Historically, colectomy is carried out through an stomach incision (laparotomy), although minimally invasive colectomy, by the use of laparoscopy, is rising each in scope of indications and recognition, and is a well-established process as of 2006 in lots of medical facilities.
Resection of any a part of the colon entails mobilization and ligation of the corresponding blood vessels. Lymphadenectomy is often carried out via excision of the fatty tissue adjoining to those vessels (mesocolon), in operations for colon most cancers.
When the resection is full, the surgeon has the choice of instantly restoring the bowel, by stitching collectively each the minimize ends (main anastomosis), or making a colostomy. A number of components are taken into consideration, together with:
* Circumstances of the operation (elective vs emergency);
* Illness being handled;
* Acute physiological state of the affected person;
* Impression of dwelling with a colostomy, albeit quickly;
* Use of a particular preoperative routine of low-residue eating regimen and laxatives (so-called “bowel prep”).
An anastomosis carries the danger of dehiscence (breakdown of the stitches), which may result in contamination of the peritoneal cavity, peritonitis, sepsis and dying. Colostomy is all the time safer, however locations a societal, psychological and bodily burden on the affected person. The selection is in no way a simple one and is rife with controversy, being a frequent subject of heated debate amongst surgeons all around the world.
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