Ukuqonda iingozi zeSleeve Gastrectomy
Inkqubo yomtya wesisu, owaziwa nangokuthi i-sleeve gastrectomy, utyando oluye linciphisa ubukhulu besisu ukuba lukhuthaze ukulahleka kwesisindo. Phantse iipesenti ezingama-80 zesisu zisuswe ngokugqithiseleyo, zishiye isahluko esifana nesisu seesisu, kwaye sisuse abanye ngokusisigxina. Isisu esiseleyo singabamba ii-ounces ezi-4 okanye i-120 milliliters, ukwehla okukhulu ukusuka kwisayizi esiqhelekileyo yesisu.
Ukwehla okuphawulekayo kwisayizi esiswini kuthetha ukuba umntu unokutya kuphela isigxube indebe ngexesha, kwaye uvimba umthamo wokutya onokudliwa, okuye okunciphisa iikhalori ezinokuthi zithathwe, okukhokelela ekulahlekeni kwesisindo.
Nangona ukwehla kwesisu, isifo sisixhobo kwaye kufuneka ukuba umntu alandele imiyalelo yokukhutshwa, anciphise ukutya, aze alandele isicwangciso esinikezwe ngugqirha. Kunokwenzeka ukutya ngokutya kunye nokulahlekelwa kwesisindo emva kokuhlinzwa. Kwakhona kunokwenzeka ukuba ube neengxaki ezinzulu emva kokuhlinzwa, ngoko inkqubo kufuneka ithathwe ngokungathí sina, njengawuphi na utyando.
Iingxaki zexesha elide leSastve Sleeve
Kukho iintlobo ezimbini zeengxaki ze-gastric sleeve operation: i-acute kwaye ingapheliyo. Iingxaki ezintle ziza kwenzeka emva nje kokuhlinzwa kunye nemiba engapheliyo ivela okanye iqhubeka inyanga ezintandathu emva komhla wokuhlinzwa. Iingxaki ezinzima ziquka ukuphuma kwegazi, intlungu, kunye negazi.
Umtya wesisu, ngokubanzi, uthathwa njengekhuselekile xa kuthelekiswa nezinye iindlela zokuhlinzwa. Ukufa kwale nkqubo kunqabile, kwaye xa kuqhutywe ngugqirha onogunyazi, inqubo inezinkinga ezincinci. Oko kwathiwa, iingxaki, xa zenzeke, zinokuvela kwiintshukumo ezincinci ukuya kwimibandela ebalulekileyo kunye neyobomi.
Kwakhona kubalulekile ukuqaphela ukuba lo uphando olutsha. Enye yemigangatho ebalulekileyo eyenziwa uphando lwezenzululwazi yimiphumo yeminyaka eyi-10. Kule meko, loo ngcaciso malunga nendlela izigulane zigcina ngayo ukulahleka kwesisindo, ukuba yintoni impilo yabo yonke ibukeka ngayo, kunye naziphi na iingxaki ezinokuba nazo ngenxa yokuhlinzwa. Ukuba yinkqubo entsha, kukho idatha engaphantsi kweminyaka eyi-10 kunokuba kukho olunye uphando, olufana neRoux En Y, kunye neengxaki ezingaphezulu kwexesha elide zingongezwa kuloluhlu kwixesha elizayo.
Ukungaphumeleli kokuqala ukulahlekelwa yile : Le ngxaki enkulu apho utyando olungenakukwazi ukulahleka kwesisindo. Ingxowa ingase ibe mkhulu kakhulu, isigulane sinokuthi siyayihoxisa imiyalelo yokukhutshwa, okanye omnye umba unokuba khona owenza ukuba ukulahleka kwesisindo kungabikho.
Ukunyamezela kokutya: Enye yeenzuzo zale nkqubo kukuba zonke ukutya zingadliwa emva kwenkqubo, ngelixa ezinye iindlela zokuhlinzwa ezifunayo zifuna ukuba ugweme ukutya okuthe ngqo. Oko akuthethi ukuba umzimba uya kukunyamezela zonke iintlobo zokutya, oko kuthetha ukuba akukho ukutya okuvunyelwe emva kwenkqubo.
Ukuhluthwa kweSleeve: Kwiintsuku zokuqala emva kokuhlinzwa, isikhwama sesisu esihlala sisincinci kwaye siya kubamba malunga nesigamu indebe yokutya ngexesha elinye.
Ngethuba lexesha, isikhwama sophula kwaye sikwazi ukufumana inani elikhulu lokutya ngexesha elilodwa. Oku kuvumela ukutya okugqithiseleyo ukuba kudliwe kwaye ekugqibeleni kunokukhokelela ekulahlekeni kwesisindo okanye ukufumana ubunzima bokuqala.
I-Dyspepsia: I- Indigestion, okanye isisu esisiphazamisayo, sinokuqhubeka rhoqo emva kokutyunjwa kweminwe yesisu.
Ukutshintshela izidakamizwa: Le nto ibonakalayo nabanye abantu xa bengasakwazi ukusebenzisa ukutya njengendlela yokuzikhupha iimvakalelo zabo. Ngokomzekelo, emva komsebenzi onzima emsebenzini, akunakwenzeka ukuba uye ekhaya kwaye utywala kwisitya sonke se-ice cream, asiyi kufumana kwisisu.
Ezinye iintlobo zezilwalathiso ziya kuba zikhangele ngakumbi njengoko zisenokwenzeka ngokusetyenziswa kakubi kweesisu-ukusetyenziswa kakubi kotywala, ukusetyenziswa kakubi kweziyobisi, kunye nokuxhatshazwa ngokwesondo phakathi kweyona nto ixhaphakileyo emva kokuhlinzwa.
Ukwahlukana: Nangona kungengona yinkinga emva kokuhlinzwa, ngokuqhawula umtshato ngokuqinisekileyo kuyinkxalabo enokuthi ithathelwe ingqalelo. EUnited States, umyinge wama-50 ekhulwini yemitshato iphele ngokuqhawula umtshato, ngelixa ezinye iindawo zibonisa ukuba izinga lomtshato emva kokuhlinzwa ngokugqithisileyo liphezulu kuma-80 ekhulwini.
I-Gastroesophageal Reflux Disease (GERD): Ukubhukuda, kunye nezinye iimpawu zesifo se-reflux esiswini esichaphayo esibandakanya ukubhubhisa, isicathulo, isisu, isisu esivuthayo, esivamile emva kokuhlinzwa kwaye kaninzi kufuna iyeza.
Isithintelo sesisu : Ukuqhekeka nokunciphisa ukuphuma kwesisu, kwaziwa ngokuba yi-stenosis, kunokukwenza kube nzima okanye akunakwenzeka ukugaya ukutya. Le nkcenkcesho yinto eqhelekileyo yugqirha ogqirhayo "owelula" okanye ulungelelanisa ummandla oye wanciphisa.
I-Absess: I-abscess yinto yokuqokelela izinto ezichaphazelekayo (i-pus) ezifomini emzimbeni kwindawo efana ne-pocket. Kule meko yokutyunjwa kwempahla yesisu, iimbumba zifunyenwe ngepeni, ezinye zifuna ukuba ishentshi isuswe, kodwa ezi zinto ziqabile.
Ukuphelelwa kwexesha elidlulileyo: Uninzi lwe-suture umgca wokuvuza, owaziwa nangokuthi ukuphazamiseka komgca we-suture okanye i-SLD, kufumaneka kungekudala emva kokuhlinzwa. Kwezinye iimeko indawo yesisu eyayitywitshwe kunye iya kuqala ukuphazamisa inyanga okanye kwiminyaka emva kokuhlinzwa. Ezi zivuza emva koko zihamba ngokugqithiseleyo kunezo zifunyenwe emva nje kokuhlinzwa kodwa zinokuxhatshazwa ngokulinganayo kwaye zingadinga unyango, ukulaliswa esibhedlele, okanye ukuhlinzwa ukulungisa.
Izilonda zesisu: Izilonda zesisu, ezibizwa ngokuba zizilonda zamathambo okanye isifo sesilonda sezilonda (PUD), ziqhelekile emva kokuhlinzwa kwesikhumba sesisu, kwaye zivakalayo ngexesha le-endoscopy ephezulu emva kokuphuma kwegazi (kubonwa njengomnyama, i-tarry stool okanye njengegazi ukuhlanza) okanye intlungu kwisisu.
I-nausea: I- nausea enye yezinto eziqhelekileyo eziqhelekileyo izigulane zijongene emva kwesigxina somzimba. Eyona mininzi, imiba iphucula emva kokuphulukana nokuhlinzwa, kodwa kwabanye ingxaki iqhubeka kwiinyanga okanye kwithuba elide. Amachiza afumaneka isicupunu, esinokuba luncedo kwabanye.
Iigalstones: Iigallstones ziqhelekile emva kokuba zonke iintlobo zonyango lwe-bariatric, zenze i-cholecystectomy (ukuhlinzwa ukuba ikhuphe i-gallbladder) eqhelekileyo kwiimeko zokugulisa umzimba. Abafazi baseCaucasus abangaphezu kweminyaka engama-40 abanesisindo, okanye ngaphandle kokuhlinzwa, banokudinga ukuhlinzwa ngokugqithiseleyo ngexesha lokuphila kwabo okanye ngaphandle kokuhlinzwa.
Idayarrhea: Kwezinye izigulane, isifo sohudo sinengxaki enkulu engayiqhubeka emva kokuhlinzwa. Kwiimeko ezihlala ixesha elongezelelweyo, ugqirha okanye igastroenterologist unokukwazi ukunceda ukuyeka uhudo, oku kunokukhokelela ekudambiseni amanzi kunye nokungondleki.
Kufuneka izongezelelo zondlo: ezininzi izigulane zokuhlinzwa zifuna iimveliso zamavithamini kunye neemaminerali emva kokuhlinzwa. Ngokungafani nokugqithwa kwamathambo amaninzi, izigulane ezineenkqubo zesigxina se-gastric sleeve zinezitshintsho ekukwazi ukufumana izondlo kwi-intestine, kodwa ukunciphisa ngokuphawulekayo ekutheni ukutya kungabangela ubunzima bokuthatha ukutya okwaneleyo. Oku kunokuncedwa ngokutya ukutya okutya konke, kodwa ukutya okufanelekileyo akunako okwaneleyo ukubonelela zonke iimfuno zomzimba.
Ukufumana kwakhona: Enye yeengxaki ezinokukhathazeka zizigulane zentsimbi yesigxina malunga neyona nto ilahlekelwa ngumzimba kuphela ukuba ungabi nesisindo. Ukulahlekelwa isisindo emva kokuhlinzwa kuphela ukufumana enye okanye yonke into ebuyele ngokuqhelekileyo iyaqala ngonyaka wesithathu emva kokuhlinzwa. Iinkqubo zeBariatric zixhobo ezinkulu zokulahleka kwesisindo, kodwa ukuba imikhuba ingatshintshi kwaye igcinwe kunokwenzeka ukuba ifumane enye okanye yonke isisindo esithintekayo kwakhona.
Ukuhlala isigxina: Ukuhlinzwa, ngokubhetele okanye kokubi, kukuguqulwa ngokusisigxina kwesisu. Ngokungafani nenkqubo yebhanti yegastric, apho ibhendi ingasuswa xa kukho ingxaki, isabelo sesisu asikwazi ukutshintshwa ukuba kukho iingxaki okanye imiba yokutya.
Ukulahlekelwa kwesisindo esincinane kunamanye amanyathelo: Abantu abanobuchopho be-gastric surpass ngokuvamile balahlekelwa bunzima kwaye bahlale bephesenti ephakamileyo yobunzima obunzima xa beqhathaniswa nokutyunjwa kwempahla yesisu. Oko kwathiwa, ezo zonyango ziyakwazi ukubonisa imiba eyahlukeneyo yimiba eyahlukeneyo. Ukukhethwa kokuhlinzwa kuyisigqibo esincinci senziwe sisigulane kunye nodokotela wabo ogqirha, ngokusekelwe kwiimfuno zabo.
Isifo sikashukela , uxinzelelo lweengcinezelo kunye nezinye izimo ezingapheliyo aziphendululanga: Kweminye, ukulahla iingxaki zempilo ezingapheliyo sizathu sokuba utyando. Kwamanye abantu, ezi ngxaki azishiyi emva kokuhlinzwa, okanye ziya kuhamba ngexeshana ezinyangeni zokuqala okanye kwiminyaka emva kokuhlinzwa, uze ubuyele kamva.
Isikhumba esikhuphayo: Le nkcenkcesha iyaqhelekileyo kuzo zonke iintlobo zokuhlinzwa ngokulahleka kwesisindo kwaye kubangelwa yesikhumba esolula ngexesha lokunyameka. Uphando luyafumaneka ukususa isikhumba esingaphezulu, kodwa abaninzi abagqirha banqwenela ukulinda de ukuba isisigxina sesigxina sibe sisigxina ukuya kwiminyaka emibini ngaphambi kokuba kususwe isikhumba esingaphezulu.
Ukungakwazi ukuthatha isixa esaneleyo sokutya: Ukulahlekelwa ubunzima obukhulu kunokuvakala njengesiphumo esihle kumntu ofuna ukulahlekelwa iipounds ezili-100 okanye ngaphezulu, kodwa inyaniso ihluke kakhulu. Kunokwenzeka ukuba isikhwama sesisu sincinci kakhulu, okanye ngeminye imiba yokwenza isikhwama esincinci kunokuba senzelwe, esikhokelela ekungenakudleni ukutya ubuninzi bokutya okwaneleyo ukuze kugcinwe umzimba emva kwexesha. Le ngxaki ingabonakali kwiinyanga zokuqala emva kokuhlinzwa kodwa iya kubonakala ibe yingozi xa isiguli singakwazi ukugcina isisindo somthwalo kwaye sinokugqithisa.
Ukungondleki: Lo mbandela uvela kwiifom ezahlukeneyo. Kukho ukungena kwehla kwiiminerali kunye neivithamini ezikhokelela ekungabikho kwezondlo ezibalulekileyo. Kukho ukungakwazi ukuthatha iikhalori ezifanelekileyo. Kukho ingxaki ngokufumanisa iikhalori ezaneleyo kunye nezondlo, ngenxa yemicimbi enjenge-diarrhea, i-nausea, okanye enye imiba. Ukungondleki kungabangela kakhulu kwaye kungathatha izongezo, amayeza kunye nezinye iindlela zokunyamezela ukuba isiguli sigcine ixesha elide.
I-hernia engabonakaliyo : I-hernia ingayifaka kwisiza saso nasiphi na ukuchonga. Lo mngcipheko uncitshiswe ngeendlela ezincinci zokusasaza (laparoscopic), kodwa i-hernia ingaqhubeka ifake kwiinyanga kunye neminyaka emva kokuhlinzwa. Ngokuqhelekileyo, oku kukhangeleka njengento encinci kwisiza sokubanjwa kocwangco.
Ukubambelela kwesisu: Izitho kunye nezicubu zesisu zisuke zityhazamisa ngokwemvelo, zivumela ukuba zihambe kwaye zidibanise ngaphaya komnye ngexesha lokuhamba, ukuguquka nokuhamba. Emva kokuhlinzwa, ukunqunyulwa kungabangela ukuba izicubu zibe "zinyame" komnye nomnye, kwaye oku kubangele ukuvakala kwinto enokubangela ukucaphukisa ukuhamba.
> Imithombo:
> I-laparoscopic sleeve gastrectomy ngokuthelekiswa nezinye iinkqubo zokupasa nge-bariatric: ukuhlaziywa ngokuchanekileyo kwezilingo ezingenamsebenzi. https://www.ncbi.nlm.nih.gov/pubmed/23993246
> Ukulungisa ngokukhawuleza okanye unyango lwexesha elide? Iinkonzo kunye neengxaki zokuhlinzwa okwenziwa nge-bariatric. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3470459/#!po=29.3103
> Ukuhlaziywa kweziphumo zokulahleka kwexesha elide emva kwe-laparoscopic sleeve gastrectomy. https://www.ncbi.nlm.nih.gov/pubmed/24507083