What Is Total Colectomy and Ileoanal Reservoir?

Medically Reviewed on 1/9/2023
Total Colectomy and Ileoanal Reservoir
Most people report an improvement in their quality of life after total colectomy and ileoanal reservoir.

Total colectomy is the complete surgical removal of the colon. Colectomy is used when medications cannot treat colon disease.

Ileoanal reservoir or anastomosis is a surgical procedure to eliminate waste after completely removing the large intestine (colon and rectum) and protecting the anal sphincter. These procedures help treat conditions, such as ulcerative colitis and familial polyposis that increase the high risk of colon and rectal cancers.

How are total colectomy and ileoanal reservoirs done?

The total colectomy and ileoanal reservoirs are performed under general anesthesia in two steps.

  1. The surgeon first makes three to five small cuts (incisions) in the abdomen before removing the large intestine. Then, the surgeon removes the rectum, leaving the anal sphincter and anus in place. (Anal sphincter is a muscle that helps open the anus during a bowel movement.)
  2. The surgeon will sew a pouch from the last 12 inches of the small intestine to the anus.

Some surgeons may use a laparoscope to perform the surgery. It requires minimal surgical cuts, which has advantages, such as faster recovery and less pain. A laparoscope is a camera-aided surgical procedure.

What are the risks of anesthesia and total colectomy and ileoanal reservoirs?

The risks of anesthesia and surgery include:

  • Reaction to the medicines
  • Breathing problems
  • Blood clots
  • Infection
  • Incisional hernia at the site where surgical cuts are made
  • Damage to nearby organs and the nerves in the abdomen
  • Infections or abscesses that could be life-threatening sometimes

What precautions to take before and after total colectomy and ileoanal reservoirs?

Before surgery

  • Two weeks before the surgery, stopping a few medications, such as blood thinners, is recommended.
  • To stop smoking before the surgery, take your doctor’s help.
  • Inform your doctor about cold, flu or herpes break out, or any illness before the surgery.
  • One day before surgery, you could be asked to stay on fluids. Enemas and laxatives are used to clear the intestines.

After surgery

You may have to stay in the hospital for five to seven days after surgery.

  • From the second day, you may be able to drink clear liquids, once the bowel starts functioning. You may have thicker fluids and a soft diet later with more recovery.
  • A bland diet, dairy, and cooked vegetables should be included to avoid ulcers, nausea, vomiting, gastroesophageal reflux disease, and heartburn.

Most children and adults report an improvement in their quality of life. Incontinence affects older people; they may need to use the bathroom more frequently, especially at night. Most people have four to six bowel movements per day and one at night on average.


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Medically Reviewed on 1/9/2023
Image Source: iStock image

Total proctocolectomy and ileal-anal pouch. https://medlineplus.gov/ency/article/007380.htm

Caring for an Ileostomy. https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/surgery/ostomies/ileostomy/management.html

Total colectomy, mucosal proctectomy, and ileoanal anastomosis. https://pubmed.ncbi.nlm.nih.gov/6777128/