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Total proctocolectomy with ileostomy

Definition

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

Description

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

For your proctocolectomy:

• Your surgeon will make an incision (cut) about 6 inches long in your lower belly.
• Then your surgeon will remove your large intestine and rectum.
• Your surgeon may also look at your lymph nodes and may remove some of them, if needed.

Next your surgeon will create an ileostomy:

• Your surgeon will make a small incision in your belly. Usually this incision is made in the lower right part of your belly.
• The end of your ileum (the last part of your small intestine) will be brought through this small incision. Your surgeon will sew your ileum onto your belly.
• This opening in your belly formed by your ileum is called the stoma. Stool will come out of the stoma and collect in a drainage bag that will be attached to you.

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:

• Wound infections
• Blood clots in the legs that may travel to the lungs
• Breathing problems
• Heart attack or stroke

Risks for this surgery are:

• Bleeding inside your belly
• Damage to nearby organs in the body and to the nerves in the pelvis
• Infection, including in the lungs, urinary tract, and belly
• Scar tissue may form in your belly and causes blockage of your intestines.
• Your wound may break open.
• Poor healing of your wound in your perineum (where the rectum was removed)
• Poor absorption of nutrients from food because of your ileostomy
• Phantom rectum, a sensation that your rectum is still there (similar to people who have amputation of a limb)

Review Date: 1/26/2009
Reviewed By: Robert A. Cowles, MD, Assistant Professor of Surgery, Columbia University College of Physicians and Surgeons, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.