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В зависимости от ситуации может быть удалён небольшой сегмент кишки (сегментарная резекция), её половина (гемиколэктомия) или даже вся толстая кишка (тотальная колэктомия) [1](https://mc21.ru/articles/rezektsiya-tolstoy-kishki/). Выбор объёма резекции определяет лечащий врач с учётом характера и распространённости заболевания, анатомических особенностей поражённых участков [1](https://mc21.ru/articles/rezektsiya-tolstoy-kishki/).\n\n\n\n## Показания\nОперация проводится при различных заболеваниях и состояниях толстой кишки, когда другие методы лечения неэффективны [1](https://mc21.ru/articles/rezektsiya-tolstoy-kishki/). Некоторые причины: \n* рак толстой кишки (если опухоль обнаружена на ранней стадии, резекция может быть единственным методом лечения) [1](https://mc21.ru/articles/rezektsiya-tolstoy-kishki/); \n* полипы толстой кишки, которые невозможно удалить эндоскопически [1](https://mc21.ru/articles/rezektsiya-tolstoy-kishki/); \n* воспалительные заболевания кишечника (неспецифический язвенный колит, болезнь Крона) [5](https://clinicnacpp.ru/centr-hirurgii/abdominalnaya-hirurgiya/rezektsiya-tolstoy-kishki/); \n* дивертикулёз с осложнениями [5](https://clinicnacpp.ru/centr-hirurgii/abdominalnaya-hirurgiya/rezektsiya-tolstoy-kishki/); \n* механическая кишечная непроходимость [5](https://clinicnacpp.ru/centr-hirurgii/abdominalnaya-hirurgiya/rezektsiya-tolstoy-kishki/). \n\nВ экстренном порядке операция проводится при перфорации, некрозе кишки или некупируемом кровотечении [5](https://clinicnacpp.ru/centr-hirurgii/abdominalnaya-hirurgiya/rezektsiya-tolstoy-kishki/).\n\n## Противопоказания\nНекоторые противопоказания к операции: \n* множественные отдалённые метастазы [7](https://www.yamed.ru/services/gastroenterologiya/gemikolektomiya/); \n* патологии крови [7](https://www.yamed.ru/services/gastroenterologiya/gemikolektomiya/); \n* воспаления и очаги инфекции, локализующиеся в брюшной стенке [7](https://www.yamed.ru/services/gastroenterologiya/gemikolektomiya/); \n* сопутствующие патологии на декомпенсированной стадии (сахарный диабет, сердечно-лёгочные патологии, печёночная и/или почечная недостаточности) [7](https://www.yamed.ru/services/gastroenterologiya/gemikolektomiya/).\n\n## Методика проведения\nСуществует два основных подхода к резекции [1](https://mc21.ru/articles/rezektsiya-tolstoy-kishki/): \n1. **Открытая операция** — хирург делает разрез на животе, чтобы получить прямой доступ к толстой кишке [1](https://mc21.ru/articles/rezektsiya-tolstoy-kishki/). \n2. **Лапароскопическая операция** — вместо большого разреза хирург делает несколько небольших разрезов (обычно от 0,5 до 1,5 см) на животе [1](https://mc21.ru/articles/rezektsiya-tolstoy-kishki/). Через них вводятся специальные инструменты, в том числе видеокамера, которая передаёт изображение на монитор [1](https://mc21.ru/articles/rezektsiya-tolstoy-kishki/). \n\nДлительность операции зависит от объёма резекции, сложности случая, выбранного метода и наличия осложнений [1](https://mc21.ru/articles/rezektsiya-tolstoy-kishki/). В среднем операция занимает от 2 до 4 часов [1](https://mc21.ru/articles/rezektsiya-tolstoy-kishki/).\n\n## Реабилитация\nПосле операции рекомендуется ранняя активация: если проведена лапароскопическая резекция, то пациент может вставать уже с конца первых суток, при лапаротомическом доступе — со вторых-третьих [12](https://www.smclinic.ru/professional-services/abdominalnaya-khirurgiya/rezektsiya-poperechnoy-obodochnoy-kishki/). Со вторых суток разрешено питание — еда должна быть жидкой комнатной температуры [12](https://www.smclinic.ru/professional-services/abdominalnaya-khirurgiya/rezektsiya-poperechnoy-obodochnoy-kishki/). \n\nДлительность госпитализации зависит от техники операции: при лапароскопии пациент в стационаре проводит 3–5 дней, а при лапаротомии — 10–15 дней [12](https://www.smclinic.ru/professional-services/abdominalnaya-khirurgiya/rezektsiya-poperechnoy-obodochnoy-kishki/). 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