colon has these possible complications:
- Bleeding (2-6% risk)
- Infection (3-9% risk)
- Leakage from colon surgical site (3-9% risk)
Overall complication rates are 15-20%. Recovery typically involves 3-5 days in the hospital and limited activity for 2-4 weeks.
Open colon resection
Removing sections of diseased colon through open abdominal surgery is more invasive. Risks include:
- Bleeding (5-10% risk)
- Infection (4-12% risk)
- Leakage from colon surgical site (5-15% risk)
Complication rates range from 20-30%. Hospital stay is 4-7 days, with 4-6 weeks recovery.
Colostomy surgery
This procedure to create an artificial opening for the colon to drain into a bag can be temporary or permanent. Risks include:
- Infection (2-10% risk)
- Bleeding (rare)
- Irritation of colostomy site
Recovery time is usually 2-3 weeks. Learning to care for a colostomy takes time for significant adjustment.
Risk factors for colon surgery
Certain factors may increase a person’s risks associated with colon surgery:
- Older age – Over 70 years old poses additional risks.
- Obesity – Higher complication rates with BMI over 35.
- Smoking – Impairs healing and increases infection risk.
- Diabetes – Poor blood sugar control raises risks.
- Immunosuppression – From medications or illnesses like HIV.
- Malnutrition – Can impair wound healing.
- Anemia – Low iron raises surgical risks.
- Prior surgeries – Adhesions may complicate new procedures.
Talk to your surgeon about any health conditions or risk factors you have. Certain precautions can help lower your surgical risks.
What complications can occur?
Some potential complications of colon surgery may include:
Bleeding
Excessive bleeding may require transfusions or return to surgery. The risk is higher with extensive resections.
Infection
Infections in the surgical incision, abdomen or blood (sepsis) occur in up to 10% of cases. Antibiotics reduce this risk.
Anastomotic leak
After bowel resection, leakage may occur from the joined colon sections. Another surgery is often needed to repair the leak.
Bowel obstruction
Scar tissue can cause blockages requiring hospitalization. This may be managed without surgery.
Pneumonia
Breathing difficulties after surgery may lead to lung complications. Early ambulation helps prevent pneumonia.
Urinary retention
Difficulty urinating after colon surgery may require a catheter. Usually resolves within days.
Diarrhea or constipation
Altered bowel function is common for weeks after colon resection. Dietary changes can help manage symptoms.
Sexual dysfunction
Nerve damage may cause problems with erection or ejaculation in some cases. Usually temporary.
Adhesions
Scar tissue attaching internal tissues together may cause chronic pain or blockages. Often difficult to treat.
What is the recovery like after colon surgery?
Recovering after colon surgery takes time. Most people spend 4-7 days in the hospital after their procedures. After discharge, activity should increase gradually over 4-6 weeks. Typical colon surgery recovery includes:
- 1-3 days: IV fluids, gradual diet advancement. Walking short distances.
- 3-5 days: Tolerating solid foods. Moving around more. Pain controlled.
- 1-2 weeks: Resuming light daily activities. Driving allowed at 2 weeks.
- 2-4 weeks: Energy levels improve. Lifting limited to 10 lbs.
- 4-6 weeks: Often cleared for full activity. Work restrictions eased.
A temporary colostomy bag may be needed for about 8-12 weeks after some colon surgeries to allow the colon to heal. Recovery is slower in patients over 70 or with complications. Close follow-up is key after hospital discharge.
How can risks be reduced?
There are things patients and doctors can do to optimize health and minimize risks around the time of colon surgery:
- Stop smoking or vaping at least 6-8 weeks before surgery.
- Eat a high protein diet to build strength.
- Lose weight if BMI is over 30.
- Control diabetes and blood pressure.
- Do aerobic exercise regularly prior to surgery.
- Discuss all medications and supplements with your doctors.
- Consider minimally invasive laparoscopic techniques when appropriate.
- Use enhanced recovery protocols – ERAS.
- Follow care instructions diligently after surgery.
- Communicate any concerning symptoms promptly to your surgical team.
Proper preparation and close monitoring are key to reducing risks around the time of colon procedures.
Conclusion
While colon surgery always carries some degree of risk, the vast majority of patients tolerate their procedures well and go on to fully recover. Advances in technique, perioperative care and patient education continue to improve outcomes and decrease complications.
Working with an experienced, board-certified colon and rectal surgeon is advised to minimize risks and achieve optimal results after colon surgery. Following all recommended pre- and post-operative instructions can facilitate recovery.
Colon procedures range from relatively simple polyp removals to major bowel resections. The seriousness of surgery also depends on the patient’s overall health condition.
While some discomfort or altered bowel function is common during the recovery period, severe complications like major bleeding or anastomotic leaks are now fairly rare in experienced hands.
Many colon operations can be performed safely using minimally invasive techniques. This allows faster return to normal activities while effectively treating a wide range of colorectal conditions.
