Hemicolectomy

ELIGIBILITY

A person who has colorectal cancer or colon cancer and is fit for surgery may undergo hemicolectomy.

PREPARATION BEFORE PROCEDURE

During your first appointment with the surgeon, some routine tests like complete blood count, chest radiograph, preoperative electrocardiogram, and carcinoembryonic antigen will be done. These tests also help in evaluating the overall health of the person. Some further investigations like ultrasonography, colonoscopy-guided biopsy, and CT scan with contrast are done to confirm the diagnosis and find the extent of the condition. CT scan of the abdomen for liver secondaries and chest X-ray for pulmonary metastasis are also done. 

You will be instructed to stop eating or drinking anything before 8-12 hours of the surgery.

PROCEDURE TYPE

Based on the location of cancer, the surgery can be of the following types: 

• Right hemicolectomy: The ascending colon (colon that runs up on the right side of the lower abdomen) along with some part of the transverse colon (middle portion of the colon) is removed. Then the transverse colon is connected to the end of the small intestine. 
• Left hemicolectomy: The portion of transverse colon, the sigmoid colon (part of the colon nearest to the anus and rectum) and descending colon (colon that runs down on the left side of the abdomen) are removed. Then the transverse colon is connected to the rectum. 

ABOUT PROCEDURE

The procedure is done under the effect of general anaesthesia. Depending on the condition, it can be performed by open surgery or laparoscopic surgery. 

• Laparoscopic surgery: In this method, small incisions (about 3-4) are made in the abdomen. A thin tube with a video camera is inserted through one incision and special surgical instrument from the other incisions. The tools are used to detach the colon from the surrounding tissues, which can be visualized on the monitor through the video camera. Then the colon is moved out through the incision and operated outside the body. After the repair is done, the colon is reinserted back through the incision. 
• Open surgery: In this method, a long incision is made on the abdomen to access the colon. Once the colon is visible, the colon is detached from the surrounding tissue with the help of the surgical tools. Then the diseased portion of the colon is cut out, and the healthy colon is attached (anastomosis) by stitches (sutures) or staples. 

The incision on the abdomen is closed by stitches or clips, which if required, are removed after 7-12 days. 

The cancer removed is sent to the laboratory for further investigations. Depending on the results of the test, you may or may not need further treatment like chemotherapy. 

In rare cases, a person may need a temporary stoma that is an opening on the surface of the abdomen, which is attached to a bag that collects the bowel contents. 

POST-PROCEDURE CARE

Based on your condition, you may have to stay for a few days in the hospital. You will receive oxygen from a face mask for at least 24-48 hours after the surgery. A drip in the vein in one arm and a catheter in the bladder will be attached to get fluids and drain urine, respectively. Pain killers may be given by drip or as an epidural (by a fine tube at the back). 

Within a few days after surgery, you may start eating again. You mightbegin with a liquid diet and slowly move to solid foods. 

RECOVERY TIPS

Following measures may aid in speedy recovery:

• Move around as much as possible 
• Do light activities like walking 
• Rest for short periods during the day for the first 2-3 weeks after discharge
• Avoid lifting heavy weights or doing strenuous activities for at least six weeks 
• Take mild painkillers regularly

FACTORS AFFECTING COST

Based on the type of surgery performed, the cost of colon surgery may differ.