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Address: 401 SW 80th St., Suite 101, Oklahoma City, OK 73139 • Phone: 405-605-4265

Colon Surgery

Anatomically the different parts of the colon are divided into the ascending, transverse, descending, sigmoid, and rectum. From a surgical perspective it is divided on the basis of blood supply and is thought of as the right colon, left colon, sigmoid colon, and rectum. Rectal operations are described in their own category on this website. The different segments of the colon are generally removed as such depending on the location of the problem.

The reasons for needing operations of the colon are many: polyps, cancer, diverticulitis, obstructions, etc. At Southwest General Surgery we are experienced with most of the operations that are required on the colon. Most of the operations are performed with at least laparoscopic assistance to allow for faster recovery and much smaller incisions. One of the biggest concerns that patients have when faced with having to have a colon operation is whether or not they are going to need a colostomy. Colostomies are sometimes needed, but the vast majority of colon operations done on a elective basis do not require colostomy. Also, most colostomies that are performed are reversible and not permanent. The information below is general and every patient is different. We would be happy to talk about your specific case and discuss the appropriate work-up and treatment of your issue.

Cancer

Colon cancer is a common problem in the United States. If identified early in the process it is a very treatable cancer. The mainstay of treatment of a colon cancer remains surgical. If a colon cancer can be removed in the early stages, before it spreads to lymph nodes, in most instances chemotherapy is not even needed. However, once the cancer spreads to the lymph nodes chemotherapy is often added to the treatment after surgery. This has been shown to increase survival and decrease recurrence risk.

We typically try to most right colon resections for cancer laparoscopically. Most of our left and sigmoid colectomies are performed laparoscopic assisted, meaning we do are much of the dissection as possible with the camera and small instruments. We are then able to make smaller incisions to complete the operation safely. We would be happy to talk to you about the specifics of your diagnosis and options for treatment.

Polyps

Colon polyps are small growths on the lining of the colon that can be seen on colonoscopy. Some of these polyps have the potential to turn into invasive cancers if left in place and are therefore generally removed through the colonoscope. There are times, however, that the size or the shape of the polyp does not lend itself to being removed through the scope. In this situation it is appropriate to be referred to a surgeon to talk about removing the part of the colon that contains the polyp. It is important to note though that even though that part of the colon is removed, regular colonoscopies remain a must. People who have a history of polyps are at higher risk of developing additional polyps in other parts of their colon.

We typically try to most right colon resections for polyps laparoscopically. Most of our left and sigmoid colectomies are performed laparoscopic assisted, meaning we do are much of the dissection as possible with the camera and small instruments. We are then able to make smaller incisions to complete the operation safely. We would be happy to talk to you about the specifics of your diagnosis and options for treatment.

Strictures/Obstruction

Strictures are tight spots in the colon that make it difficult for thing within the colon to move through, leading to obstructions. There are other causes of obstruction of the colon, but they are generally treated in more of an emergent manner or are caused by cancerous tumors, which are discussed above. Most strictures of the colon happen after there has been some ischemia, or low blood flow, to part of the colon from dehydration, low blood pressure, etc. This leads to scarring of the tissues that didn't get enough blood flow and tight areas in the colon. Sometimes these strictures can be treated without an operation and dilated through a colonoscope. However, if the stricture is too tight or not amenable to dilation, surgical resection may be needed.

We typically try to most right colon resections laparoscopically. Most of our left and sigmoid colectomies are performed laparoscopic assisted, meaning we do are much of the dissection as possible with the camera and small instruments. We are then able to make smaller incisions to complete the operation safely. We would be happy to talk to you about the specifics of your diagnosis and options for treatment.

Diverticulitis

Diverticulitis is inflammation and infection caused by perforation of the colon wall at weak spots or outpouchings called diverticuli. These outpouchings are very common and are thought to arise from high pressure in the colon brought about by low fiber Western diets. When they perforate, or break open, they can do so through small holes call microperforations, or through large holes which can lead to abscesses. The most common area for perforation is in the sigmoid colon. The small perforations can generally be treated with oral antibiotics on an outpatient basis, however, the larger perforations often require hospitalization and IV antibiotics at first. If the perforation is not contained, emergent operation may be necessary. However, if it is contained and an abscess forms that can be drained without an operation, referral to a surgeon can be made to talk about elective operations for your problem.

Not everyone who has an episode of diverticulitis, whether it is treated inpatient or outpatient, will need part of their colon removed. It is typically in patients who have repeated episodes that we recommend having part of the colon removed. We try to perform most these operations at least laparoscopically assisted to allow for smaller incisions and shorter recovery. When done on an elective basis colostomies are not often needed.

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