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Colon Resection

Pre-Op and Procedure

Colon resection is surgery to take out part or all of the large intestine (the colon). It is also called a colonectomy.


There are several reasons this surgery may be needed. They include:

  • Colon cancer.
  • A blockage (obstruction) in the colon. Sometimes this is caused by scar tissue. Blockage can also be the result of an infection.
  • An inflammatory bowel disease, such as Crohn's disease or ulcerative colitis. These diseases can cause swelling and soreness inside the colon.
  • An accident that harmed the colon.
  • Polyps. These are growths in the colon that are not cancerous. They can cause bleeding. They can also turn into cancer over time.  Sometimes colon resection is used to prevent this.

The colon is the last part of the intestine that waste goes through on its way to the anus, where it leaves the body. If part of the colon is taken out, the ends of the healthy colon that are left are sewn together. In most people, bowel movements can continue normally after they have recovered from the surgery. Sometimes, though, not enough healthy colon remains. Then, an opening would be made in the abdomen (belly). Waste would be collected in a bag outside of the body. This is called a colostomy. Not everyone who has a colon resection needs a colostomy.


  • A medical evaluation will be done. This may include:
    • A physical examination.
    • Blood tests.
    • Electrocardiogram. This test checks the heart's rhythm.
    • Special X-rays, such as magnetic resonance imaging (MRI). This can take pictures of the colon. An MRI scan uses a magnet, radio waves and a computer.
    • Talking with an anesthesiologist. This is the person who will be in charge of the anesthesia (medication) during the surgery. Colon resection is done under general anesthesia (being asleep during surgery). If you have any questions, talk with your anesthesiologist or surgeon.
  • The person having a colon resection will need to give what is called informed consent. This requires signing a legal paper that gives permission for the surgery. To give informed consent:
    • You must understand how the procedure is done and why.
    • You must be told all the risks and benefits of the procedure.
    • You must sign the consent. Sometimes a legal guardian can do this.
    • Signing should be witnessed by a healthcare professional.
  • Other preparations include:
    • Two weeks before the surgery, stop using aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief. This includes prescription drugs and over-the-counter drugs. Also stop taking vitamin E.
    • If you take blood-thinners, ask your healthcare provider when you should stop taking them.
    • Do not eat or drink anything for 8 to 12 hours before the surgery. Ask your caregiver if it is OK to take any needed medicines with a sip of water.
    • Before coming to the hospital, the colon must be emptied. This is called bowel prep. The surgeon will explain how and when to start this process. It might include:
      1. Taking in liquids only.  No solid foods.
      2. Taking medication to cause diarrhea.
      3. Using an enema. This involves injecting a special liquid through the anus. It helps clean out the colon.
      4. Taking an antibiotic (a medication to prevent infection).
  • Arrive at least an 1 1/2 hours before the surgery, or whenever your surgeon recommends. This will give you time to check in and fill out any needed paperwork.
  • Most people spend three to seven days in the hospital after this surgery. Ask your healthcare provider what to expect. And, make arrangements in advance for someone to drive you home.


On the day of your surgery, your caregivers will need to know the last time you had anything to eat or drink. This includes water, gum and candy. In advance, also make sure they know about:

  • Any allergies.
  • All medications you are taking, including:
    • Herbs, eyedrops, over-the-counter medications and creams.
    • Blood thinners (anticoagulants), aspirin or other drugs that could affect blood clotting.
  • Use of steroids (by mouth or as creams).
  • Previous problems with anesthetics, including local anesthetics.
  • Possibility of pregnancy, if this applies.
  • Any history of blood clots.
  • Any history of bleeding or other blood problems.
  • Previous surgery.
  • Smoking history.
  • Any recent symptoms of colds or infections.
  • Other health problems.


The type that is used will depend on how much of the colon needs to be removed. It can also depend on the disease or condition that is being treated. Colon resection can take up to four hours.

  • The open procedure:
    • Once you are asleep, the surgeon will make an incision in the abdomen about 6 to 12 inches long.
    • Clamps are put on both ends of the diseased part of the colon.
    • It is then cut free and removed.
    • If possible, the ends of the healthy colon that remain will be stitched or stapled together.
    • This might not be possible if a large amount of the colon was taken out. Then, a colostomy is needed.
    • For a colostomy:
      1. An opening to the outside (called a stoma ) is made through the abdomen. 
      2. The end of the colon is brought through the opening. It is stitched to the skin. 
      3. A bag is attached to the opening. Waste will drain into this bag. The bag will be removable.
      4. The colostomy may be temporary or permanent.  Ask your surgeon what to expect.
    • The incision from the colon resection will be closed with stitches or staples.
    • A dressing (medication and a bandage) will be put over the incision.


  • You will stay in a recovery area until the anesthesia has worn off.  Your blood pressure and pulse will be checked every so often. Then you will be taken to a hospital room.
  • You will continue to get fluids through the IV for awhile. This usually continues for 24 to 48 hours after the surgery ends. The IV will be taken out when the colon starts working again.
  • The nasogastric tube also will be taken out once the intestines are working normally.
  • You will gradually go back to a normal diet. You will start with clear fluids. Soft foods will be next, and then regular foods.
  • Some pain is normal after a colon resection. Ask for pain medicine if the pain becomes too much.
  • You will be urged to get up and start walking after a day or two, at the most.
  • If you had a colostomy, your hospital caregivers will explain how it works and what you will need to do.
  • Before you go home, be sure to ask if there are things you should or should not do while you recover. For instance, you will probably need to avoid lifting heavy objects for up to two months. When you can return to work will depend on why the surgery was done and on the type of work that you do.


There are always risks for surgery with general anesthesia. They include breathing and heart problems. However, this risk is low for people who have no other health problems. Other complications from colon resection may include:

  • Infection. This can develop in the area where the surgery was done.
  • Problems with the incisions.
    • Bleeding from an incision.
    • The wound might reopen.
    • Tissues from inside the abdomen may bulge through the incision.
  • Bleeding inside the abdomen.
  • Reopening of the colon where it was stitched or stapled together. This is a serious complication. Another operation may be needed to fix the problem.
  • Damage to other organs in the abdomen.
  • Blood clots. A clot that forms in a vein in the leg can travel to the lungs. This is an emergency that must be treated right away.
  • Future obstruction of the colon. This can be caused by scar tissue that forms after the surgery.


People usually do well after a colon resection. Many people can go back to the activities they enjoyed before the surgery. People with inflammatory bowel disease or cancer will probably need further treatment.

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