Iintlobo ezahlukileyo ze-Colectomy Ingqungquthela enokuthi Yenzelwe Ukugula Kwezilwanyana
Ukubeka ngokubanzi, utyando lokususa yonke into okanye inxalenye yekoloni (intumbu enkulu) kuthiwa yi-colectomy. Nangona kunjalo, kukho iintlobo ezahlukeneyo zokuhlinzwa. Abantu abanezifo zesibindi sokuvuvukala (IBD) banokuhlinzwa okwenziwe ngumzimba ukuze baphathe isifo sabo, kodwa uhlobo lotyando olwenziweyo, kwaye lukhulu kangakanani ikoloni lususwe, luyahlukahluka ngokubhekiselele kukuphi uhlobo lwesifo olukhoyo, kwaye Umonakalo omkhulu kumathumbu amakhulu.
Utyando lwe-Colectomy luvame ukufakwa kwenye yeendidi ezahlukahlukeneyo, ngokusekelwe kwinqanaba le-colon elisuswayo, okanye ukuba zonke zisuswe.
Nangona kunjalo, kufuneka kuphawulwe ukuba akuyiyo yonke into eyenziwa ngayo i-IBD iya kulala kwezi zigaba: kukho ukuhluka. Ngaphambi kokuba utyunjwe ukususa inxalenye okanye yonke ikolon yakho, xela iqela lakho lokugqala malunga nokuhlinzwa okwenziweyo. Sebenzisa isicatshulwa esingezantsi ukuziqonda kunye neminye yemigqaliselo, ukuzinceda ukuba uqonde ngakumbi utyando olwenziwa kwimeko ethile.
Proctocolectomy
Kulo hlobo lotyando lwe-colectomy, i-colon isuswa, kunye ne- rectum . "IProcto" ithetha "umqolo." I-rectum iyinxalenye yomzimba osekupheleni kwekholoni esetyenziselwa ukubamba isitulo ngaphambi kokuba isuswe emzimbeni nge- anus . Ngomibini kunye ne-rectum isuswe, umzimba uzakufuna indlela entsha yokulahla isitoli.
Kuba abaninzi abantu abane-IBD (okanye isifo sikaCrohn okanye isifo se-ulcerative colitis), i-proctocolectomy ithetha ukudala i- ileostomy . I-ileostomy yilapho inxalenye yamathumbu amancinci iziswa ngesisu ukuze idale i-stoma. I-Stool iphuma emzimbeni ngokusebenzisa i-stoma, kwaye iqokelelwa kwisixhobo somsebenzi we- ostomy esugqithwe ngaphandle komzimba.
I-ileostomy ingasigxina okanye ingaba yesikhashana.
J-Pouch Surgery
Olunye uhlobo lotyando olwenziwa ngelo xesha okanye ngamanye amaxesha emva kwe-proctocolectomy yi- poal - lial-anal anastomosis (IPAA) . Olu hlobo lotyando luyaziwa ngokuba ngu- j-pouch otyando (nangona ngamanye amaxesha iifolothi zenziwe nge "S" okanye "W"). Kulo msebenzi, inxalenye yokugqibela yamathumbu amancinci (i-terminal leum), ihlanganiswa ndawonye ibe yimilo ye "J" kwaye iyakubamba isithuba ixesha, isebenze njengengqungquthela. I-j-poch ixhunyiwe kwi-anus ngexesha lomnye utyando, ngokuphindaphindiweyo emva kwexesha kunye ne-uleostomy yesikhashana. Emva kokuba utyando lwenziwe ukuxhuma intumbu encinci kunye ne-anus, isitulo sinokuphinda siphunyezwe kwi-anus (phantsi). Olu hlobo lwenzululwazi lwenziwa ngokusesikweni kwizigulane zezilonda zesilonda, kodwa kwezinye iimeko ezikhethekileyo kunokwenziwa ngabantu abanesifo sikaCrohn .
Ileoanal Anastomosis
Olunye uhlobo lotyando olwenziwe ukubuyisela amandla okuhambisa isitulo ngokusebenzisa i-anus lubizwa ngokuba yi-ileoanal anastomosis (ukukhupha). Kulo msebenzi, emva kokuba ikhunjulwe kunye ne-rectum, intlungu encinci ifakwe ngqo kwi-anus. Kukho ixesha lokulinda phakathi kwe-colectomy nokuhlinzwa, apho isigulane sinalo i-uleostomy yesikhashana ukuvumela ukuphilisa.
Akukho sikhwama esenziwe kwimbilini encinane. Olu hlobo lwenziwa ngokuphindaphindiweyo kubantu abanesifo sokulonda esiswini ngaphambi kowe-1980, ngaphambi kokuba inkqubo ye-j-pouch ibe yindlela yokuhlinzwa ekhethiweyo. Kuye kwambi ngezinye iinkqubo zenziwa ngabantu abanesifo sikaCrohn abangenayo isifo emathunjini abo amancinci.
Yonke iClectomyomy
I-colectomy iyonke ithetha ukuba yonke ikolon isusiwe. Eli gama linokudideka xa kuthelekiswa ne-proctocolectomy kuba ku-colectomy epheleleyo, i-rectum ishiywe endaweni. I-colectomy epheleleyo kunye nezinye okanye i-rectum ekhohlo kwindawo enokuthi ingenziwa kwiimeko ezithile ze-ulcerative colitis okanye isifo sika-Crohn.
I-colectomy iyonke iya kufuna ukudala i-ileostomy (nge stoma, apho isikhwama sigqoke ngaphandle komzimba ukuqokelela isitulo). I-ileostomy inokuhlala isigxina, kodwa kwezinye iimeko kungenokuba yesikhashana. Utyando olungakumbi, olunjenge-j-pouch ukuhlinzwa okanye ukutyunjwa, ungenziwa ukuze "uphinde uxhume" emathunjini amancinci kwi-rectum kwaye uguqule i-ileostomy yesikhashana. Emva kokuba utyando lwenziwe ukuxhuma intlungu encinci kunye ne-rectum, isitofu sinokuphinda siphunyezwe nge-anus (phantsi).
Colectomy ekhethekileyo
I-colectomy ekhethekileyo yilapho iqela lekholoni lisuswa, kwaye ngamanye amaxesha lingabizwa ngokuba yi-colectomy e-subtotal. Kule ngqesho, nayiphi na inxalenye yekholoni ingasuswa. I-colectomy ekhethekileyo inokwenziwa ngabantu abathile abanesifo sikaCrohn, kwaye kungenziwa kwakhona ukunyanga umdlavuza we-colon okanye i- diverticulitis . Emva kokuba inxalenye yekholoni isifo isuswe, ikholoni enempilo ngapha nangapha ixhunyiwe. I- colostomy , apho inxalenye yekholoni ikhutshwe ngesisu ukuze isitopu sinqunywe kwikhwama egqitywe kwisisu, ayifuni.
I-colectomy encinci ayinakuze yenzelwe abantu abane-ulcerative colitis, kuba isifo siza kuphinda sibuyele kwicandelo eliphilileyo lekholoni esele. Kwi-Crohn's disease, kukho umngcipheko wesifo esiphindayo kwi-colon, kwaye uphando olungakumbi kwezinye iimeko.
Isigqibo sokususa nje ingxenye yekoloni kubantu abaneCrohn isigqibo esenziwe ngabanye, kwaye siqwalasela ubungakanani besifo kwi-colon ne-rectum, kunye nobudala kunye nempilo yonke yesigulane.
Hemicolectomy
Ngophando lwe-hemicolectomy, mhlawumbi i-right or half half left colon isuswa. Kwi-right hemicolectomy, i- cecum , ekhuphuka kolonon , kunye nenxalenye yecolon ehambayo isuswa, kunye nesihlomelo , esiqhotyoshelwe kwikolon ephakamayo. Kwi-hemicolectomy ekhohlo, ukuhla kwe-colon , kunye nenxalenye yecolon ehambayo. Le nqubo ingenziwa ukwenzela ukuphatha isifo sika-Crohn, ukukhutshwa komzimba , okanye umdlavuza wekoloni. Ngokuqhelekileyo, iindawo eziphilileyo zekholoni zixhunyiwe kunye kwaye i-ostomy ayifuni.
Umthombo:
Umntu B, uKhayikin M. "Imisebenzi yokubuyisela izifo kwi-Crohn's Disease." Klinikhi Colon Rectal Surg . 2007 Nov; 20 (4): 314-321. i-doi: 10.1055 / s-2007-991031. 22 Disemba 2015.