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Colorectal surgery encompasses a wide range of procedures involving the anus, rectum and small and large intestine. Some are performed on an outpatient basis with local anesthetics or sedation, while others take place in the hospital鈥檚 operating room (OR) under general anesthesia.听听
In what follows, Dr. Lea Lowenfeld, a colorectal surgeon and an Assistant Professor of Surgery in the Division of Colon and Rectal Surgery at AV研究所, provides answers to your FAQs regarding the conditions that require surgical treatment, the procedures surgeons perform and the steps patients need to take to prepare for surgery, from minor surgical 鈥渇ixes鈥 to major operations.听
Smaller procedures don鈥檛 always require preparation, Dr. Lowenfeld says. They may be performed in the doctor鈥檚 office, and patients are awake throughout.听听
Outpatient (office-based) procedures include:听
At most, the surgeon will use lidocaine鈥攁 topical anesthetic鈥攖o minimize any discomfort.听
A colonoscopy or sigmoidoscopy, which is an abbreviated version of a colonoscopy that visualizes only the lower segment of the intestine, can be done in an endoscopy suite under light anesthesia. 鈥淵our doctor will give you instructions on how to prepare for these,鈥 she adds, 鈥渁nd you鈥檒l be able to go home an hour or two afterwards, once you鈥檙e fully awake and alert.鈥听
Make sure to have someone pick you up after any procedure involving sedation or anesthesia. That鈥檚 a must!听
These include larger operations involving the removal of all or part of the colon鈥攁 procedure called a colectomy. Patients with the following conditions may require a partial or total colectomy:听
The main issue, says Dr. Lowenfeld, is anesthesia safety. 鈥淭hat鈥檚 why you鈥檒l need to stop eating solid food the night before and stop taking liquids 2 hours before sedation.鈥听
More extensive surgical procedures may also require patients to stop taking blood-thinning medications before surgery, and that includes colorectal surgery. But baby aspirin is usually okay, she says. It鈥s important to discuss all your medications with your doctor and review which, if any, should be stopped prior to surgery.听
Don鈥檛 forget to provide the hospital with the following information:听听
Just in case, please also include your 鈥advance directive,鈥 defined by the National Institute on Aging as a legal document containing instructions for medical care that go into effect if you 肠补苍鈥檛 communicate your own wishes. An advance directive is also called a 鈥渓iving will.鈥听
Bring a list of your medications, but no need to bring the pills themselves, as the hospital pharmacy has most medications. The only exceptions may be very specific creams, eye drops or pills, says Dr. Lowenfeld.听听
And bring anything that makes you feel more comfortable, whether a favorite pillow, body lotion or your preferred foods and beverages (but no alcohol, of course!).听听
There are several criteria that need to be met before you can be discharged from the hospital, she says: 鈥淵ou鈥檒l need to resume eating and drinking enough for adequate nutrition and hydration, and you鈥檒l need to experience a return of bowel function. And your pain, if any, will need to be well controlled.鈥听
Once you鈥檙e home, 鈥we encourage you to get back to your normal routines as soon as you鈥檙e able,鈥 she adds.听听
And as for home care, that depends on your needs. If you鈥檙e independent before surgery, chances are you won鈥檛 need extra help at home. But it鈥檚 always good to have someone there for a while, whether a family member, a friend or a professional to help you take a shower or deal with wound care.听听
鈥If there are wound care needs, we can set you up with a visiting nurse,鈥 says Dr. Lowenfeld. 鈥淛ust ask to speak with a social worker, and they鈥檒l get in touch with the Visiting Nurse Service.鈥听
If you have further questions about colorectal surgery, don鈥檛 hesitate to visit here to learn more.