Izinhlobo Ezihlukahlukene Zezokwelapha Ze-Colectomy Engahle Zenziwe Ngezifo Zokugaya
Ukubeka ngokubanzi, ukuhlinzwa ukukhipha konke noma ingxenye yamakoloni ( intombazane enkulu) kuthiwa i-colectomy. Kodwa-ke, kunezinhlobo ezahlukene zokuhlinzwa okwenziwa yi-colectomy. Abantu abanezifo zesifo sofuba (IBD) bangase babe nokuhlinzekwa kwe-colectomy ukuphatha isifo sabo, kodwa uhlobo lohlinzekwa lwenziwa, nokuthi ingakanani ikoloni isusiwe, kuzohluka ngokususelwa kusiphi isimo sesifo esikhona, nokuthi umonakalo omkhulu kumathumbu amakhulu.
Ukuhlinzwa kwe-Colectomy kuvame ukufakwa kwesinye sezigaba ezihlukahlukene, ngokusekelwe ukuthi ingakanani ikoloni isusiwe, noma uma isuswe sonke.
Kodwa-ke, kufanele kuqashelwe ukuthi akuwona wonke umsebenzi owenzelwe i-IBD oyowela ngqo kulezi zigaba: kungaba khona ukuhlukahluka. Ngaphambi kokuhlinzwa ukuze ususe ingxenye noma yonke ikholoni yakho, khuluma neqembu lakho lokuhlinzeka mayelana nokuhlinzwa okuqondile okukhona. Sebenzisa umhlahlandlela ngezansi ukuze uzijwayeze ngamanye emigomo, ukuzisiza ngokwakho ukuqonda kangcono ukuhlinzwa okwenziwe ngecala lakho.
Proctocolectomy
Kuloluhlobo lwenqubo yokuhlinzwa ye-colectomy, ikholoni isusiwe, kanye ne- rectum . "I-Procto" isho ukuthi "i-rectum." I-rectum iyingxenye yomzimba osekupheleni kolononi esetshenziselwa ukubamba isitokisi ngaphambi kokuba isuswe emzimbeni ngokusebenzisa i- anus . Ngombili ikolon kanye ne-rectum isusiwe, umzimba uzodinga indlela entsha yokulahla isitoloni.
Kubantu abaningi abane-IBD (noma i-Crohn's disease noma i-ulcerative colitis), i-proctocolectomy nayo isho ukudala i- ileostomy . I-ileostomy yilapho ingxenye yengxenyane encane ilethwa ngesisu ukuze idale isisu. Isitoreli sishiya isidumbu emzimbeni, futhi siqoqwe ku- ostomy appliance egqoke ngaphandle komzimba.
I-ileostomy ingase ibe yunaphakade noma ingase ibe yesikhashana.
I-J-Pouch Surgery
Uhlobo olulodwa lokuhlinzwa olwenziwe ngesikhathi esifanayo noma ngezinye izikhathi ngemuva kwe-proctocolectomy yi- pouch-anal anal anastomosis (IPAA) . Lolu hlobo lohlinzekwa luvame ukubizwa ngokuthi i- j-pouch ukuhlinzwa (nakuba ama-pocket abuye ayenziwe nge "S" noma "W"). Kulo msebenzi wokuhlinzwa, ingxenye yokugcina yamathumbu amancane (i-leum esibulalayo), ihlanganiswa ndawonye ibe yimilo "J" futhi ingabe ibambe isitoreji isikhathi esithile, ikhonza njenge-rectum. I-j-poch ixhunywe ku-anus ngesikhathi sokuhlinzwa, ngokuvamile ngemva kwesikhathi esithile ne ileostomy yesikhashana. Emva kokuhlinzwa kwenziwa ukuxhuma intombazane encane nge-anus, isitokisi singaphinda sichithwe ngokusebenzisa i-anus (ngezansi). Lokhu kuhlinzekwa kwenziwa ngokujwayelekile ngeziguli ezilonda ulcerative, kodwa kwezinye izimo ezikhethekile kungenziwa kubantu abane-Crohn's disease .
Ileoanal Anastomosis
Olunye uhlobo lohlinzekwa olwenziwe ukubuyisela ikhono lokuhambisa isitolishi ngokusebenzisa i-anus kuthiwa i-ileoanal anastomosis (ukudonsa). Kulesi ukuhlinzwa, ngemuva kokukhishwa kwe-colon kanye ne-rectum, amathumbu amancane axhunyiwe ngqo i-anus. Kuvame ukuhlala isikhathi sokulinda phakathi kokuhlinza colectomy kanye nokuhlinzwa ngokudonsa, lapho isiguli sinesi-leostomy yesikhashana ukuze sivumele ukuphulukiswa.
Ayikho isikhwama esenziwe kusukela emathunjini amancane. Lokhu kuhlinzekwa kwenziwa kaningi kubantu abane-ulcerative colitis ngaphambi kuka-1980, ngaphambi kokuba inqubo ye-j-pouch ibe ukuhlinzwa okukhethwa kakhulu. Kanti ngezinye izikhathi kwenziwa abantu abane-Crohn's disease abangenayo isifo emathunjini abo amancane.
I-Colectomy Yonke
I-colectomy yenani lisho ukuthi yonke ikoloni isusiwe. Leli gama lingase lidideke uma kuqhathaniswa ne-proctocolectomy ngoba ku-colectomy ephelele, i-rectum ishiywe endaweni. I-colectomy ephelele neyodwa noma yonke indawo engakwesobunxele endaweni engase isenziwe kwezinye izimo ze-ulcerative colitis noma isifo se-Crohn.
I-colectomy ephelele izodinga ukudala i-ileostomy (ene-stoma, lapho isikhwama sigqoke khona ngaphandle komzimba ukuqoqa isikhala). I-ileostomy ingase ibe yunaphakade, kodwa kwezinye izimo ingase ibe yesikhashana. Ukuhlinzekwa okwengeziwe, njengokuhlinzwa kwe-j-pouch noma ukuhlinzwa ngokudonsa, kungenziwa ukuze "uxhumane" nomathumbu omncane ku-rectum bese uphendulela i-ileostomy yesikhashana. Emva kokuhlinzwa kwenziwa ukuxhuma intombazane encane nge-rectum, isitokisi singaphinda sichithwe ngokusebenzisa i-anus (ngezansi).
Colectomy ekhethekileyo
I-colectomy eyingxenye yilapho ingxenye yekoloni isusiwe, futhi ngezinye izikhathi ingabizwa ngokuthi i-colectomy ye-subtotal. Kulesi ukuhlinzwa, noma iyiphi ingxenye yekoloni ingasuswa. I-colectomy encane ingenziwa kwabanye abantu abane-Crohn's disease, futhi kungenziwa futhi ukwelapha umdlavuza we-colon noma i- diverticulitis . Ngemuva kokuthi ingxenye yekoloni isifo isusiwe, ikholomu enempilo nganoma yiluphi uhlangothi ixhunyiwe. I- colostomy , lapho ingxenye yekoloni ilethwa esiswini ukuze isobho singasuswa esikhwameni esigqoke esiswini, ngokuvamile asidingeki.
I-colectomy eyingxenye cishe ayinakwenziwa kubantu abane-ulcerative colitis, ngoba lesi sifo sizovame ukubuyela esigabeni esiphephile sekholoni esisele. Esigabeni sikaCrohn, kukhona ingozi yokuthi lesi sifo siphindela ekoloni, futhi ukuhlinzwa okwengeziwe kuyadingeka kwezinye izimo.
Isinqumo sokususa nje ingxenye yekoloni kubantu abanesifo sikaCrohn yisinqumo esithathwe ngabanye, futhi sicabangela ubukhulu besifo ku-colon kanye ne-rectum, kanye nobudala kanye nesimo sempilo yesiguli.
Hemicolectomy
Kuhlinzekwa kwe-hemicolectomy, noma ingxenye engakwesokunxele yekoloni isusiwe. E-hemicolectomy elungile, i- cecum , ekhuphuka kolononi , nengxenye yekoloni eguquguqukayo isuswa, kanye nesithasiselo , esihlanganiswe nekoloni ekhuphukayo. E-hemicolectomy engakwesobunxele, ukwehla kolononi , kanye nengxenye yekoloni eguquguqukayo kususwa. Le nqubo ingenziwa ukwelapha isifo sikaCrohn, ukuvimbela isisu , noma umdlavuza wekoloni. Ngokujwayelekile, izingxenye ezinempilo ze-colon zixhunyiwe ndawonye futhi i-ostomy ayidingi.
Umthombo:
Umuntu B, Khaikin M. "Imisebenzi Yokubuyiselwa Kwezifo ZaseCrohn." I-Clin Colon Rectal Surg . 2007 Nov; 20 (4): 314-321. i-doi: 10.1055 / s-2007-991031. 22 Dec 2015.