Colectomy and proctocolectomy are major gastrointestinal surgical procedures performed to remove part or all of the colon, and in some cases, the rectum. These procedures are essential in the management of serious colonic and rectal diseases, including colorectal cancer, inflammatory bowel disease, and complex benign conditions that do not respond to medical treatment. With colorectal disorders on the rise in the UAE, these surgeries play a critical role in life-saving and life-improving care.

A colectomy involves removal of a portion of the colon, while a proctocolectomy involves removal of both the colon and rectum. The extent of surgery depends on the underlying disease, its location, and severity. Whenever possible, surgeons aim to preserve bowel continuity by reconnecting healthy segments of the intestine. In some cases, a temporary or permanent stoma (ileostomy or colostomy) may be required to allow safe healing or manage disease effectively.

These procedures are most commonly indicated in colorectal cancer, where surgical removal of the tumor offers the best chance of cure when disease is localized. They are also indicated in ulcerative colitis and Crohn’s disease when medical therapy fails or complications such as bleeding, perforation, or cancer risk arise. Other indications include diverticular disease with complications, familial polyposis syndromes, ischemic colitis, and traumatic injury.

Preoperative evaluation is comprehensive and includes colonoscopy, biopsy, CT or MRI imaging, and laboratory testing. In cancer cases, staging investigations and multidisciplinary tumor board discussions are essential to guide treatment planning. Nutritional assessment and optimization are also important, particularly in patients with chronic inflammatory conditions.

Colectomy and proctocolectomy are performed under general anesthesia and may be carried out using open, laparoscopic, or robotic-assisted techniques. Minimally invasive approaches are increasingly preferred due to reduced postoperative pain, faster recovery, shorter hospital stays, and improved cosmetic outcomes. Open surgery remains necessary in advanced disease, emergency settings, or complex anatomical situations.

Postoperative care focuses on pain management, early mobilization, gradual return of bowel function, and monitoring for complications such as infection or leakage at the surgical connection. Patients with stomas receive specialized education and support to adapt confidently to postoperative life. Long-term follow-up ensures optimal bowel function, nutritional balance, and cancer surveillance when applicable.

Colectomy and proctocolectomy offer definitive treatment for serious colorectal conditions. When performed by experienced GI surgeons within a multidisciplinary framework, these procedures deliver excellent clinical outcomes, restore digestive health, and significantly improve long-term survival and quality of life.