The large intestine (colon) is the section of the digestive tract between the small intestines and the rectum, which is located in an inverted U shape in the abdominal cavity, and is divided into the cecum (with its attached wormhole), the ascending, the cecal and descending sections, and the sigmoid colon. It is in this section of the intestine that the final phase of digestion, the reabsorption of water and the exchange of ions, takes place, forming the formed faeces, which are passed out through the final outlet of the large intestine, the rectum.
Due to inflammatory, benign and malignant tumours of the colon, partial or, in rare cases, complete removal of the colon may be necessary. Colon sigmoid resection is a complete removal of the sigmoid colon, with no long-term lifestyle changes.
Open surgery is performed by making an incision in the mid-lower abdomen to remove the affected section of bowel after cutting through the abdominal wall connective tissue skeleton and muscles.
Recurrent sigmoid diverticulitis and consequent perforation at the base of sigmoid diverticulosis (protruding formations) can cause abscess formation, peritonitis, bloodstream infection. Removal of perforated, inflamed sigmoid colon can in the majority of cases only be achieved by stoma repair. Benign tumours may continue to grow without surgery and some may develop into malignant tumours. In advanced cases, malignant lesions can lead to intestinal obstruction, haemorrhage, peritonitis through perforation of the intestinal wall, metastasis to distant organs and fatal complications.
You will most likely arrive the day before your operation. However, we will carry out the necessary tests 1-2 weeks before the planned day of surgery, which may include laboratory tests, ECG, X-ray and anaesthesia if necessary.
Colonoscopies may require complete emptying of the colon and rectum, and your surgeon may ask you to follow a fluid diet for a few days before the operation, and you may also need to take a stool softener or enema before the operation. Your surgeon will give you detailed advice on this.
The operation is performed under general anaesthesia, during which a skin incision is made in the mid-lower abdomen, after which the connective tissue sheets of the abdominal muscles are cut through, as well as the abdominal muscles. The sigmoid colon is lifted from the posterior abdominal wall, together with the potentially affected lymph nodes and lymphatic vessels. The continuity of the intestine is restored by suturing.
If the surgical situation so requires, a silicone tube (drain) is temporarily left in the abdominal cavity to drain any blood clots or bleeding.
Sometimes, on the basis of the findings, the intestinal segments cannot be safely reconciled, so the retained colon is temporarily drained through an opening in the abdominal wall to the abdominal wall, forming a so-called stoma (guest opening). After the operation, the stool is emptied into a stoma bag that can be fixed to the abdominal wall. If possible, the healed bowel segments can be fused at a later date during another operation.
In the case of sigmoid diverticulosis, strict dietary restrictions and antibiotic therapy may eliminate the inflammation, but the resolution of diverticula may not occur spontaneously.
Benign tumours in the early stages (polyps) can sometimes be removed by colonoscopy, but larger polyps can only be removed surgically.
For malignant lesions of the colon, there is no alternative therapy. In some cases, so-called neoadjuvant treatment (radiotherapy, chemotherapy) may be needed to reduce the size of the tumour tissue to help the surgery succeed.
After waking up, you can expect to feel discomfort, and we will do our best to minimise this, or if it has developed, to alleviate it.
There may also be discomfort around incisions, which should also improve considerably with the use of painkillers. Following surgery, incisions are anaesthetised with a local anaesthetic, which minimises wound pain.
You will usually have to spend 3-5 days in our institution.
Haemorrhage, abdominal haematoma, dissection of intestinal sutures, infection of abdominal wound, fistula formation, skin around the scar may become numb (usually resolves within 2-3 months), deep vein thrombosis.
The operation involves the insertion of an intravenous cannula, a bladder catheter and a gastric tube, which is passed through the nose and is used to drain the intestinal fluid that builds up in the upper intestinal tract and reduce the possibility of nausea. These devices are expected to be removed within 1-3 days after surgery.
After partial removal of the colon, it is normal to feel weaker and more tired for up to weeks, but you should usually return to normal activity within 6-8 weeks. It is important that you follow the diet recommended by your doctor at home and gradually increase your exercise. If you have had stoma training during surgery, a stoma therapy nurse can help you learn how to manage your stoma after surgery.
When can I take a bath or shower?
You will have a clean cover dressing in the wound, which will need to be changed periodically by appointment. You are welcome to wash the rest of the body, but keep the dressings completely dry for the first 48 hours. Avoid bathing or swimming until the stitches are removed, soaking the wound increases the likelihood of infection. Do not allow water to be directed onto the wound while showering during this period
When can I start exercising after surgery?
You will feel more tired in the few weeks after the operation and a gradual return to daily activity is recommended. For the first 6-8 weeks, avoid heavy physical work, lifting weights and intense sports activities.
When can I go back to work?
Return to work depends on the type of work and the extent of the surgery. You can expect to return to work within 1-2 weeks.
