Preparing for colon
surgery and what
to expect after

     


You have an important role
in your own surgery.   

You want the best possible outcome. So does your surgeon. That’s why it’s important that you do your part by following your surgeon’s instructions prior to your procedure. And consider doing the following to help set yourself up for success1:

  • Stop smoking. This helps reduce your risk of breathing problems after surgery. Smoking can also negatively impact wound healing.

  • Reduce alcohol consumption. It is important to reduce or stop drinking alcohol to avoid infections after surgery.

  • Increase gentle exercise. Simple activities such as walking and aerobic/resistance exercises can reduce surgical complications and enhance recovery.

  • Eat healthy foods. Good nutrition is important to overall health which, in turn, can help improve outcomes.

Your doctor may recommend additional things to help you prepare for colorectal surgery, such as adjusting your medications, taking antibiotics, cleansing your bowel or other treatments specific to your colorectal disease.2

Smiling man


What life looks like after surgery

After colorectal surgery, your main job is to heal.

While specific post-surgery practices vary by individual, most patients will be able to eat, drink, and move around the first day after surgery. Movement is important after surgery to reduce things such as blood clots, fluid in your lungs or pneumonia. So, soon after surgery, you can expect to sit in a chair and take short walks in the hospital hallway.3

Following colorectal laparoscopic surgery, the average hospital stay is 6.5 days and normal activities usually resume within 1 to 2 weeks. With open surgery, the average hospital stay is 9 days and typically 6 weeks of recovery.4-19

During your recovery from colorectal surgery at home, you may need a caregiver to assist you with household duties and transportation. Your doctor will explain what you should and should not do such as20:

  • Do not lift anything over a certain weight.
  • Follow a low fiber diet after surgery.
  • Avoid straining to have a bowel movement.
  • Do not drive while taking pain medication.
Father cooking

Proper nutrition and good hydration

Your hospital discharge instructions will include guidance on what to eat. Eating a healthy diet and drinking plenty of fluids help the healing process. If you have any questions about food “dos and don’ts,” contact your doctor.

As you recover, pay attention to your body.

Regardless of the type of procedure, complications can arise after surgery and cause a variety of reactions. If you experience any of the following, call your doctor2:

  • Fever and/or chills (over 101F or 39C)
  • Nausea or vomiting
  • Abdominal pain and/or swelling
  • Bleeding from the rectum
  • Pus draining from an incision
  • Persistent cough or shortness of breath
  • Worsening redness around your incisions
  • Unable to eat or drink

Your healthcare team will continue to monitor your progress both during and after your recovery period from surgery. Follow up care typically includes physical exams and to watch for disease recurrence, manage any side effects, and track your overall physical health.


Caring for an ostomy at home

An ostomy is a surgical procedure that creates an opening from inside the body to the outside. The opening is called a stoma to which a bag is attached allowing stool and gas to exit the body. If you have an ostomy, your ostomy nurse will show you how to care for it before you leave the hospital. Here are few basics21:

  • It’s important to use the right size pouch and skin barrier opening. Poor fitting bags and barriers can injure the stoma and irritate the skin around it.
  • Follow a regular schedule for changing the bag. Different types of bags are designed to be changed at different intervals — some every day, or every few days, or once a week. Regardless of which bag you use, a regular changing schedule will help avoid leaks and skin irritation.
  • When pulling the pouching system away from skin, do so gently. Use water to clean the skin around the stoma and dry completely before reattaching the bag.
  • Bathing and showering is fine. Normal exposure to water is not harmful. And if you use soap, be sure to rinse your skin well — especially the area around the stoma.
  • Pay attention to skin problems. Skin allergies and sensitivities can develop over time. You may need to try different products to find those that are compatible with your skin.
Couple hugging

If you have any of the following, call your stoma nurse or doctor21:

  • Injury or cut to the stoma
  • Severe skin irritation or sores
  • No ostomy output for 4 to 6 hours with cramping and nausea
  • Cramps lasting more than 3 hours
  • Ongoing vomiting and nausea
  • Stoma bleeding, either from the opening or where the stoma meets the skin
  • Unusual change in your stoma size or color
  • Bad odor lasting more than a week which may be a sign of infection

You are probably wondering about clothing and if the bag is visible beneath it. You may be surprised to learn that many ostomy pouches are fairly flat and, therefore, are not noticeable under clothing. Snug undergarments also help conceal bags. So wear what you normally do — no special garments are necessary.21

As for your ostomy supplies, they are easily obtained online from your local pharmacy, or medical supply store. Your stoma nurse will help you line up pouches, skin barriers, and other products. You’ll want to order supplies a few weeks before you run out, but don’t stockpile because they can be ruined by temperature changes and moisture.21


What’s next after surgery?

It is important to talk to your surgeon and primary care doctors about what to expect in the days and weeks ahead.

  • Monitoring your own recovery: Ask your surgeon or nurse to explain what they want to you to do and when they want you to check in. For example, they may have recommendations about how much you should eat, drink, or exercise. Or, they may want you to call them if you notice that you aren’t producing any stool or are having significant pain. Be sure to review their expectations and the reasons why you should call their office.
  • Post-surgery check-up: It’s important to have a post-surgery check with the surgeon to make sure that you are healing properly.
  • Temporary ostomy reversal: If you received a temporary ostomy, be sure to talk to your surgeon about when to schedule the reversal procedure.
  • Colorectal cancer follow-up care: If you have colorectal cancer, ask your medical team — oncologist, surgeon, primary care doctor, nurse, or patient navigator — about treatment going forward (such as chemotherapy), and what the schedule is for monitoring any cancer reoccurrence. This follow-up care may be a combination of periodic doctor visits, blood tests, scans, and colonoscopies.22
  • Non-cancer follow-up care: Ask your surgeon and your primary care doctor about what comes next in treating your colorectal disease such as your daily routines and medications.
  • Support groups: Many patients find that a support group helps them emotionally after surgery. Ask your medical team if they can recommend a colorectal patient or caregiver support group.
1

Gustafsson UO, Scott MJ, Hubner M, et al. Guidelines for perioperative care in elective colorectal surgery: Enhanced recovery after surgery (ERAS®) society recommendations: 2018. World J Surgery, vol. 43, no. 3, 13 Nov. 2018, 659–695, link.springer.com/article/10.1007/s00268-018-4844-y, 10.1007/s00268-018-4844-y. Accessed April 5, 2022.

2

Laparoscopic Colon Resection Patient Information from SAGES. SAGES. https://www.sages.org/publications/patient-information/patient-information-for-laparoscopic-colon-resection-from-sages Accessed March 25, 2022.

3

American College of Surgeons. Surgical Patient Education. Colectomy: surgical removal of the colon. ACS. https://www.facs.org/-/media/files/education/patient-ed/colectomy.ashx  Accessed April 5, 2022.

4

Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Webmaster. Laparoscopic colon resection surgery patient information from SAGES. SAGES. https://www.sages.org/publications/patient-information/patient-information-for-laparoscopic-colon-resection-from-sages/. Updated March 1, 2015. Accessed Jan. 10, 2017. 

5

Fitch K, Engel T, Bochner A. Cost differences between open minimally invasive surgery. Manag Care. 2015;24(9):40-48.

6

Veldkamp R, Kuhry E, Hop WC, et al. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol. 2005;6(7):477-484.

7

Juo YY, Hyder O, Haider AH, Camp M, Lidor A, Ahuja N. Is minimally invasive colon resection better than traditional approaches?: First comprehensive national examination with propensity score matching. JAMA Surg. 2014;149(2):177-184.

8

Orcutt ST, Marshall CL, Robinson CN, et al. Minimally invasive surgery in colon cancer patients leads to improved short-term outcomes and excellent oncologic results. Am J Surg. 2011;202(5):528-531.

9

Steele SR, Brown TA, Rush RM, Martin MJ. Laparoscopic vs. open colectomy for colon cancer: results from a large nationwide population-based analysis. J Gastrointest Surg. 2008;12(3):583-591.

10

Odermatt M, Miskovic D, Siddiqi N, Khan J, Parvaiz A. Short- and long-term outcomes after laparoscopic versus open emergency resection for colon cancer: an observational propensity score-matched study. World J Surg. 2013;37(10):2458-2467.

11

Prakash K, Varma D, Rajan M, et al. Laparoscopic colonic resection for rectosigmoid colonic tumors: a retrospective analysis and comparison with open resection. Indian J Surg. 2010;72(4):318-322.

12

Chen K, Zhang Z, Zuo Y, Ren S. Comparison of the clinical outcomes of laparoscopic-assisted versus open surgery for colorectal cancer. Oncol Lett. 2014;7(4):1213-1218.

13

Hardy KM, Kwong J, Pitzul KB, et al. A cost comparison of laparoscopic and open colon surgery in a publicly funded academic institution. Surg Endosc. 2014;28(4):1213-1222.

14

Thompson BS, Coory MD, Gordon LG, Lumley JW. Cost savings for elective laparoscopic resection compared with open resection for colorectal cancer in a region of high uptake. Surg Endosc. 2014;28(5):1515-1521.

15

Marshall CL, Chen GJ, Robinson CN, et al. Establishment of a minimally invasive surgery program leads to decreased inpatient cost of care in veterans with colon cancer. Am J Surg. 2010;200(5):632-635. 

16

da Luz Moreira A, Kiran RP, Kirat HT, et al. Laparoscopic versus open colectomy for patients with American Society of Anesthesiology (ASA) classifications 3 and 4: the minimally invasive approach is associated with significantly quicker recovery and reduced costs. Surg Endosc. 2010;24(6):1280-1286.

17

Day AR, Smith RV, Jourdan IC, Rockall TA. Survival following laparoscopic and open colorectal surgery. Surg Endosc. 2013;27(7):2415-2421.

18

Kapritsou M, Korkolis DP, Konstantinou EA. Open or laparoscopic surgery for colorectal cancer: a retrospective comparative study. Gastroenterol Nurs. 2013;36(1):37-41.

19

Agarwal S, Gincherman M, Birnbaum E, Fleshman JW, Mutch M. Comparison of long-term follow up of laparoscopic versus open colectomy for transverse colon cancer. Proc (Bayl Univ Med Cent). 2015;28(3):296-299.

20

Surgical Procedures: Colectomy | OncoLink. www.oncolink.org. https://www.oncolink.org/cancers/gastrointestinal/colon-cancer/treatments/colectomy Accessed April 5, 2022.

21

American Cancer Society. Caring for a colostomy.  www.cancer.org.  Published October 16, 2019. https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/surgery/ostomies/colostomy/management.html Accessed April 5, 2022.

22

Colon and rectal cancer follow-up care expanded version | ASCRS. fascrs.org. https://fascrs.org/patients/diseases-and-conditions/a-z/colon-and-rectal-cancer-follow-up-care-expanded-ve. Accessed April 14, 2022.