ما هي إزالة القولون والدقاق: نظرة عامة ، الفوائد ، والنتائج المتوقعة

التعريف والنظرة العامة

The colon, also known as the large intestine, is connected to the small intestine by the ileum. When certain gastrointestinal conditions cause irreversible damage to both the colon and the ileum, it sometimes becomes necessary to remove them both through a surgical procedure.

The removal of the colon is called large bowel resection, colectomy, or simply colon resection surgery. When the ileum is also removed during the same procedure, it is called an ileocolic resection or an ileocolectomy.

من يجب أن يخضع للنتائج المتوقعة

Colon and ileum removal is commonly performed on patients who suffer from gastrointestinal conditions that affect their colon and ileum. These include:

• Inflammatory bowel diseases, especially Crohn’s disease – While there are many different types of inflammatory bowel diseases, Crohn’s disease is the first indication for ileocolectomy as it affects both the colon and the ileum.

• Colon or ileum polyps or lesions

• Lower gastrointestinal hemorrhage

• Colorectal cancer

• Traumatic injury to the abdomen such as perforation or gunshot wounds

• Birth defects

The procedure removes the damaged part of the colon and the damaged part of the terminal ileum to relieve any symptoms the patient may be experiencing. It is beneficial for those who are suffering from lifelong inflammatory bowel diseases that cause the intestines to become chronically inflamed resulting in abdominal cramps, diarrhea, rectal bleeding, and even fatigue. Chronic inflammation may even cause bowel perforations, ulcers, or lead to the development of an abnormal connection called a ناسور. Thus, these diseases tend to get in the way of patients’ ability to live normally, especially since medications only provide temporary relief and cannot really cure the disease. For this reason, up to 75% of patients who suffer from Crohn’s disease choose to undergo surgical treatment.

Patients who undergo ileocolic resection do not require a colostomy or an ileostomy. A colostomy is an opening in the abdominal wall through which the colon is diverted, while an ileostomy is an opening in the lower right side of the abdomen through which the small intestine is diverted. These are necessary when only either the colon or the ileum is removed, but not both. However, in a procedure that removes both the colon and the ileum, a colostomy or ileostomy is not typically necessary.

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Due to the popularity of minimally invasive surgical methods, even colon and ileum removal can now be performed without making a large abdominal incision. The procedure can be done through laparoscopic or keyhole surgery. This means that patients experience less pain, less bleeding, and a shorter recovery time.

Once the diseased parts of the colon and terminal ileum have been removed, the surgeon will make a surgical connection (anastomosis) between the small intestine and what remains of the large intestine using sutures or surgical staples. The entire procedure usually takes around 2 hours.

However, in some cases, surgeons encounter problems while performing minimally invasive keyhole surgery preventing them from achieving the goal of the procedure. If this happens, they will make an abdominal incision to access the problem areas and perform the surgery in a traditional manner.

Following the removal of the colon and ileum, the removed organs are sent to a pathologist for closer examination, which may take a couple of weeks.

The patient is often asked to stay in the hospital for the first 24 hours or longer after the surgery, during which they will have an intravenous drip and a catheter drain in place. Some may need to stay until they can resume normal fluid intake, which means that the intestines are already working properly. This may take two to five days for those who undergo keyhole surgery or up to 7 days for those who undergo an open surgery.

Upon being discharged from the hospital, patients still need to avoid strenuous activities, such as heavy lifting, for about six weeks. They are, however, advised to stay active and mobile without straining their bodies. They are allowed to resume driving two weeks after a laparoscopic colon and ileum removal, but the wait may be longer if they undergo an open surgery.

Patients are scheduled for a follow-up appointment two weeks after the procedure and are advised to go to the doctor anytime they experience any worrying symptoms following the surgery.

المخاطر والمضاعفات المحتملة

Patients who undergo an ileocolic resection may face certain risks including suffering from short bowel or short gut syndrome. This disorder develops when a large part of the small intestine, including the ileum, is removed, resulting in a shorter small intestine. This may also lead to malabsorption.

Colon and ileum removal surgery may also have several effects on a person’s health. Thus, patients undergo a comprehensive heart and lung assessment to make sure they are healthy enough for the procedure and that the risk of them suffering from major health issues is minimal. Patients are also advised to wear compression stockings to help prevent thrombosis or blood clots from forming during and after the surgery.

Other risks involved include:

• نزيف

• Wound infections

• Blood loss (in some cases, patients require a blood transfusion)

• Anastomotic leak – An anastomotic leak can be resolved by placing a drain through the abdominal wall. However, if it cannot be repaired or if it is too big, the patient may require ileostomy surgery.

• Obstruction or blockage

• Abdominal distension

• Vomiting

The last two risks may occur when the bowel is taking longer than normal to heal. In such cases, the patient has to go on bowel rest with the help of intravenous feeding or a nasogastric tube.

The risk of developing complications mentioned above is lower for those who undergo laparoscopic surgery. Keyhole bowel resection is a safer alternative to its traditional equivalent, although its success heavily depends on the skill of the surgeon.

مراجع:

• Sangster W, Berg AS, Choi CS, Connelly TM, et al. “Outcomes of early ileocolectomy after percutaneous drainage for perforated ileocolic Crohn’s disease.” The American Journal of Surgery. 2016 October. 2012(212)4:728-734. http://www.americanjournalofsurgery.com/article/S0002-9610(16)30213-6/abstract

• Makni A. et al. “Laparoscopic-assisted versus conventional ileocolectomy for primary Crohn’s disease: Results of a comparative study.” J Visc Surg. 2012 October. 150(2): 137-143. https://www.ncbi.nlm.nih.gov/labs/articles/23092647/

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## Comprehensive Overview of Colon⁣ and ⁤Ileum Removal



### Understanding Colon and Ileum Removal



Colon and ileum removal, also known as colectomy or ‌ilectomy, is a surgical procedure that involves removing parts or all of the colon and/or⁢ ileum. The colon is the large intestine, responsible for absorbing water and electrolytes‍ from waste, while the ileum⁤ is the⁢ final portion of the small intestine that connects to the large intestine.



### Benefits of Colon and Ileum Removal



This ⁢surgery is often performed to treat various medical conditions, including:



* Inflammatory bowel disease (IBD), such as Crohn’s disease or ulcerative colitis

* Colon⁢ cancer

* Diverticular disease

* Intestinal obstruction



By removing the⁤ affected portion of the intestines, colon and ileum removal‍ can alleviate symptoms such as:



* ‌Abdominal pain

* Diarrhea

* Constipation

* Blood in stools

* Weight ‍loss



###‍ Procedure Overview



Colon and ileum removal surgery typically⁢ involves the following steps:



1. **Preoperative ‍Preparation:** The patient undergoes tests and receives instructions to prepare⁣ for the surgery.

2. **General Anesthesia:** The patient is placed under general anesthesia for the duration of the procedure.

3. **Surgical Incisions:** The surgeon‍ makes incisions​ in‍ the abdomen to access the affected intestines.

4. **Intestine Removal:** The diseased portion of the intestines is carefully removed.

5. **Wound Closure:** The remaining intestines are reconnected, and the incisions are closed.



### Expected ​Results



The expected results of colon and ileum removal ⁤surgery vary depending on the individual and the extent⁤ of the surgery performed. Generally, patients can expect:



* **Relief ‍of Symptoms:** The surgery aims to alleviate the symptoms associated‌ with the underlying medical condition.

* **Improved Quality of Life:** By reducing symptoms, colon and ileum removal can significantly enhance ⁤a patient’s quality⁣ of life.

* **Potential Complications:** As with any surgery, there are potential complications, such as infection or bleeding. However, these are generally rare and managed by a ⁤medical professional.



### Post-Operative Care and Recovery



After colon and ileum removal surgery, patients typically spend a few days in the hospital to recover. During this time, they receive pain medication, antibiotics, and intravenous fluids.



Once​ discharged, patients may experience fatigue and dietary restrictions. They‍ will need​ to gradually resume normal activities and follow their doctor’s instructions for post-operative care.



In⁤ some cases, a temporary or​ permanent colostomy or ​ileostomy may be necessary to divert waste from the affected ⁤portion of⁤ the intestines.



### Conclusion



Colon and ileum removal surgery is‌ a significant procedure with the potential‍ to improve the quality of life for individuals with certain medical conditions. It is performed by a specialized colorectal surgeon and requires careful pre- and post-operative care. While complications can occur,⁤ they ⁤are relatively rare, and most patients‍ experience significant benefits from the procedure.