Total proctocolectomy with ileostomy

Definition

Total proctocolectomy with ileostomy is surgery to remove all of the colon (large intestine) and rectum.

Description

You will receive general anesthesia right before your surgery. This will make you be asleep and unable to feel pain.

For your proctocolectomy:

Next your surgeon will create an ileostomy:

Why the Procedure Is Performed

Total proctocolectomy with ileostomy surgery is done when other medical treatment does not help problems with your large intestine.

It is most commonly done in people who have inflammatory bowel disease, which includes ulcerative colitis or Crohn's disease.

This surgery may also be done if you have:

Risks

Total proctocolectomy with ileostomy is usually safe. Your risk will depend on your general overall health. Ask your doctor about these possible complications:

Risks for any surgery are:

Risks for this surgery are:

Before the Procedure

Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription. Ask your doctor which drugs you should still take on the day of your surgery.

Talk with your doctor or nurse about these things before you have surgery:

During the 2 weeks before your surgery:

The day before your surgery:

On the day of your surgery:

After the Procedure

You will be in the hospital for 3 to 7 days. You may have to stay longer if you had this surgery because of an emergency.

You may be given ice chips to ease your thirst on the same day as your surgery. By the next day, you will probably be allowed to drink clear liquids. Your doctor or nurse will slowly add thicker fluids and then soft foods as your bowels begin to work again. You may be eating a soft diet 2 days after your surgery.

While you are in the hospital, your nurse and doctor will teach you how to care for your ileostomy.

You will have an ileostomy pouch that is fitted for you. Drainage into your pouch will be constant. You will need to wear the pouch at all times.

Outlook (Prognosis)

Most people who have total proctocolectomy with ileostomy are able to do most activities they were doing before their surgery. This includes most sports, travel, gardening, hiking, and other outdoor activities, and most types of work.

If you have a chronic condition, such as Crohn's disease or ulcerative colitis, you may need ongoing medical treatment.

References

Cima RR, Pemberton JH. Ileostomy, colostomy, and pouches. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 113.

Cunningham D, Atkin W, Lenz HJ, et al. Colorectal cancer. Lancet. 2010 Mar 20;375(9719):1030-47.

Fry RD, Mahmoud N, Maron DJ, Ross HM, Rombeau J. Colon and rectum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 52.


Review Date: 12/10/2012
Reviewed By: Robert A. Cowles, MD, Associate Professor of Surgery, Yale University School of Medicine, New Haven, CT. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, and Stephanie Slon.
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