Proctectomy

Proctectomy is a surgical procedure to remove all or part of the rectum, which is the lower part of the large intestine. This procedure may be performed for various conditions, including cancer, inflammatory bowel disease, or rectal prolapse. In this article, we will discuss the indications, types, and complications of proctectomy.

Proctectomy Indications:

Proctectomy may be indicated for the following conditions:

  • Rectal cancer
  • Ulcerative colitis
  • Crohn’s disease
  • Rectal prolapse
  • Familial adenomatous polyposis

Types of Proctectomy:

There are several types of proctectomy, including:

  1. Low anterior resection: This procedure involves removing the rectum and part of the colon, then reconnecting the remaining colon to the anus.
  2. Abdominoperineal resection: This procedure involves removing the rectum and anus, then creating a permanent colostomy.
  3. Hartmann’s procedure: This procedure involves removing the rectum and anus, then creating a temporary colostomy.

Preoperative Preparation:

Before undergoing proctectomy, the patient will need to undergo several tests to ensure they are healthy enough for surgery. These may include blood tests, imaging studies (such as CT scans or MRI), and a colonoscopy. The patient will also need to follow a special diet and may need to use laxatives or enemas to empty their colon prior to surgery.

 

Surgical Procedure:

Proctectomy is usually performed under general anesthesia. The surgeon will make incisions in the abdomen and/or perineum to access the rectum. The type of procedure will determine the location and size of the incisions. The surgeon will then remove the affected portion of the rectum, along with any nearby lymph nodes if necessary. They will then create a new connection between the remaining colon and the anus (if performing a low anterior resection) or create a colostomy (if performing an abdominoperineal resection or Hartmann’s procedure).

Complications:

Proctectomy is a major surgery and carries the risk of several complications, including:

  • Infection
  • Bleeding
  • Anesthesia complications
  • Blood clots
  • Bowel obstruction
  • Urinary incontinence
  • Sexual dysfunction
  • Colostomy complications (such as blockages or leaks)
 Recovery:

After the surgery, the patient will need to stay in the hospital for several days to recover. They will receive pain medication and antibiotics to prevent infection. They will also need to follow a special diet and may need to use a catheter to help them urinate. The patient will need to avoid strenuous activities and heavy lifting for several weeks after surgery. They may also need to undergo chemotherapy or radiation therapy, depending on the reason for the proctectomy.

Conclusion

Proctectomy is a complex surgery that may be necessary for several conditions affecting the rectum. It is important for patients to understand the indications, types, and potential complications of the procedure. Patients should also work closely with their healthcare team to prepare for the surgery and ensure a smooth recovery.