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Resection Surgery for Crohn's Disease

Resection Surgery Is A Common Treatment For Crohn's Disease

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Updated September 14, 2013

Resection Surgery

During a resection, diseased bowel tissue is removed, and healthy tissue is reattached.

Image © A.D.A.M.

When medications prove to be ineffective in managing the symptoms of Crohn's disease (a type of inflammatory bowel disease), a gastroenterologist may recommend surgery. The most common form of surgery used to treat Crohn's disease is called a resection.

During a resection, the diseased portion of the large intestine or the small intestine is removed, and the intestine is reattached together using the two healthy ends. Resections are typically performed by a colorectal surgeon, a type of surgeon who has special training in surgery done on the lower digestive tract.

Why Resection Surgery?

Resection surgery may be used to remove strictures, which could include one long stricture or a group of strictures that are close to one another, or it may be used to remove severely diseased portions of the small or large intestine. The goal of a resection is to keep as much of the healthy bowel as possible and to only remove portions of the bowel that are beyond healing. In particular, removing large segments of the small intestine is avoided. The small intestine is where vitamins and minerals are absorbed into the body, and if too much of it is removed, it could lead to nutritional deficiencies. In extreme cases, removing too much small intestine can lead to short bowel syndrome.

Is Resection Surgery Used For Ulcerative Colitis?

Partial resection of the colon is not typically used to treat ulcerative colitis. This is because the colitis tends to return in the healthy section of the colon that is left. A total colectomy, with or without the creation of an internal pouch (a j-pouch), is the surgery most often used to treat ulcerative colitis.

How Is A Resection Done?

During a resection, general anesthesia is used to manage pain. The surgery may be done either through open surgery or laparoscopic surgery, but open surgery is far more common. Laparoscopic surgery is typically used only in cases where the diseased section of intestine is located in the ileum, and there are no other complications.

In open surgery, one large incision will be made. The diseased section of the bowel is clamped off and removed. After the diseased portion of the intestine is removed, the two healthy ends of intestine are attached together (called anastomosis).

In laparoscopic surgery, 3 to 4 small incisions are used. The abdomen is filled with gas so the surgeon can better see the abdominal cavity and a camera is inserted through one of the incisions. The rest of the procedure is the same as in open surgery: the diseased bowel is removed and the healthy tissue is reattached.

How Long Is The Recovery Period?

The hospital stay for an open surgery with no complications can be anywhere from 5 to 10 days. For laparoscopic surgery, the hospital stay tends to be shorter.

Recovery from resection surgery can take from 6 to 8 weeks. Returning to work after surgery is a very individual decision, but it generally will be 4 weeks or more after the surgery. Your surgeon will advise you of what activities you can undertake, but in general, heavy lifting, driving, and other strenuous activities should not be undertaken for several weeks after surgery.

What Are The Potential Complications?

Potential complications include those that can occur with any surgery: infection, bleeding, or reaction to the anesthetic. With a resection, there is also a risk that the two sections of joined intestine may split apart or leak (called dehiscence).

Sources:

ADAM Illustrated Health Encyclopedia. "Crohn's Disease: Inflammatory Bowel Disease." MedLine Oct 29 2012. 13 Sept 2013.

Crohn’s and Colitis Foundation of America. "Surgery for Crohn's Disease." Crohn’s and Colitis Foundation of America. March 2006. CCFA.org 13 Sept 2013.

Tilney HS, Constantinides VA, Heriot AG, Nicolaou M, Athanasiou T, Ziprin P, Darzi AW, Tekkis PP. "Comparison of laparoscopic and open ileocecal resection for Crohn's disease: a metaanalysis." Surg Endosc. 2006 Jul;20:1036-1044. Epub 2006 May 17. 13 Sept 2013.

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