Bowel resection

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Bowel resection

Introduction

The purpose of this tool is to help you decide whether to have bowel resection surgery. When making a decision like this, you must balance:

The reasons for doing the procedure
The potential health risks, drawbacks, or limitations of the procedure
Whether there are alternative procedures that may be more appropriate
Cost

This tool is not a substitute for professional medical care and advice. Work with your doctor to help you make this decision. A second opinion from another doctor may be valuable. Surgery always carries risks, and you should be fully informed about the risks and benefits of this type of surgery. You should also be aware that research evidence is often limited, and the risks of surgery may not be completely understood. For this type of surgery, there is usually no exact right or wrong answer.

Your physician may make certain recommendations to you. However, the final decision about whether to have the surgery rests with you.

What is the surgery?

Your intestines (bowels) are located between your stomach and anus. The intestines digest food, absorb water, and produce feces. The small intestine is about 20 feet long, and the large intestine (colon) is about 5 feet long.

Surgery to remove a section of your intestine is called bowel resection. The surgery may be recommended to treat cancer, precancerous polyps, inflammation, diverticulitis, bleeding, a block in your intestine, or other problems.

Bowel resection is performed while you are under general anesthesia. This means you will be unconscious and pain-free. First, a cut is made in your abdomen. The diseased part of your intestine is removed and the two healthy ends of the intestine are sewn back together (resected). Then, the cut in your abdomen is closed. If the entire colon is removed, it is called a proctocolectomy.

Click the icon to see an illustrated series showing small bowel resection surgery.

There are two general ways to do the surgery:

A traditional "open" surgery involves a larger incision in your abdomen.
A laparoscopic approach uses several smaller incisions. A tiny camera is inserted to help the doctor see the area to be worked on.

Key points

As with any surgery, weigh the potential benefits against the risks. If this surgery is done for the right reasons, the benefits of bowel resection far outweigh the chance of harm.
Once you have decided to have the surgery, decide with your surgeon when to have it performed, taking the circumstances of your case into account.
Bowel resection surgery involves anesthesia, which has risks that you should discuss with your doctor. Other risks of surgery include scarring, bleeding, and infection.
In about 5% of colon surgeries, an artificial opening in the bowel is made. The opening is called a stoma. A bag is attached to the opening to drain the bowel. The stoma may be made to allow the bowel to heal or for other reasons. In most cases, the stoma is temporary and can be closed with another operation at a later date. If a large portion of the bowel is removed, the stoma may be permanent.

How much time this decision tool will take

5 - 10 minutes

What this tool will provide

A personalized list of factors for you to weigh
Questions to ask your doctor
Alternatives to this surgery
Recommended reading

Review Date: 4/7/2010
Reviewed By: A.D.A.M. Editorial: David Zieve, MD, MHA, David R. Eltz. Robert A. Cowles, MD, Assistant Professor of Surgery, Columbia University College of Physicians and Surgeons, New York, NY. Review provided by VeriMed Healthcare Network (11/9/2007).

References:

The Clinical Outcomes of Surgical Therapy Study Group. A Comparison of Laparoscopically Assisted and Open Colectomy for Colon Cancer. New England Journal of Medicine. 2004;350:2050-2059.
Rudy DR, Zdon MJ. Update on colorectal cancer. American Family Physician. 2000;61(6):1759-70,1773-4.
Salzman H, Lillie D. Diverticular disease: diagnosis and treatment. American Family Physician. 2005;72(7):1229-34.
Podolsky DK. Inflammatory bowel disease. New England Journal of Medicine. 2002;347(6):417-29.
Botoman VA, Bonner GF, Botoman DA. Management of inflammatory bowel disease. American Family Physician. 1998;57(1):57-68, 71-2.

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