Kubwezeretsa matumbo akulu

Kutulutsa matumbo akulu ndikuchita opareshoni yochotsa zonse kapena gawo la matumbo anu akulu. Kuchita opaleshoniyi kumatchedwanso colectomy. Matumbo akulu amatchedwanso matumbo akulu kapena colon.

• Kuchotsa koloni yonse ndi rectum kumatchedwa proctocolectomy.
• Kuchotsa mitundu yonse koma osati rectum kumatchedwa subotal colectomy.
• Kuchotsa gawo la coloni koma osati rectum kumatchedwa colectomy pang'ono.

Matumbo akuluakulu amalumikiza matumbo ang'onoang'ono ndi anus. Nthawi zambiri, chopondapo chimadutsa m'matumbo akulu musanatuluke mthupi kupyola mu chotulukira.

Mudzalandira anesthesia wamba panthawi ya opaleshoni yanu. Izi zidzakupangitsani inu kugona ndi kumva ululu.

Kuchita opaleshoniyo kumatha kuchitidwa laparoscopically kapena ndi opaleshoni yotseguka. Kutengera ndi opaleshoni yomwe muli nayo, dokotalayo azidula kamodzi kapena zingapo m'mimba mwanu.

Ngati muli ndi opaleshoni ya laparoscopic:

• Dokotalayo amapanga mabala atatu mpaka asanu m'mimba mwanu. Chida chamankhwala chotchedwa laparoscope chimalowetsedwa kudzera mwa mabala amodzi. Kukula kwake ndi chubu chowonda, chowala chomwe chili ndi kamera kumapeto. Amalola dokotalayo kuona mkati mwa mimba yanu. Zida zina zamankhwala zimalowetsedwa kudzera pakucheka kwina.
• Kudula masentimita awiri mpaka awiri (5 mpaka 7.6 masentimita) amathanso kupangidwa ngati dotolo wanu akuyenera kuyika dzanja lake m'mimba mwanu kuti mumve kapena kuchotsa matumbo omwe ali ndi matenda.
• Mimba yanu imadzazidwa ndi mpweya wopanda vuto kuti mukulitse. Izi zimapangitsa kuti malowa akhale osavuta kuwona komanso kugwiriramo ntchito.
• Dokotalayo amafufuza ziwalo m'mimba mwanu kuti awone ngati pali zovuta.
• Gawo la matenda a m'mimba mwanu likupezeka ndikuchotsedwa. Ma lymph node ena amathanso kuchotsedwa.

Ngati muli ndi opaleshoni yotseguka:

• Dokotalayo amadula mainchesi 6 mpaka 8 (15.2 mpaka 20.3 masentimita) m'mimba mwanu.
• Ziwalo zam'mimba mwanu zimayesedwa kuti muwone ngati pali zovuta.
• Gawo la matenda a m'mimba mwanu likupezeka ndikuchotsedwa. Ma lymph node ena amathanso kuchotsedwa.

Mu mitundu yonse ya opaleshoni, njira zotsatirazi ndi izi:

• Ngati pali matumbo akulu okwanira okwanira, malekezero amalumikizidwa kapena kulumikizana. Izi zimatchedwa anastomosis. Odwala ambiri achita izi.
• Ngati palibe matumbo akulu okwanira kuti agwirizanenso, dokotalayo amatsegula chotupa chotchedwa stoma kudzera pakhungu la mimba yanu. Colonicho chimaphatikizidwa ndi khoma lakunja la mimba yanu. Chopondapo chimadutsa mu stoma kupita m'thumba lotulutsa madzi kunja kwa thupi lanu. Izi zimatchedwa colostomy. Colostomy ikhoza kukhala yayifupi kapena yosatha.

Colectomy nthawi zambiri imatenga pakati pa 1 mpaka 4 maola.

Kugulitsa matumbo akulu kumagwiritsidwa ntchito pochiza zinthu zambiri, kuphatikiza:

• Kutsekeka m'matumbo chifukwa chofufumitsa
• Khansa ya m'matumbo
• Matenda osokonekera (matenda amatumbo akulu)

Zifukwa zina zotulutsira matumbo ndi izi:

• Wodziwika bwino polyposis (tizilombo tating'onoting'ono timafalikira pazitsulo za m'matumbo)
• Kuvulala komwe kumawononga matumbo akulu
• Kulimbana (pamene gawo limodzi la m'matumbo limakankhira kwina)
• Tizilombo ting'onoting'ono khansa
• Kutuluka magazi kwambiri m'mimba
• Kupindika kwamatumbo (volvulus)
• Zilonda zam'mimba
• Kutuluka magazi kuchokera m'matumbo akulu
• Kuperewera kwa mitsempha m'matumbo akulu

Zowopsa za anesthesia ndi opaleshoni yonse ndi izi:

• Zomwe zimachitika ndi mankhwala
• Mavuto opumira
• Kuundana kwa magazi, kutuluka magazi, matenda

Zowopsa za opaleshoniyi ndi izi:

• Kukhetsa magazi mkati mwa mimba yako
• Minyewa yotupa kudzera pakucheka kwa opaleshoni, yotchedwa nthenda yotupa
• Kuwonongeka kwa ziwalo zapafupi m'thupi
• Kuwonongeka kwa ureter kapena chikhodzodzo
• Mavuto ndi colostomy
• Minofu yotupa yomwe imapanga m'mimba ndikupangitsa kutsekeka kwa matumbo
• Mphepete mwa matumbo anu omwe atsekedwa palimodzi amatseguka (anastomotic leak, omwe atha kukhala owopseza moyo)
• Kutsegula bala
• Matenda opweteka
• Matenda a m'mimba
  

Uzani dokotala wanu kapena namwino mankhwala omwe mukumwa, ngakhale mankhwala, zowonjezera, kapena zitsamba zomwe mwagula popanda mankhwala.

Lankhulani ndi dokotala wanu kapena namwino za momwe opareshoni angakhudzire:

• Kukondana komanso kugonana
• Mimba
• Masewera
• Ntchito

Pakati pa masabata awiri musanachite opareshoni:

• Mutha kufunsidwa kuti musiye kumwa mankhwala ochepetsa magazi. Izi zimaphatikizapo aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), ndi ena.
• Funsani dokotalayo mankhwala omwe muyenera kumamwa patsiku la opareshoni yanu.
• Ngati mumasuta, yesetsani kusiya. Kusuta kumawonjezera ngozi yamavuto monga kuchira pang'onopang'ono. Funsani dokotala wanu kapena namwino kuti akuthandizeni kusiya.
• Uzani dokotalayo nthawi yomweyo ngati mukudwala chimfine, malungo, malungo, kapena matenda ena musanachite opareshoni.
• Mutha kufunsidwa kuti mukonzekeretse matumbo kutsuka matumbo anu onse. Izi zitha kuphatikizira kukhala ndi chakudya chamadzimadzi kwamasiku ochepa ndikugwiritsa ntchito mankhwala ofewetsa tuvi tolimba.

Tsiku lisanachitike opaleshoni:

• Mutha kupemphedwa kuti muzimwa zakumwa zomveka bwino monga msuzi, madzi oyera, ndi madzi.
• Tsatirani malangizo okhudza nthawi yosiya kudya ndi kumwa.

Patsiku la opareshoni:

• Tengani mankhwala omwe dokotala wanu wakuuzani kuti mumamwe pang'ono.
• Fikani kuchipatala nthawi yake.

Mudzakhala mchipatala masiku atatu mpaka 7. Muyenera kukhala nthawi yayitali ngati colectomy inali ntchito yadzidzidzi.

Muyeneranso kukhala nthawi yayitali ngati matumbo anu akulu atachotsedwa kapena mukukhala ndi mavuto.

Pofika tsiku lachiwiri kapena lachitatu, mudzatha kumwa zakumwa zomveka bwino. Madzi owola kenako zakudya zofewa zidzawonjezedwa pamene matumbo anu ayambanso kugwira ntchito.

Mukapita kunyumba, tsatirani malangizo amomwe mungadzisamalire mukamachira.

Anthu ambiri omwe ali ndi matumbo akuluakulu amachira bwino. Ngakhale atakhala ndi colostomy, anthu ambiri amatha kuchita zomwe anali kuchita asanachite opareshoni. Izi zimaphatikizapo masewera ambiri, maulendo, kulima, kukwera mapiri, zochitika zina zakunja, ndi mitundu yambiri ya ntchito.

Ngati muli ndi vuto lalitali, monga khansa, matenda a Crohn, kapena ulcerative colitis, mungafunike kupitiliza kulandira chithandizo chamankhwala.

Kukwera kwa colectomy; Kutsika kwa colectomy; Colectomy yopingasa; Kumanja hemicolectomy; Kumanzere hemicolectomy; Kutsika kwapansi kwapansi; Matenda a Sigmoid colectomy; Colectomy yocheperako; Proctocolectomy; Kutulutsa koloni; Laparoscopic colectomy; Colectomy - tsankho; M'mimba perineal resection

• Chitetezo cha bafa cha akulu
• Zakudya za Bland
• Kusintha thumba lanu la ostomy
• Ileostomy ndi mwana wanu
• Ileostomy ndi zakudya zanu
• Ileostomy - kusamalira stoma yanu
• Ileostomy - kusintha thumba lanu
• Ileostomy - kumaliseche
• Ileostomy - zomwe mungafunse dokotala wanu
• Kutulutsa matumbo akulu - kutulutsa
• Zakudya zochepa
• Kupewa kugwa
• Chisamaliro cha bala la opaleshoni - chotseguka
• Mitundu ya ileostomy
• Mukakhala ndi nseru ndi kusanza

• Matumbo akulu
• Colostomy - Mndandanda
• Kubwezeretsa matumbo akulu - Series

Brady JT, Althans AR, Delaney CP. Laparoscopic colon ndi opaleshoni yam'mbali. Mu: Cameron JL, Cameron AM, olemba, eds. Chithandizo Chamakono Cha Opaleshoni. Wolemba 12. Philadelphia, PA: Elsevier; 2017: 1520-1530.

Mahmoud NN, Bleier JIS, Aarons CB, Paulson EC, Shanmugan S, Fry RD. Colon ndi rectum. Mu: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: Maziko Achilengedwe a Njira Zamakono Zopangira Opaleshoni. Wolemba 20th. Philadelphia, PA: Elsevier; 2017: mutu 51.