What Is A Colectomy? Partial Vs. Total Colectomy Explained

It often begins quietly, like changes in bowel habits, unexplained fatigue and persistent abdominal discomfort. These symptoms might seem normal in the early stages, but when they persist and do not improve with medications, they signify something far more serious.

For many patients, these signs indicate colorectal cancer, a life-threatening condition that needs to be addressed promptly. One of the effective treatments for colorectal cancer is colectomy, a surgical procedure that forms the backbone of modern colorectal cancer surgery.

In this blog, we will talk about the procedure involved and the differences between its two types, i.e., partial and total colectomy.

What Is A Colectomy?

The colon is an important organ of the body that plays a vital role in how our body uses the food that we eat. However, when abnormal cells start to grow in the organ and take the form of cancer, removing the damaged section of the colon becomes extremely important to stop the spread of the malignant cells to the nearby lymph nodes and organs.

Dr. Purnendu Bhowmik, an expert in treating colorectal cancer surgery, usually recommends colectomy as part of colorectal cancer surgery, but at times, the procedure is also suggested to treat other conditions, including the following.

• Ulcerative Colitis
• Crohn's Disease
• Severe diverticulitis
• Bowel obstruction or perforation

What Does The Procedure Involve?

During colectomy, the surgeon removes part or all of the colon (large intestine), depending on the stage of the colon cancer. The procedure can be performed using open, laparoscopic, or robotic techniques.

After removing the affected portion, the surgeon reconnects the healthy sections of the intestine or, in some cases, creates a temporary or permanent colostomy to allow waste to exit the body.

Partial Vs. Total Colectomy: What Are The Differences?

Depending on how much the cancer cells have affected the colon, Dr. Purnendu Bhowmik employs the following approaches: partial colectomy and total colectomy.

Partial Colectomy: An Overview

In a partial colectomy, only the affected portion of the colon is removed. If required, the procedure also involves excision of the margin of healthy tissue along with nearby lymph nodes. After removing the diseased segment, the surgeon reconnects the remaining healthy parts of the colon, which is known as 'anastomosis', thereby restoring bowel function.

Partial colectomy is carried out for Stage 1 or localised colorectal cancer. In simpler terms, it means removing the affected part of the colon where there is the growth of the tumour while preserving the rest to allow the digestive system to function as normal.

Benefits Of Partial Colectomy

Having performed multiple colorectal cancer surgeries, Dr. Purnendu Bhowmik highlights the benefits of partial colectomy.

• Reserves most of the colon: Here, only the affected section is removed, thereby preserving as much of the healthy bowel as possible to maintain the normal digestive function.
• Better bowel function: In the majority of patients, a large portion of the colon is retained. This means the bowel habits of the patients are going to remain the same after recovery.
• Targeted treatment: The procedure effectively removes the targeted tissues and the nearby lymph nodes to prevent the spread of the cancer cells to the healthy organs.
• Faster recovery: The healing time is generally shorter, especially when minimally invasive techniques are used. Patients are able to return to their daily activities in a few days.
• Avoidance of permanent ostomy: In a partial colectomy, the healthy cells are reconnected. This means that patients do not require a permanent colostomy bag.
• No risk of complications: Since only a smaller portion of the colon is excised, the chances of postoperative complications are almost negligible.

Total Colectomy: An Overview

Unlike a partial colectomy, a total colectomy, as a part of colorectal cancer surgery, involves the removal of the entire colon (large intestine), with or without the rectum, followed by creating a permanent stoma. Dr. Purnendu Bhowmik usually recommends this approach when the cancer cells start affecting multiple areas of the colon or when the tumour has largely spread within the bowel.

During the procedure, the surgeon removes the entire colon along with nearby lymph nodes to prevent the spread of cancer. Once it is done, the digestive tract is reconstructed.

For some patients, the small intestine is directly connected to the rectum, allowing waste to pass through the body normally. Whereas for others, a permanent stoma (an opening in the abdomen) is created, and waste is collected in an external bag, known as an ileostomy.

Total colectomy is typically performed under the following scenarios.

• Advanced-stage colorectal cancer (Stage 3 or 4): When the cancer cells are present beyond a localised area.
• Recurrent colorectal cancer: If the cancer returns even after treatment.
• Multiple tumours in the colon: When there are multiple tumours, removing the entire colon may be the safest option.
• High-risk genetic conditions: Genetic disorders like familial adenomatous polyposis (FAP) put an individual at a high risk of developing cancer throughout the colon.

Benefits Of Total Colectomy

Here are the advantages of total colectomy as a part of colorectal cancer surgery.

• Complete removal of the colon: The major benefit of total colectomy is that it removes all the cancer cells within the colon to eliminate its further spread.
• Significantly reduces recurrence risk: As the whole colon is removed, there is no chance of colorectal cancer recurrence.
• Suitable for High-risk patients: Sometimes, the procedure is carried out in individuals with inherited conditions (like familial adenomatous polyposis) to prevent the development of cancer cells in the future.
• Long-term disease control: It is the best option for individuals suffering from advanced colorectal cancer cases to increase the survival rate.
• Life-saving: Many patients report a significant increase in overall well-being after getting relief from the troublesome symptoms.

Conclusion

If you or a loved one is experiencing persistent digestive symptoms, seek early medical advice from Dr. Purnendu Bhowmik, a leading expert in colorectal cancer surgery.

He will determine whether you need a partial or total colectomy to remove diseased tissue and prevent the cancer from progressing to the advanced stage.