What is a hemicolectomy?

From the Guidelines

A hemicolectomy is a surgical procedure that removes approximately half of the colon, and it is commonly performed to treat colon cancer, large polyps, inflammatory bowel disease, or certain bowel obstructions, with the goal of improving morbidity, mortality, and quality of life outcomes. During this operation, the surgeon removes the diseased portion of the colon along with nearby lymph nodes, then reconnects the healthy remaining sections to restore intestinal continuity. There are two main types: right hemicolectomy, which removes the right side of the colon (cecum, ascending colon, and part of the transverse colon), and left hemicolectomy, which removes the left side (part of the transverse colon, descending colon, and sometimes part of the sigmoid colon) 1. The procedure can be performed using either traditional open surgery with a larger incision or laparoscopically with several small incisions, which generally allows for faster recovery 1. Some key points to consider when deciding on the approach include:

• The location and extent of the disease
• The patient's overall health and surgical risk
• The potential benefits and risks of each approach
• The surgeon's expertise and experience with each technique Recovery typically takes 4-6 weeks, with patients usually staying in the hospital for 3-7 days after surgery 1. Potential complications include infection, bleeding, bowel obstruction, and changes in bowel habits, though most patients regain normal bowel function over time 1. It's worth noting that the role of preoperative imaging to predict T stage and N stage is an area of ongoing investigation, and the standard surgical approach is radical resection 1. Additionally, the decision to perform primary colorectal anastomosis, defunctioned colorectal anastomosis, or end colostomy should be individualized, with consideration of both the overall condition of the patient and the colon 1. The most recent and highest quality study suggests that the choice of surgical approach should be based on the individual patient's needs and circumstances, with the goal of minimizing morbidity, mortality, and improving quality of life outcomes 1.

From the Research

Definition of Hemicolectomy

• A hemicolectomy is a surgical procedure that involves the removal of a portion of the colon, which is a part of the large intestine 2, 3, 4, 5, 6.
• The procedure can be performed using either an open or laparoscopic approach, with the latter being a minimally invasive technique that utilizes small incisions and a camera to visualize the area 2, 5.

Types of Hemicolectomy

• Right hemicolectomy (RH): involves the removal of the right side of the colon 2, 5.
• Left hemicolectomy (LH): involves the removal of the left side of the colon 2, 6.
• The choice of procedure depends on the location and extent of the disease or condition being treated 2, 5, 6.

Indications for Hemicolectomy

• The procedure is often performed to treat various conditions, including:
  • Colon cancer 2, 3, 4, 5, 6.
  • Diverticulitis 4.
  • Benign tumors 4.
  • Other colon-related diseases 2, 4.

Outcomes and Complications

• Studies have shown that laparoscopic hemicolectomy can be performed safely and effectively, with outcomes comparable to those of open surgery 2, 5.
• Complications can occur, including wound infections, leakage, and intestinal obstruction, but these are similar in frequency to those associated with open surgery 2, 5.
• The choice of approach depends on various factors, including the patient's overall health, the extent of the disease, and the surgeon's expertise 2, 5, 6.