Ngokubanzi, i-J-Pouch Surgery Isetyenziselwa Ukuphatha I-Ulcerative Colitis
Ingxowa ye-Ileoanal anal anastomosis (i-IPAA) -kunjengoko iyaziwa ngokuqhelekileyo, utyando lwe-j-pouch- ibe yindlela ekhethiweyo yokuhlinzwa kubantu abaninzi abanesifo sokulonda kwesilonda kunye nabafuna ukuhlinzwa. Olu hlobo lotyando lunokwenziwa kwakhona kwi-familial adenomatous polyposis (FAP) okanye kwiimeko ezithile zesifo somhlaza . Nangona kunjalo, ukuba abantu baxilongwa ngenye indlela yesifo sobhubhane (IBD) , isifo sika-Crohn, i-j-pouch ayinakucingwa njengendlela efanelekileyo.
Yintoni i-J-Pouch?
Utyando lwe-J-pouch ngokuqhelekileyo lwenziwa kubantu abane-ulcerative colitis mhlawumbi xa unyango lwezokwelapha luphela kwaye iimpawu zingenakunzima, okanye xa kukho utshintsho olusengumdlavuza kwi-colon (emathumbu amakhulu) . Kwinqanaba elithile labantu abane-ulcerative colitis, amayeza atholakala ekuphatheni i-IBD akunakunceda ekuqaliseni ukuxolelwa okanye ngokunciphisa iimpawu, kwaye ubunzima bobubomi bunokuba bubuhlwempu kangangokuba ukucatshungulwa kuqwalaselwa. Abantu abane-ulcerative colitis banomngcipheko omkhulu wokuba nomdlavuza wekoloni, kwaye ukususwa kwekolon kuvame ukucetyiswa xa iziphumo ze- biopsy zivela kwi-colon bonisa ngaphambi komhlaza okanye umhlaza.
Kutyando lwe-j-pouch, ikholoni isuswe, kunye nenxalenye okanye yonke i- rectum . Icandelo lokugqibela lentlungu elincinci lisetyenziselwa ukwenza isikhwama-ngokuqhelekileyo kwimilo ye "J," kodwa iimo "S" ne "W" zenziwa ngamanye amaxesha. Ingxowa eyenziwa emathunjini amancinci ke ixhunywe kwi- anus (okanye i-rectum, ukuba kukho enye ikhohlo), eyenza ukupheliswa kwesigxina "ngokuqhelekileyo." Utyando luvame ukuqhutyelwa ngamanyathelo amabini, kodwa lunokuthi lwenziwa kwinyathelo elinye okanye ezintathu.
Kutheni Kungabikho Oku Kuphanda Okuqhelekileyo Ukwenziwe Ngezifo Ze-Crohn?
I-ulcerative colitis, isifo, kunye nokuvuvukala okuhambisanayo, kufumaneke emathunjini amakhulu. Ukususwa kwamathumbu amakhulu, ngelixa kungekho guliso kwi-IBD, lithatha inkunkuma echaphazelekayo sisifo. Ngenxa yesifo sikaCrohn, nayiphi na inxalenye yendlela yokugaya ingasichaphazelwa ukuvuvukala nangona isithukuthelo esikhulu sisuswe, isifo sikaCrohn sisenokubuyela.
Enyanisweni, indawo eziqhelekileyo ukuvuvukala kubantu abanesifo sikaCrohn yi-ileum kunye nomathumbu omkhulu. I-ileum yinqanaba lokugqibela lesisu esincinci, kwaye yinxalenye esetyenziselwa ukwenza iipokethi kwi-IPAA. Inqobo yesiqhelo kukuba, ukuba isifo sikaCrohn sichaphazela isikhwama, isikhokhethi sinokuthi "siphumelele" kwaye ekugqibeleni kufuneka sisuswe. Kukho izigulane eziye zafumanisa ukuba zine-ulcerative colitis, zenze utyando lwe-j-pouch, kwaye emva koko zinezifo eziguqulwe kwisifo sikaCrohn (nangona oku akuqhelekanga).
Nangona kunjalo, uphando malunga nee-j-isikhwama kubantu abanesifo sikaCrohn baye bafumana iziphumo ezidibeneyo. Ezinye iingxelo zibonisa ukuba ininzi yesigulane sezigulane se-Crohn nesifo se-j-poch esikwazi ukuhluleka kwesikhwama kwaye kufuneka ukuba utyando olungakumbi ukukususa kwaye udale ileostomy esisigxina . Kanti ezinye iingxelo zibonisa ukuba izigulane ezithile ezikhethiweyo ezikhethekileyo zezifo ezithile zeCrohn ziyakwazi ukunyamezela ukutyunjwa kwe-j-pouch. Ngokuza kwezinto ze-biologic ze-IBD (ezifana ne- Remicade , i- Humira , i- Cimzia , i-Tysabri, ne-Entyvio), abantu abanesifo sikaCrohn baneendlela ezininzi zokonyango kunanini ngaphambili.
Ngoko, i-IPAA AKAZA YENZIWA KWIINTLOKO ZEZIMALI ZASIKRONIN?
Njengokuba kukho ezininzi izinto malunga ne-IBD, kukho ukungafani.
Okwangoku kukho impikiswano phakathi kweenkokheli zoluvo oluphambili malunga nokuba ngaba ezinye izigulane ezinezifo ze-Crohn zingayifumana i-j-pouch kwaye yenza kakuhle. Kukho ezinye iziganeko zabantu abaxilongwa ngeColhn's colitis okanye i-colitis engapheliyo eyenziwa ngu-j-pouch. Nangona kunjalo, kukho umngcipheko ophezulu weengxaki kunye nokungaphumeleli kwesikhwama esilandelayo kweli qela lezigulane. Akuzange kubekho uphando olungenamsebenzi kwi-j-pouch kwizigulane zezifo zikaCrohn eziza kunika ubungqina obunene bokugqitywa kwengxoxo enye indlela okanye enye.
Njengokuba kunjalo nezinye izihloko eziphikisanayo kwi-IBD, akukho sicwangciso esivunyelwe ukuba sikhulu.
Nasiphi na isigqibo malunga nokudala i-j-pouch yezigulane ngesifo sikaCrohn kufuneka senziwe kuphela ngamaqela okhethekileyo kumaziko okuncedisa amaziko aphakamileyo aphezulu kwaye akhethekileyo ekuphatheni i-IBD.
Imithombo:
UBraveman JM, uSchoetz DJ Jr, uMarcello PW, uRoberts PL, uColler JA, uMurray JJ, uRusin LC. "Isiphumo sesigxobo se-ileal kwizigulane ezenza isifo seCrohn." I-Dis Colon Rectum . 2004 Oct; 47 (10): 1613-1619.
I-Brown CJ, iMaclean AR, uCohen Z, iMacrae HM, i-O'Connor BI, iMcLeod RS. Isifo sikaCrohn kunye ne-colitis engapheliyo kunye neengxowa ye-ileal-anal anastomosis: iziphumo kunye neepatheni zokungaphumeleli. " I-Dis Colon Rectum . 2005 Aug; 48 (8): 1542-1549.
UJoyce MR, Fazio VW. "Ngaba i-ileal isikhwama se-anastomosis ingasetyenziswa kwisifo sikaCrohn?" Adv Surg . 2009; 43: 111-137.