Resection of the sigmoid colon is performed for injuries and tumors that damage the large intestine. In most cases, such surgery is carried out urgently. There are several ways to carry out this operation. Most often it is done by the Mikulich or Hartmann method. Preparation for surgery is of great importance. Only if all conditions are met, negative consequences can be excluded.
General information
What is a sigmoid colon resection surgery? This term refers to the incision of a part of an organ. In certain pathologies, part of the sigmoid colon must be removed.
The choice of removal method depends on the type of pathology. For example, laparoscopic resection of the sigmoid colon is performed using a specialized medical technique called a laparoscope. The surgeon makes several incisions in the navel to insert the instruments. The laparoscopic technique is consideredless traumatic and more gentle than open surgery.
What is the sigmoid colon?
The average length of the intestine in the human body is 4 meters. The sigmoid colon occupies about 1/8 of the part. This part of the intestine is located on the border between the peritoneal cavity and the small pelvis - in the left iliac fossa. Behind the sigmoid colon are the external iliac vessels, the left piriformis muscle, and the left sacral plexus. In front - the bladder in men and the uterus in women, as well as loops of the small intestine. Due to the proximity of the intestine to these organs, the operation is considered difficult from a technical point of view. Due to its location, the sigmoid colon is easily palpable.
Diagnosis
What is it and what is its peculiarity? The doctor can determine several parameters at once: the thickness of the organ, the approximate consistency, the intensity of peristalsis and the texture of the surface. In the normal state, this section of the intestine is quite dense, does not rumble, its thickness reaches 2.5 cm. At the same time, it can be quite mobile. If the doctor detects a lump or tumor on palpation, other diagnostic methods can be used. The patient is prescribed a blood test, radiography, sigmoidoscopy and irritoscopy. Women are additionally sent for examination to a gynecologist, since many female diseases are similar in appearance to pathologies of the sigmoid colon.
Indications
In what cases is a resection of the sigmoid colon performed? The operation is scheduled fordeveloping tumors, progressive polyposis, the presence of large benign formations, which can subsequently lead to complications. Also an indication for this operation is a violation of innervation, causing an increase in the volume of the intestine, and ulcerative lesions of the mucous membranes. An emergency need for surgical intervention may arise in case of trauma to the abdomen and internal organs.
Preparatory stage
Let's take a closer look at this. Before the operation, the patient must undergo some preparation. To exclude the possibility of infection during the intervention, it is necessary to clean the intestines. This will avoid further complications. For cleansing, special enemas with laxatives are put. Drugs and their dosage are selected by the doctor individually. The preparation phase usually lasts all day.
Special nutrition is prescribed a few days before the surgical intervention for resection of the sigmoid colon. The diet usually excludes the use of hard-to-digest and solid foods. You can eat milk porridge, soups and other liquid dishes.
Special medicines are usually prescribed before the operation. These are inhibitors, diuretics and drugs to normalize pressure. These medicines reduce the risk of heart complications. A few weeks before the operation, it is recommended to stop taking medications that have an anti-inflammatory effect - Ibuprofen, Nurofen, Aspirin. They change the functioning of platelets and affect blood clotting. It is also better to consult with your doctor about taking dietary supplements and vitamins. Before resection of the sigmoid colon, it is better to stop taking them.
Before the operation, the patient must be examined by an anesthesiologist. He assesses the patient's condition and prescribes appropriate anesthesia. When preparing the intestine for resection, it is not recommended to take any food, and before the operation - drink water.
Methodology
How is the resection of the sigmoid colon performed? The course of the operation depends on the type of pathology. In case of intestinal volvulus, which provoked the development of gangrene, an operation according to Hartmann or Mikulich is usually prescribed.
What is her speci alty? Resection of the sigmoid colon according to Hartmann involves the removal of the dead section of the sigmoid, the stitching of the distal end and the further withdrawal of the through hole. This method is usually used for elderly and debilitated patients.
Resection of the sigmoid colon according to Mikulich is carried out in two stages. First, part of the sigmoid colon is removed. Its endings are sutured for 5 cm. After that, they are sutured in the form of a double-barreled shotgun into the wall of the peritoneum. After 3.5 months, the intestinal fistula is closed.
The method of the operation is determined by the nature of the development of the pathology. If a tumor is found in the middle third of the sigmoid, complete removal of the sigmoid colon may be required.
Post-operative period
What is its feature? How shouldbe nutrition after resection of the sigmoid colon? Semi-finished products, fried and fatty foods are contraindicated for patients. It is better to cook food in a steamer or in a slow cooker.
Diet after resection of the sigmoid colon involves the use of mostly liquid food: cereals, light soups and mashed potatoes. You can gradually introduce solid foods into your diet. The menu is designed so that the body receives all the vitamins and minerals necessary to restore the patient. After resection, canned food, smoked foods and alcohol should be excluded. Approximately 10 days after surgery, you can begin to consume low-fat dairy products, eggs, and meat. A month later, you can include regular dishes on the menu. The main condition is that the food should be well chopped.
Contraindications
Who should not undergo such an operation as a resection of the sigmoid colon? Contraindications are factors that cause complications in the process of removing a section of the sigmoid colon, as well as making it difficult to identify nearby organs and vessels. Non-admissions also include large tumors and severe obesity. Recent surgical interventions and adhesions also make it impossible to perform the operation.
Consequences and forecast
This aspect should be given special attention. What complications are possible after the operation? Resection of the sigmoid colon is an intervention that is characterized by a high risk of internal bleeding as a result of poor vascular treatment. The cause of negative consequences can also be incorrectpreoperative preparation, poor bowel cleansing and broken suture tightness during stump healing. Unprofessional drainage of the peritoneum can also entail certain difficulties. Sometimes intestinal adhesions appear after surgery, resulting in obstruction.
Does sigmoid colon resection help? Doctors usually give a favorable prognosis. The probability of death tends to zero. With oncology, relapses usually do not occur. The main condition for a successful operation is the high professionalism of the surgeon and the attending physician.
Features of operations
There is a relationship between gut he alth and most diseases. Failures in the work of its departments can lead to such unpleasant consequences as soreness, bloating and even shortness of breath. Surgical methods of treatment are used only if other methods do not bring positive results. When performing a number of operations, such as excision of the fistula, partial removal of the colon and treatment of purulent peritonitis, the likelihood of contamination of the surgical site increases. This can cause infection of the intestinal tract and subsequently manifest itself in the form of inflammation.
Resection of any part of the intestine is a last resort. It is prescribed in case of a cancerous tumor of the large or sigmoid intestine. The damaged section of the intestine is removed, and the free ends are sewn together. If there are contraindications for such an operation,colostomy is used. With this type of surgical intervention, a fistula is used, which is brought out. It is joined by a colostomy bag for artificial defecation. Some time later, this defect can be eliminated by a second operation to restore bowel function.
Fistula after surgery
So what do you need to know about this? Fistula treatment can be performed both conservatively and surgically. The first option involves the use of special antiseptic washes, as well as taking antibiotics. Usually such procedures do not give the desired effect.
Surgery is more efficient. Usually, the operation involves opening the inflamed area and draining cavities with accumulations of pus. The tissues around the excised fistula are restored for about a week. The first time after the operation, minor bleeding is possible. Relapses are quite rare, and they are treated with repeated surgical intervention. Recovery is fairly quick in most cases.
Late rehab
Since the main purpose of the sigmoid colon is to absorb moisture from the stool, when this part of the intestine is removed, the feces can become liquid and almost uncontrollable. This may cause some inconvenience. After the operation, you will have to radically revise the diet. The late period of rehabilitation requires certain restrictions. Usually the patient is prescribed a diet with a minimum content of toxins. There should be nothing spicy on the menu,fatty, smoked and spicy. Doctors do not advise eating legumes, roughage from plant fibers, carbonated drinks, whole milk. This will reduce gas production.
Conclusion
In this review, we examined in detail what a resection of the sigmoid gland is, in what cases it is performed and what complications can be after this operation. The procedure can be carried out both planned and on an emergency basis in case of injury. There are several methods for performing this type of surgery. The specifics of the operation is determined by the doctor based on the characteristics of the patient's body. With proper preparation for surgery, there are practically no complications. After the intervention, such consequences as intra-abdominal bleeding, peritonitis (with poor-quality sanitation of the abdominal cavity or incomplete tightness of the sutures), as well as abscesses and early adhesive obstruction, are possible. During rehabilitation, it is recommended to reduce the load on the body and change the diet. The diet after resection of this section of the intestine excludes the use of spicy, fried, smoked, s alty foods, as well as alcohol.
Despite the fact that complications after surgery can be avoided, it is better not to bring things before the operation. Do not spare time for yourself, at the first symptoms of the disease, immediately consult a doctor.
