Our Summary

This research paper studies the risks associated with urgent colorectal surgery (removal of part or all of the colon), as compared to planned or emergency surgeries. The study included adult patients who underwent this type of surgery between 2013 and 2017.

The results showed that patients who had urgent surgeries often had more health problems to begin with, and faced a higher risk of death (2.5-4.1%) compared to those who had planned surgeries (0.4%). Urgent surgeries also led to more short-term complications, such as bleeding, blood clots in deep veins, lung artery blockage, urinary tract infections, and longer hospital stays.

Patients who had urgent surgeries more than a week after being admitted to the hospital faced an even higher risk of these complications. The study concludes that urgent surgeries carry a higher risk of negative outcomes compared to planned surgeries. Further understanding of the specific challenges faced by patients needing urgent surgery may help reduce these risks.

FAQs

  1. What are the increased risks associated with urgent colorectal surgery as compared to planned surgeries?
  2. What kind of complications are more common in patients who undergo urgent colorectal surgery?
  3. Does the study indicate that the time between hospital admission and urgent surgery affects the risk of complications?

Doctor’s Tip

One helpful tip a doctor might give a patient about colectomy is to try to schedule the surgery as soon as possible in order to reduce the risk of complications. It is important to communicate with your healthcare team and follow their recommendations for preparing for the surgery to improve the chances of a successful outcome. Additionally, it is important to discuss any concerns or questions with your doctor before the surgery to ensure you have a clear understanding of what to expect and how to best prepare for the procedure.

Suitable For

Patients who are typically recommended colectomy include those with:

  1. Colorectal cancer: Colectomy may be recommended as part of the treatment plan for patients with colorectal cancer.

  2. Inflammatory bowel disease (IBD): Patients with severe cases of Crohn’s disease or ulcerative colitis may require colectomy to remove the affected portion of the colon.

  3. Diverticulitis: Patients with severe or recurrent diverticulitis may require colectomy to remove the affected portion of the colon.

  4. Familial adenomatous polyposis (FAP): Patients with FAP, a genetic condition that causes numerous polyps to form in the colon, may require colectomy to reduce the risk of developing colorectal cancer.

  5. Colon polyps: Patients with large or numerous colon polyps may require colectomy to remove the polyps and reduce the risk of developing colorectal cancer.

  6. Chronic constipation: Patients with severe chronic constipation that does not respond to other treatments may require colectomy as a last resort.

  7. Bowel obstruction: Patients with a complete or severe bowel obstruction may require colectomy to remove the blockage and restore normal bowel function.

Overall, patients who are recommended colectomy are those with conditions that cannot be effectively managed with medications or other treatments, and for whom surgery is the best option to improve their quality of life and reduce the risk of serious complications.

Timeline

Before colectomy:

  1. Patient experiences symptoms such as abdominal pain, bloating, changes in bowel habits, blood in stool, weight loss, and fatigue.
  2. Patient undergoes diagnostic tests such as colonoscopy, CT scans, and blood tests to confirm the need for surgery.
  3. Patient consults with a surgeon to discuss the procedure, risks, and recovery process.

After colectomy:

  1. Patient undergoes the surgery to remove part or all of the colon.
  2. Patient stays in the hospital for several days to monitor for complications and begin the recovery process.
  3. Patient may experience side effects such as pain, fatigue, changes in bowel habits, and difficulty eating.
  4. Patient follows a strict diet and exercise regimen to promote healing and prevent complications.
  5. Patient attends follow-up appointments with their surgeon to monitor their progress and address any concerns.
  6. Patient may need additional treatments such as chemotherapy or radiation therapy, depending on the reason for the colectomy.
  7. Patient gradually resumes normal activities and adjusts to life with a changed digestive system.

What to Ask Your Doctor

  1. What are the reasons for recommending a colectomy surgery in my case?
  2. What are the potential risks and complications associated with this surgery?
  3. How long is the recovery period expected to be?
  4. Will I require a temporary or permanent colostomy after the surgery?
  5. What is the success rate of this surgery in treating my condition?
  6. Are there any alternative treatment options available?
  7. How many similar surgeries have you performed and what is your success rate?
  8. What are the long-term implications of having a colectomy?
  9. How will my diet and lifestyle need to change after the surgery?
  10. What can I do to prepare for the surgery and optimize my recovery process?

Reference

Authors: Hajirawala L, Leonardi C, Orangio G, Davis K, Barton J. Journal: J Surg Res. 2021 Dec;268:394-404. doi: 10.1016/j.jss.2021.06.081. Epub 2021 Aug 14. PMID: 34403857