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Colectomy

Colectomy is a surgical procedure that involves the partial or complete removal of the colon, also known as the large intestine.
This operation may be necessary to treat various conditions, such as colorectal cancer, inflammatory bowel diseases, diverticular disease, or chronic constipation.
During a colectomy, the diseased or damaged portion of the colon is excised, and the remaining healthy segments are reconnected.
Depending on the extent of the procedure, the surgeon may create a temporary or permanent stoma, which is an opening in the abdomen that allows waste to be eliminated.
Colectomy can be performed using open, laparoscopic, or robotic surgical techniques.
The recovery time and potential complications vary depending on the individual patient's health status and the complexity of the procedure.
Careful pre-operaative planning and postoperative care are essential to ensure the best possible outcomes for patients undergoing colectomy.

Most cited protocols related to «Colectomy»

The Clinformatics™ Data Mart captures administrative health claims across the United States for members of a large national managed care company affiliated with OptumInsight (Eden Prairie, MN). We examined claims from January 1, 2012 to June 30, 2015 among adults ages 18 to 64 to capture surgical procedures performed between 2013 and 2014 to account for the 12-month preoperative and 6-month postoperative study period. We included only individuals with continuous medical and prescription drug coverage to evaluate the complete health care experience. We excluded patients ages 18 and younger, as well as patients older than 64 years due to incomplete capture of Medicare Part D prescriptions claims data. The study was deemed exempt from review by the University of Michigan Institutional Review Board.
We selected 13 common elective surgical procedures, and categorized these into minor and major groups based on prior literature. Minor surgical procedures included varicose vein removal, laparoscopic cholecystectomy, laparoscopic appendectomy, hemorrhoidectomy, thyroidectomy, transurethral prostate surgeries, and parathyroidectomy. Major surgical procedures included ventral incisional hernia repair, colectomy, reflux surgery, bariatric surgery, and hysterectomy. We identified patients undergoing surgery using Current Procedural Terminology (CPT) or International Statistical Classification of Diseases and Related Health Problems (ICD9_ procedure codes (Supplemental Table 1).
We sought to determine new persistent opioid use after surgery, and included only patients who filled an opioid prescription fill either in the month prior to surgery or within two weeks after discharge. Comparable to previous studies of opioid naïve surgical populations,7 (link),8 patients who had filled one or more prescriptions for opioids 12 months to 31 days prior to their surgical procedure were excluded from the analysis (Figure 1). To account for prescriptions provided preoperatively for postoperative pain control, patients filling opioids in the 30 days prior to surgery were included, and prescriptions filled in this time was included as a covariate in the analyses. Lastly, we excluded patients who underwent additional surgical procedures during the study period using subsequent procedural codes for anesthesia in the 6-month postoperative period.
As a comparison cohort of patients who did not undergo surgery, we identified a random 10% sample patients ages 18 to 64 years of age who did not undergo surgery in the study period We included only patients in the nonoperative group who did not fill an opioid prescription during a 12 month period and did not have any codes for surgical procedures or anesthesia during this period. These patients were then given a random date of surgery. No patients had an opioid fill in the year prior to their fictitious surgery date nor did they have any anesthesia codes in the 6 months following their fictitious surgery date.
Publication 2017
Adult AN 12 Anesthesia Appendectomy Bariatric Surgery Cholecystectomy, Laparoscopic Colectomy Elective Surgical Procedures Ethics Committees, Research Hemorrhoidectomy Herniorrhaphy Hysterectomy Laparoscopy Managed Care Minor Surgical Procedures Operative Surgical Procedures Opioids Pain, Postoperative Parathyroidectomy Patient Discharge Patients Prescription Drugs Prostate Surgery, Day Thyroidectomy Varices Youth
Over the 6‑month period covering April 2010 to September 2010, all patients admitted to one of our patient wards at the Division of General Surgery, Department of Surgery, Medical University of Vienna were included in this study.
The Division of General Surgery in our university hospital consists of the following teams and specializations: colorectal surgery, hepatobiliary surgery, endocrine surgery, upper gastrointestinal (GI) surgery (esophageal and stomach surgery), bariatric surgery, breast surgery, and pancreatic surgery.
The patient data were extracted by reviewing all discharge letters from that period taken from the digital archives.
Overall, 517 patients were admitted over this period, some repeatedly, leading to a total of 817 admissions. These 517 patients underwent 463 operations. The complications of these operations were then rated according to the Clavien-Dindo classification (Table 1). For easier use, the suffix “d” for permanent disability was not drawn upon.

Clavien-Dindo classification

GradeDefinition
Grade IAny deviation from the normal postoperative course without the need for pharmacological treatment, or surgical, endoscopic, and radiological interventions.Allowed therapeutic regimens are: drugs as antiemetics, antipyretics, analgetics, diuretics and electrolytes, and physiotherapy. This grade also includes wound infections opened at the bedside
Grade IIRequiring pharmacological treatment with drugs other than such allowed for grade I complications.Blood transfusions and total parenteral nutrition are also included
Grade IIIRequiring surgical, endoscopic, or radiological intervention
Grade IIIaIntervention not under general anesthesia
Grade IIIbIntervention under general anesthesia
Grade IVLife-threatening complication (including central nervous system complications) requiring IC/ICU management
Grade IVaSingle organ dysfunction (including dialysis)
Grade IVbMultiorgan dysfunction
Grade VDeath of a patient

According to Dindo et al. [6 (link)]

IC intermediate care, ICU intensive care unit

The operations were sorted according to the complexity ranking (eight groups) in the accounting system of the Austrian Chamber of Physicians (Table 2; [8 ]).

Operation groups (complexity according to the Austrian Chamber of Physicians)

Operation groupExamples
IAbscess incisions, secondary sutures, proctoscopy, skin biopsy
IIExcisions of atheromas, fibromas, lipomas, incisions of anal abscesses
IIIToe amputation, small lymph node extirpation, thoracic drainage, colonoscopy
IVTracheotomy, appendectomy, hernia operation, colostomy, gastrostomy, ERCP
VGastroenterostomy, interventions for recurrent hernia, Cimino fistula, radical varicose vein stripping
VIStrumectomy, cholecystectomy, splenectomy, hemicolectomy, reduction mammoplasty
VIIPartial pancreatectomy, subtotal colectomy, subsegmental and large liver resections
VIIIEsophageal resection, open surgery of aortic aneurysms, organ transplantation
Publication 2018
Amputation Antiemetics Antipyretics Anus Aortic Aneurysm Appendectomy Atheroma Bariatric Surgery Blood Transfusion Central Nervous System Cholecystectomy Colectomy Colostomy Dialysis Disabled Persons Diuretics Drainage Electrolytes Endocrine Surgical Procedures Fibroma Fingers Fistula Gastrointestinal Surgical Procedure Gastrostomy Hemicolectomy Hepatectomy Hernia Intensive Care Lipoma Lymph Node Excision Operative Surgical Procedures Organ Transplantation Pancreas Pancreatectomy Parenteral Nutrition, Total Patient Discharge Patients Pharmaceutical Preparations Pharmacotherapy Physicians Proctoscopy Skin Splenectomy Stomach Surgical Endoscopy Surgical Wound Sutures Therapeutics Therapy, Physical Thoracic Surgical Procedures Treatment Protocols Upper Gastrointestinal Tract Varices Wound Infection X-Rays, Diagnostic

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Publication 2013
Colectomy Colon Grafts Inpatient Laparoscopy Operative Surgical Procedures Outpatients Pancreatectomy Patient Discharge Patients Surgeons Wounds and Injuries
The SAGES study is an ongoing prospective cohort study of older adults
undergoing elective major non-cardiac surgery. The study design and methods have
been described previously.13 (link)Briefly, eligible participants were age 70 years and older, English speaking,
scheduled to undergo elective surgery at one of two Harvard-affiliated academic
medical centers and with an anticipated length of stay of at least 3 days.
Eligible surgical procedures were: total hip or knee replacement, lumbar,
cervical, or sacral laminectomy, lower extremity arterial bypass surgery, open
abdominal aortic aneurysm repair, and colectomy. Exclusion criteria included
evidence of dementia, delirium, hospitalization within 3 months, terminal
condition, legal blindness, severe deafness, history of schizophrenia or
psychosis, and history of alcohol abuse. A total of 566 patients were enrolled
between June 18, 2010 and August 8, 2013. Written informed consent was obtained
from all participants according to procedures approved by the institutional
review boards of Beth Israel Deaconess Medical Center and Brigham and Women's
Hospital, the two study hospitals, and Hebrew SeniorLife, the study coordinating
center, all located in Boston, Massachusetts.
Publication 2015
Abuse, Alcohol Aortic Aneurysm Arteries Blindness, Legal Colectomy Delirium Elective Surgical Procedures Hospitalization Knee Replacement Arthroplasty Laminectomy Lower Extremity Lumbar Region Neck Operative Surgical Procedures Patients Presenile Dementia Sacrum Schizophrenia Surgical Procedure, Cardiac
This paper presents a series of normative data for overall QOL LASA scale (Additional file 1) drawn from different populations ranging from healthy volunteers to hospice patients. In total, baseline QOL LASA data from 36 clinical trials and 6 observational studies are included (Table 1). The reference indicated for each study was either a published manuscript, a protocol, an abstract or unpublished dataset as indicated. Healthy NCCTG volunteers (54) provided LASA data via a survey at a semi-annual meeting. Mayo physician and residents data is drawn from a survey. Please refer to Additional file 2 for the details about where each sample was obtained.

Data sources, population type, summary statistics for overall QOL

Patient categoryNMeanMedianMinimumMaximumStandard deviation
Advanced cancer1207.268.100.209.702.31
Brain cancer266.467.002.009.001.88
Breast cancer2967.778.201.4010.001.84
Lung cancer11557.257.800.0010.002.10
Colon cancer −2 Wks Post Surgery (Colectomy)3887.578.001.5010.001.80
Colon cancer-Pre Surgery (Colectomy)4038.068.502.0010.001.75
GI cancer24097.748.300.0010.001.86
GU cancer1808.299.002.4010.001.61
Gynecologic cancer1177.838.201.8010.001.75
Head and neck cancer2547.247.800.0010.002.27
Hematologic cancer327.337.701.709.302.03
Lymphatic cancer87.218.453.209.202.51
Multiple site cancer148.028.006.0010.001.56
Musculoskeletal site cancer186.687.551.8010.002.78
Neurologic cancer2147.428.001.0010.001.90
Other cancer527.918.801.0010.002.34
Lung cancer- Mayo study5297.037.000.0010.002.18
Lung cancer - Mayo study 6 months post diagnosis14097.057.600.0010.002.40
Skin cancer77.597.905.909.401.17
Unknown site cancer296.607.002.1010.002.25
Healthy NCCTG volunteers548.319.005.0010.001.19
Hospice caregivers537.447.503.7510.001.74
Hospice525.895.752.009.752.03
Minnesota medical students5437.167.001.0010.001.76
Mayo physicians4607.307.001.0010.001.69
Mayo residents2956.467.001.0010.001.91

GI, gastroenterological; GU, genitourinary; NCCTG, North central chapter treatment group.

Distributions for the various cohorts of Table 1 are displayed in Figures 2 and 3.

Simple summary statistics (means, standard deviations) are the primary analytical tool for this work. Correlation between the LASA and other measures/demographics was accomplished via correlation coefficients. We compared LASA scores across subpopulations by Fisher’s exact tests for categorical variables and Kruskal-Wallis testing for continuous variables.
Publication 2014
Cancer of Neck Colectomy Healthy Volunteers Hospice Care lipid-associated sialic acid Malignant Neoplasms Operative Surgical Procedures Patients Physicians Population Group System, Genitourinary

Most recents protocols related to «Colectomy»

In all centres, patients undergoing FMT treatment were registered prospectively. Data about IBD outcome and long-term follow-up were in part collected retrospectively (Supplemental Figure 1).
Data collection was performed by each centre using files of the FMT services and hospital records for the patients. If possible, patients were contacted directly. The following baseline characteristics were collected: age, gender, and the use of PPIs. The following data about the CDI were collected: number of episodes; diagnostics by polymerase chain reaction or toxin enzyme immunoassay; and information about previous treatment with metronidazole, vancomycin, fidaxomicin, or bezlotoxumab. Severe CDI was defined as leukocytes ⩾15 × 109/L and/or a 50% increase in creatinine at baseline.17 (link) FMT data included the pre-treatment regimen (antibiotics, bowel lavage), total number of FMTs needed per patient, the route of administration of FMT, and the total amount of faeces (grams) used for preparation of the suspensions or capsules that were administered per patient. Data about clinical recurrence and microbiological testing for CDI after FMT were collected at 8–12 weeks after FMT. Long-term follow-up data of CDI recurrence were included if available.
For IBD, information was collected about the diagnosis according to the Montreal classification and the disease duration. Previous and current IBD medication at the moment of FMT and the use of immunosuppressive medication (including corticosteroids and budesonide, immunomodulators and biologicals) was assessed. Both at baseline and 8 weeks after FMT, the presence of an IBD flare was based on information from the treating physician and/or endoscopic scores. In case of a concomitant flare, remission-induction therapy was defined as the use of prednisolone or budesonide at the moment of FMT, or recently initiated antitumor necrosis factor (TNF) treatment (⩽2 months before FMT). Also haemoglobin (mmol/l) and C-reactive protein (mg/l) in the blood and the calprotectin (µg/g) in the faeces were collected at baseline and after 8 weeks.
The long-term follow-up period per patient was calculated from the date of FMT up to 31 December 2020. Long-term follow-up data included information about possibly occurring events and if yes, the number of days after FMT it occurred. Possible occurring events, collected via patient recall or from hospital records, were as follows: a recurrence of CDI, the development of an IBD flare, general infection and antibiotic use, hospital admission, colectomy, and occurrence of death.
Publication 2023
Adrenal Cortex Hormones Antibiotics bezlotoxumab Biological Factors BLOOD Budesonide Capsule Colectomy C Reactive Protein Creatinine Diagnosis Endoscopy Enzyme Immunoassay Feces Fidaxomicin Gender Hemoglobin Immunologic Adjuvants Immunosuppressive Agents Intestines Leukocyte L1 Antigen Complex Leukocytes Mental Recall Metronidazole Necrosis Neoadjuvant Therapy Patients Pharmaceutical Preparations Physicians Polymerase Chain Reaction Prednisolone Prepulse Inhibition Recurrence Remission Induction Sepsis Toxins, Biological Treatment Protocols Vancomycin
A Markov model (Appendix 2) was constructed to estimate the long-term cost-effectiveness of infliximab versus ciclosporin beyond the trial follow-up period. The cohort of UC patients entered into the Markov model after completing first 2 years in DT. The model had a time cycle of one year, and forecasted the impact of long-term probability of colectomy on costs and QALYs over 18-year time horizon. The model assumed that those patients who attained remission from any of two trial drugs could remain in the remission state for the whole analysis period or lose response and undergo for colectomy, and after surgery they achieve surgical remission or can die. It was assumed that post-colectomy complications occur immediately after the surgery in the same cycle as surgery, and after treatment for complications they recover in the following cycle, achieve surgical remissions or can die.
A total of 56% UC patients in the trial were without a colectomy at the last follow-up, and the number (%) of colectomies in trial patients at different follow-up time points is shown in Appendix 3. We estimated a Weibull regression [27 ] to estimate time-to-colectomy data over 2 years follow-up period (only one patient had a colectomy after 2 years FU), with age-at-randomisation and weight as covariates. The Weibull scale (lambda) and shape (gamma) parameter estimates were linked to extrapolate time-dependent transition probabilities of colectomy over 18-year time horizon [28 ]. For comparisons, we also estimated a number of other regressions e.g. Gompertz, exponential, log-logistic to estimate time-to-colectomy data, and compared performance of these models using AIC (Akaike Information Criterion) and BIC (Bayesian Information Criterion) values.
There was no reported mortality in one of the treatment arms of the CONSTRUCT trial. The study accounted for the impact of within-trial mortality in the cost-effectiveness DT model. For long-term modelling in the Markov model, the study considered 3-year mortality data from a published observational study conducted in England for ulcerative colitis and Crohn’s patients during 1998–2003 [29 (link)]. Following clinical experts’ opinion, our study only considered mortality for ‘emergency colectomy’ and ‘no colectomy’, excluded mortality for ‘elective colectomy’ patients from the observational study. The 3-year mortality rate was then converted into a yearly rate to be used in the Markov model, following appropriate steps mentioned in Briggs et al. [28 ]. Apart from the health state mortality rates, other parameter values used to run the Markov model are based on data from the CONSTRUC trial.
Publication 2023
Aftercare Arm, Upper Colectomy Crohn Disease Cyclosporins Emergencies Gamma Rays Infliximab Operative Surgical Procedures Patients Pharmaceutical Preparations Ulcerative Colitis
We also investigated the impact of a fixed-transition probability of colectomy in Markov model. In the trial, colectomy rates were very low in both groups beyond 2 years follow-up. So, we considered colectomies that occurred during 4–24 months period, converted these rates into a yearly probability following steps mentioned in Briggs et al. [28 ] and applied this as a fixed-transition probability of colectomy in the Markov model. A separate fixed transition probability of colectomy was considered for both infliximab and ciclosporin treatment groups.
Publication 2023
Colectomy Cyclosporins Infliximab
The decision models are based on healthcare services use and costs captured in the CONSTRUCT trial. NHS resource use were collected from case report forms (CRFs) and participant follow-up questionnaires (PFQs) completed at each follow-up time points, supplemented by post-colectomy questionnaire, SAE forms and relevant data provided by participating sites. The costs of all healthcare services use were estimated using standard NHS Pay and Price index. These included trial drugs, their preparation and administration costs, NHS contacts, consultant (clinic visit, telephone call, dietician), primary care general practitioner (at practice, home visit, telephone call), health visitor, nurse specialist, tests and investigations, hospitalizations (with and without surgery), readmissions, etc. Details on NHS resource uses, how these were captured and their costs (in 2012–13 prices in Great Britain Pound (GBP) sterling) were reported in the CONSTRUCT main report [22 ] hence not repeated in the manuscript, however, in this study an adjustment was made by using consumer price index (CPI) to inflate these costs to the year 2019 [31 (link)]. The unit costs of the two trial drugs are given in Appendix 5.
Publication 2023
Clinic Visits Colectomy Consultant Dietitian Health Visitors Hospitalization Nurse Specialists Operative Surgical Procedures Pharmaceutical Preparations Primary Health Care
Given the acute phase of the disease, a decision analytical (decision tree) model was developed and adapted from Punekar and Hawkins [20 (link)] to simulate the progression of a cohort of steroid-resistant severe UC patients receiving infliximab or ciclosporin. The associated costs and outcomes were tracked over 2-year time horizon to capture medium-term colectomy risks as observed in clinical studies. Treatment outcomes in the DT model were characterised into three time periods: 0–3 months, 4–12 months and 13–24 months. The model was built using Microsoft Excel, where treatment options and patient pathways are depicted in Appendix 1.
Following treatments with infliximab or ciclosporin, ASUC patients either achieved remission, or failed treatment and underwent colectomy. It was assumed that if treatments failed, patients underwent a colectomy [19 , 20 (link)].
Publication 2023
Acute Disease Colectomy Cyclosporins Disease Progression Infliximab Patients Steroids

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More about "Colectomy"

Colectomy is a surgical procedure that involves the partial or complete removal of the colon, also known as the large intestine.
This operation may be necessary to treat various conditions, such as colorectal cancer, inflammatory bowel diseases (IBD), diverticular disease, or chronic constipation.
During a colectomy, the diseased or damaged portion of the colon is excised, and the remaining healthy segments are reconnected.
Depending on the extent of the procedure, the surgeon may create a temporary or permanent stoma, which is an opening in the abdomen that allows waste to be eliminated.
Colectomy can be performed using open, laparoscopic, or robotic surgical techniques.
The recovery time and potential complications vary depending on the individual patient's health status and the complexity of the procedure.
Careful pre-operative planning and postoperative care are essential to ensure the best possible outcomes for patients undergoing colectomy.
Colectomy is a procedure that may be recommended for individuals with conditions affecting the large intestine, such as colorectal cancer, inflammatory bowel diseases (e.g., ulcerative colitis, Crohn's disease), diverticular disease, or chronic constipation.
The surgery involves the partial or complete removal of the colon, with the remaining healthy segments being reconnected.
Depending on the extent of the procedure, a temporary or permanent stoma may be created to allow for waste elimination.
Various surgical techniques can be employed for colectomy, including open, laparoscopic, and robotic-assisted approaches.
The choice of technique often depends on the specific patient's condition, the surgeon's expertise, and the available resources.
Recovery time and potential complications can vary, so careful pre-operative planning and postoperative care are crucial to optimize outcomes.
Researchers studying colectomy may utilize a range of tools and techniques, such as SAS version 9.4, Stata version 14, RNAlater, DNeasy Blood & Tissue Kit, SAS Enterprise Guide, Caco-2 cell lines, SPSS Statistics for Windows, Version 20.0, and SPSS Statistics.
These tools can assist in data analysis, sample preparation, and other aspects of colectomy research.
Additionally, the HT-29 cell line, a human colorectal adenocarcinoma cell line, may be used in colectomy-related studies.
By understanding the insights gained from the MeSH term description and the provided metadescription, researchers and healthcare professionals can better navigate the complexities of colectomy and optimize their research, clinical practice, and patient outcomes.