Manhattan Abdominal Surgeons
There are some conditions, such as cancer and Crohn's disease that
require removal of the last segment of small intestine (ileum) and the
first segment of the large intestine (colon). This procedure is called
an ileocolic resection.
Learn more about this procedure and how our Manhattan colorectal surgeons
can help you. Call us at 646.798.4606 or
send us an email today.
Colon cancer and Crohn's disease are diagnosed using a combination
of patient history, physical examination, endoscopy, radiology, and pathology.
The diagnosis is often made using colonoscopy with biopsies. When patients
have endoscopy or surgery for the disease, tissue is often submitted to
the Pathologist for evaluation. The pathologist looks at the tissue under
the microscope and helps make the diagnosis.
Radiology tests that may be ordered include:
- A plain X-ray
- A CT scan of the chest
- Scans of the abdomen and pelvis
These studies are often utilized in the evaluation for evidence of metastatic
disease (tumor spread beyond the primary site in the colon) in cancer
and to evaluate potential complications of Crohn's disease (perforation,
obstruction, or fistula).
The treatment of colon cancer varies based upon whether there is spread
beyond the primary site in the colon. If there is no spread beyond the
primary site in the colon, the treatment is often removal of the involved
colon. Following removal of the colon, the pathologist will evaluate the
tumor under the microscope and give it a stage based upon the depth of
penetration of tumor in the wall of the colon and the presence of tumor
in the lymph nodes surrounding the tumor. Based upon the stage of the
tumor, postoperative chemotherapy may be recommended. Chemotherapy is
administered by a medical oncologist.
In selected patients with limited spread in the liver or lungs, removal
of the involved colon along with the tumor in the liver or lungs may be
feasible. The recommendation for this treatment strategy is individualized
based upon the extent of disease and overall clinical presentation of
the patient. If this approach is chosen, it is common for postoperative
chemotherapy to be administered.
If there is tumor spread beyond the primary tumor and it is not amenable
to removal, surgery may not be recommended. In this situation, chemotherapy
is often administered.
Treatment for Crohn’s Disease
The treatment of Crohn's diseases varies between patients, based upon
the location of the disease, the severity of symptoms, and the presence
of complications such as obstruction, perforation, abscess, or fistula.
Often, the initial treatment in non-surgical and is commonly directed by
a gastroenterologist. The medications used for Crohn's disease vary,
- Antibiotics such as Cipro and Flagyl
Indications for surgery include worsening symptoms despite adequate medical
therapy, intolerance of medical therapy, complications of the disease
(obstruction, perforation, abscess, or fistula), and difficulty maintaining
nutrition. Depending on the location of the Crohn's disease, intestinal
resection (removal) may be recommended. A common surgical procedure performed
for Crohn's disease is an ileocolic resection.
The night prior to the procedure, you will be instructed to take nothing
to eat or drink after midnight. In addition, you will be prescribed a
bowel preparation. The preparation should be taken as instructed.
For an ileocolic resection, you will receive general anesthesia, in which
you are completely asleep and monitored at all times by an anesthesiologist.
After anesthesia is established, an incision will be made in your abdomen
and the abnormal ileum and colon will be identified using the laparoscope.
This segment of ileum and colon will be removed, and the two ends reconnected
(anastomosis). Rarely, a diverting stoma (bag) will be performed. Often
a stoma is performed to maximize the safety of the operation for you.
You will have a dressing placed over the operative site.
Following an ileocolic resection, you will be admitted to the hospital.
You will receive pain medication and intravenous fluid. Once bowel function
returns, as evidenced by passage of gas or stool, your diet will be advanced.
Once you tolerate a diet, and have no signs of fever or other complications
of the surgery, you will be discharged from the hospital. You will be
given a prescription for pain medication. In the 1-2 weeks following surgery,
you will see your surgeon for a follow-up appointment.
In the intervening time period, you should
contact your surgeon with any questions or concerns.