Our Summary

This study looked at the quality of care for patients undergoing colorectal surgery in the United States between 2012 and 2020. It found that during this period, there was a significant increase in the use of minimally invasive surgery (MIS) - a type of surgery that is less damaging to the body. This increase in MIS use was associated with better outcomes for patients, including a reduction in the length of hospital stays, fewer surgical site infections, and a decrease in pulmonary embolism (a condition where a blood clot gets lodged in an artery in the lung). However, the mortality rate within 30 days of surgery remained unchanged. The study concludes that the increase in quality improvement initiatives, such as the use of MIS, has had a positive impact on patient care in the field of colorectal surgery.

FAQs

  1. What was the time period of the study on colorectal surgery in the United States?
  2. What improvements in patient outcomes were associated with the increased use of minimally invasive surgery (MIS) in colorectal surgery?
  3. Despite the increased use of MIS, why did the mortality rate within 30 days of surgery remain unchanged?

Doctor’s Tip

One helpful tip a doctor might tell a patient about colectomy is to follow a healthy diet post-surgery. This can help promote healing and prevent complications such as constipation or diarrhea. It’s important to consume plenty of fiber-rich foods, stay hydrated, and avoid foods that may be difficult to digest. Additionally, patients should gradually reintroduce solid foods into their diet and listen to their body’s cues for what foods work best for them. Consulting with a dietitian can also be beneficial in creating a personalized nutrition plan.

Suitable For

Patients who may be recommended for colectomy include those with:

  • Colon or rectal cancer
  • Inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease)
  • Diverticulitis
  • Colonic polyps that are large or causing symptoms
  • Bowel obstruction
  • Familial adenomatous polyposis (FAP)
  • Chronic constipation or bowel motility disorders

In general, colectomy may be recommended for patients who have not responded to conservative treatments or for those at high risk for complications or progression of their underlying condition.

Timeline

Before colectomy:

  • Patient undergoes pre-operative evaluation and consultation with their surgeon
  • Patient may need to undergo bowel preparation to clean out the colon before surgery
  • Patient may need to adjust their diet and medication regimen leading up to surgery
  • Patient may need to undergo additional tests or imaging studies to assess the extent of the disease and plan for surgery

After colectomy:

  • Patient will be closely monitored in the hospital for complications and to ensure proper healing
  • Patient will gradually start to resume eating and drinking, starting with clear liquids and progressing to solid foods
  • Patient will be given instructions on wound care, pain management, and activity restrictions
  • Patient may need to undergo physical therapy to help with mobility and strengthen the abdominal muscles
  • Patient will have follow-up appointments with their surgeon to monitor their progress and address any concerns or complications
  • Patient may need to make lifestyle changes, such as adjusting their diet and exercise routine, to promote overall health and prevent future complications.

What to Ask Your Doctor

  1. What is the reason for recommending a colectomy?
  2. What are the potential risks and complications associated with colectomy surgery?
  3. What is the expected recovery time and rehabilitation process after the surgery?
  4. Will I need to make any changes to my diet or lifestyle after the surgery?
  5. What are the long-term effects of having a colectomy?
  6. Are there any alternative treatment options to consider before undergoing a colectomy?
  7. How many colectomy surgeries have you performed, and what is your success rate?
  8. What follow-up care will be needed after the surgery?
  9. What can I expect in terms of pain management after the surgery?
  10. Are there any support groups or resources available for patients who have undergone a colectomy?

Reference

Authors: Kane WJ, Kuron M, Gooding JL, Hoang SC, Friel CM, Jin R, Turrentine FE, Hedrick TL. Journal: Am J Surg. 2024 Nov;237:115808. doi: 10.1016/j.amjsurg.2024.115808. Epub 2024 Jun 24. PMID: 38944622