What Is a Hemicolectomy?
The scope of left hemicolectomy includes the sigmoid colon, descending colon, transverse colonic spleen, left lateral transverse colon and its mesentery. The radical operation method is to remove the area of the inferior mesenteric artery and the lymph nodes next to the abdominal aorta and the iliac artery. The effect of this surgery is slightly higher than that of conventional resection, and it is suitable for cases with better general conditions and wider cancer.
Basic Information
- Chinese name
- Left colectomy
- Purpose of surgery
- Treating colon cancer
- Visiting department
- General surgery
Left anesthesia
- Continuous epidural or general anesthesia.
Preoperative preparation for left colectomy
- (1) Correct anemia and hypoproteinemia.
- (2) Pay attention to check heart, lung, liver, kidney and other important organ functions, coagulation mechanism and distant metastasis.
- (3) Semi-liquid food was taken 3 to 5 days before the operation, and clear liquid food was taken 1 to 2 days before the operation.
- (4) Take laxatives orally.
- (5) Mechanical intestinal lavage.
- (6) Oral antibiotics.
- (7) A gastrointestinal decompression tube is placed on the morning of the operation.
Indications for left colectomy
- 1. Malignant tumors of the sigmoid colon, descending colon and colonic spleen curvature.
- 2. Torsion of the sigmoid colon where blood circulation disorders have occurred.
- 3. Multiple diverticula of the sigmoid and descending colon.
Contraindications of left hemicolectomy
- Left hemicolonic lesions with obstruction and necrosis should not be performed in a single stage.
Left colectomy surgery steps
- The general steps of surgery: incision and exploration. Ligation and cutting of mesenteric blood vessels. Free left colon. Resection and anastomosis. suture the incision.
Complications of left hemicolectomy
- 1. Anastomotic fistula.
- 2. Anastomosis is narrow.
Nursing care after left hemicolectomy
- 1. Continue decompression of the gastrointestinal tract until intestinal peristalsis is restored and anal exhaust is removed. Intravenous rehydration is required during decompression.
- 2. Continue using antibiotics.
- 3. From the 5th day after the operation, liquid paraffin is taken orally every night.
- 4. Closely observe the wound for bleeding.
- 5. Strengthen nutrition and management.
- 6. Indwell the catheter until you can urinate.
- Avoid enema for 7.2 weeks.
Precautions for left hemicolectomy
- Follow up on time after discharge. If there is sudden physical discomfort after discharge from the hospital, such as abdominal pain, abdomen and jaundice, etc. You can do some outdoor activities with a small amount of exercise, such as walking after a meal, playing chess, playing Tai Chi and other outdoor activities. Prevent colds, avoid tobacco and alcohol, and try to avoid public places with a lot of people.
Diet after left colectomy
- A small amount of water can be taken on the second day after surgery, a liquid meal on the third day, and a half-liquid meal on the fifth day. High-calorie, high-protein, high-vitamin, low-fat, digestible food, eat less animal fat, animal offal, fried, spicy food. How to eat: Eat small meals and frequent meals, 5-6 meals / day, regular diet, pay attention to food matching, and reasonable nutrition.