Ukuqonda Izingozi Ze-Sleeve Gastrectomy
Inqubo yomkhonto wezinyosi, owaziwa nangokuthi i-gastrectomy yomkhono, iyindlela yokuhlinzwa eyenza ubukhulu besisu bukhuthaze ukulahlekelwa isisindo. Cishe amaphesenti angama-80 wesisu asuswe ngokuhlinzwa, eshiya ingxenye efana nethubhu yesisu endaweni, futhi asuse konke okuhlala unomphela. Isisu esisele singabamba ama-ounces angu-4 noma ama-milliliters angu-120, ukwehla okuphawulekayo kusukela kwesayizi evamile yesisu.
Lokhu kwehla okukhulu ngokwezinga lesisu kusho ukuthi umuntu angadla kuphela isigamu sendebe ngesikhathi esisodwa, futhi avimbela ivolumu yokudla engadliwa, okuyinto eyanciphisa amakholori angathathwa, okuholela ekulahlekeni kwesisindo.
Naphezu kwehla kwesayizi esiswini, ukuhlinzwa kuyithuluzi futhi kusadingeka ukuthi umuntu alandele imiyalelo yokukhishwa, anciphise ukungenisa ukudla, futhi alandele uhlelo olunikezwa udokotela ohlinzayo. Kungenzeka ukuba udle ngokweqile futhi ube nokulahlekelwa isisindo esincane ngemuva kokuhlinzwa. Kungenzeka futhi ukuthi ube nokucindezeleka okukhulu ngemuva kokuhlinzwa, ngakho-ke inqubo kufanele ithathwe ngokungathí sina, njenganoma yikuphi ukuhlinzwa.
Izinkinga Zesikhathi Eside Zemijoqo Yomzimba
Kunezinhlobo ezimbili zezinkinga zokuhlinza umjovo wesisu esiswini: okuyisimanga futhi esingapheliyo. Izinkinga eziyinkimbinkimbi yizona ezenzeka ngemuva nje kokuhlinzwa kanye nezinkinga ezingapheliyo ezivela noma eziqhubeka izinyanga eziyisithupha emva kokuhlinzwa. Izinkinga ezinzima zihlanganisa ukuphuma kwegazi, ubuhlungu, namacici egazi.
Umjoqo wesisu, jikelele, uthathwa njengokuphephile uma kuqhathaniswa nezinye ukuhlinzwa okwenziwa njalo. Ukufa okuvela kule nqubo akuvamile, futhi uma kwenziwa udokotela ohlinzayo osebenza kahle, inqubo inezinkinga ezincane. Lokhu kusho ukuthi, izinkinga, lapho zenzeke, zingabuka ezinkwaneni ezincane eziya ezinkingeni eziphawulekayo nezingenzeka zokuphila.
Kubalulekile ukuqaphela ukuthi lokhu kuyindlela entsha yokuhlinzwa. Enye yezindinganiso ezibalulekile ezicwaninga ososayensi abhekayo yimiphumela engu-10 yonyaka. Kulesi simo, lolo lwazi luqondene nokuthi iziguli zigcina kanjani ukulahlekelwa isisindo, ukuthi impilo yabo yonke ibukeka kanjani, nanoma yikuphi ukucindezeleka okungaba khona ngenxa yokuhlinzwa. Ukuba yinkambiso entsha, kunemininingwane engaphansi kweminyaka engu-10 kunokunye ukuhlinzwa, okufana noRoux En Y, nokunye ukucindezeleka kwesikhathi eside kungangezwa kulolu hlu esikhathini esizayo.
Ukuhluleka kokuqala ukulahlekelwa: Lena inkinga enkulu lapho ukuhlinzeka kungasebenzi ekulahlekeni kwesisindo. Isikhwama singase sibe sikhulu kakhulu, isiguli singase sishaye indiva imiyalelo yokukhulelwa, noma enye inkinga ingaba khona evimbela ukulahlekelwa kwesisindo.
Ukungabekezelelani kokudla: Enye yezinzuzo zalesi nqubo ukuthi konke ukudla kungadliwa emva kwenqubo, kanti ezinye ukuhlinzeka nge-bariatric zidinga ukuthi ugweme ukudla okuqondile. Lokhu akusho ukuthi umzimba uzobekezelela zonke izinhlobo zokudla, kusho ukuthi akukho ukudla okuvinjelwe ngemuva kwenqubo.
Ukunwetshwa kwemikhono: Ezinsukwini zokuqala emva kokuhlinzwa, isikhwama sesisu esihlala sisincane kakhulu futhi sizogcina isigamu sendebe yokudla ngesikhathi esisodwa.
Ngokuhamba kwesikhathi, isikhwama sikhwama futhi sikwazi ukufaka inani elikhulu lokudla endaweni eyodwa. Lokhu kuvumela ukudla okukhudlwana ukuthi kudliwe futhi ekugcineni kungaholela ekunqandeni isisindo noma ukutholakala kwesisindo.
I-Dyspepsia: Indigestion , noma isisu esithukuthele, ingaba njalo ngemva kokuhlinzwa komunwe wesisu.
Ukudluliswa komlutha: Lokhu kuyinto eyenzeka ngabanye abantu lapho bengasakwazi ukusebenzisa ukudla njengendlela yokuzibulala. Isibonelo, emva kosuku olukhuni emsebenzini, akusekho ukubuyela ekhaya futhi ugobele kuso sonke isitsha se-ayisikhilimu, ngeke nje sifane nesisu.
Ezinye izinhlobo zezidakamizwa ziba zikhangayo kakhulu njengoba zisengenzeka ngezinga elincane lomzimba-ukusetshenziswa kabi kotshwala, ukusetshenziswa kabi kwezidakamizwa, nokulutha kocansi kube phakathi kokuvamile ngemva kokuhlinzwa.
Ukuhlukaniswa: Ngenkathi kungesona inkinga yangempela emva kokuhlinzwa, ukuhlukanisa ngokuqinisekile kuyinkinga engaba khona okufanele icatshangelwe. E-United States, isilinganiso semishado engu-50 siphelela ngesehlukaniso, kanti imithombo ethile ibonisa ukuthi izinga lesahlukaniso emva kokuhlinzwa kwe-bariatric liphakeme ngamaphesenti angu-80.
I-Reflux Disease (GERD) ye-Gastroesophageal (GERD): I- Heartburn, kanye nezinye izimpawu zesifo se-reflux esinesifo se-gastro esibandakanya ukubhuka, isicanucanu, imizwa yokugcwala, isisu esithukuthele, kuvamile ngemva kwalokhu kuhlinzwa futhi kuvame ukudinga imithi.
Isithintelo sesisu : Ukuqhaqhazela nokwehliswa kwesisu, okubizwa nangokuthi i-stenosis, kungenza kube nzima noma akunakwenzeka ukugaya ukudla. Lezi zinkinga ngokuvamile zilungiswe udokotela ohlinzayo "owelula" noma ohlinzekela ukulungisa indawo eseduzane.
I-abscess : I-abscess iyinhlangano yeqoqo lezinto ezithathelwanayo (i-pus) eyenza emzimbeni endaweni efana ne-pocket. Kule nkinga yokuhlinzeka ngemikhono yesisu esiswini, ama-abscesses atholakale ehlathini, abanye badinga ukuba isilwane sisuswe, kodwa lezi zingavamile kakhulu.
Ukuvuza okulehlisiwe: Ukuvuza okukhulu komgwaqo, okubizwa nangokuthi ukuphazanyiswa komugqa we-suture noma i-SLD, kutholakala kungekudala ngemuva kokuhlinzwa. Kwezinye izimo indawo yesisu ehlanganiswe ndawonye izoqala ukuvuza izinyanga noma ngisho neminyaka emva kokuhlinzwa. Lokhu kuvuza kamuva kuhamba kakhulu kunelabo abathintekayo ngemva nje kokuhlinzwa kodwa kungabangela ukuhlukunyezwa okufanayo futhi kungadinga imithi, ukuhanjiswa esibhedlela, noma ukuhlinzwa ukulungisa.
Izilonda zesisu: Izilonda zesisu, ezaziwa ngokuthi izilonda zamaphilisi noma izifo zesilonda se-peptic (PUD), zivame ukuhlinzwa ngemva kokuhlinzwa kwesisu, futhi zivame ukutholakala ngesikhathi se-endoscopy esiphezulu ngemva kokuphaphazeka kwesiguli (kubonakala njengobumnyama, i-tarry stool noma njengegazi ukuhlanza) noma ubuhlungu esiswini.
I-nausea: I- nausea ingenye yezindaba ezivame kakhulu iziguli ezibhekana nazo ngemuva kwesigcawu se-gastrectomy. Kwabaningi, lezi zinkinga ziyathuthuka ngemuva kokuphulukiswa ekuhlinzekeni, kodwa kwabanye inkinga iqhubeka izinyanga noma ngisho nesikhathi eside. Imithi iyatholakala nge-nausea, engase ibe usizo kwabanye.
Ama-gallstones: Ama- gallstones ajwayelekile kakhulu ngemva kwazo zonke izinhlobo zokuhlinzwa kwe-bariatric, okwenza i-cholecystectomy (ukuhlinzekwa ukukhipha i-gallbladder) kuvame kakhulu iziguli zokuhlinzwa kwesisindo. Abesifazane baseCaucasia abangaphezu kweminyaka engama-40 abakhuluphele ngokweqile, noma ngaphandle kokuhlinzekwa, kungenzeka ukuthi badinga ukuhlinzeka nge-gallbladder ngesikhathi sokuphila noma ngaphandle kokuhlinzeka nge-bariatric.
Ukuhuda kwesisu: Kwezinye iziguli, ukuhuda kuyinkinga enkulu engase iqhubeke emva kokuhlinzwa. Ezimweni ezihlala isikhathi eside, udokotela ohlinzayo noma isifo se-gastroenterologist angakwazi ukusiza ukuyeka uhudo, okungabangela ukuphelelwa amandla kwamanzi nokungondleki.
Kudingeka izithako zokudla okunomsoco: Iziguli eziningi zokuhlinzeka nge-bariatric zidinga izithako zamavithamini namaminerali ngemuva kokuhlinzwa. Ngokungafani nezinqubo eziningi zokuhlinza ngezifo zesisu esiswini, iziguli ezinezinyosi zesisu zesisu sezinyosi azikho ushintsho emandleni abo okubamba izakhi emathunjini, kodwa ukwehlisa okukhulu ekutheni ukudla kungabangela ubunzima ekutholeni ukudla okwanele. Lokhu kungasiza ngokudla ukudla konke okudlayo, kepha ngisho nokudla okunempilo okungase kungabi ngokwanele ukunikeza zonke izidingo zomzimba.
Thola futhi: Enye yezinkinga ezibhekene neziguli zesisu esiswini ngokukhathazeka ngokuthi iningi lilahlekelwa isisindo kuphela ukuze ungabi nesisindo esingenasisekelo emuva. Ukulahlekelwa isisindo ngemuva kokuhlinzwa ukuze uthole okuthile noma konke okubuyiselwayo ngokuvamile kuqala ngonyaka wesithathu ngemuva kokuhlinzwa. Izinqubo zeBariatric iyithuluzi elikhulu lokulahleka kwesisindo, kodwa uma imikhuba ingashintshi futhi igcinwe kungenzeka ukuthi uthole noma isisindo esiningi ngokweqile.
Ukuhlala njalo: Ukuhlinzwa, okungcono noma okubi kakhulu, ukuguqula unomphela kwesisu. Ngokungafani nenqubo yegastric band, lapho ibhentshi ingasuswa uma kunenkinga, ingxenye yesisu ayikwazi ukushintshwa uma kunezinkinga noma izinkinga ngokugaya.
Ukulahlekelwa kwesisindo esincane kunezinye izinqubo: Abantu abanesifo sokugaya esiswini ngokuvamile balahlekelwa isisindo futhi bagcine amaphesenti aphezulu okweqile okwedlulele isikhathi eside uma kuqhathaniswa nokuhlinzwa komunwe wesisu. Lokho kusho ukuthi lezo zindlela zokuhlinza zingabonisa ngezinkinga ezehlukene nezinselele zesikhathi eside. Ukuzikhethela kokuhlinzwa kuyisinqumo somuntu siqu esenziwe kakhulu isiguli kanye nodokotela wabo odokotela, ngokusekelwe ezidingo zabo ngabanye.
Isifo sikashukela , umfutho wegazi ophakeme , nezinye izimo ezingapheli azixazululi: Kwabanye, ukuqeda izinkinga zempilo ezingapheli yisona isizathu sokuhlinzwa. Kwamanye abantu, lezi zinkinga azihambi ngemuva kokuhlinzwa, noma zingase zihambe okwesikhashana ezinyangeni zokuqala noma eminyakeni ngemva kokuhlinzwa, bese ubuyela kamuva.
Isikhumba sokuhlunga: Le nkinga ijwayele zonke izinhlobo zokuhlinzwa kwesisindo futhi kubangelwa isikhumba eselulele ngesikhathi sokukhuluphala. Ukwelashwa kuyatholakala ukuze ususe isikhumba esidlulele, kodwa odokotela abaningi abahlinzayo bakhetha ukulinda kuze isisindo sesiguli sesineke iminyaka eyodwa kuya kwemibili ngaphambi kokususa isikhumba esiphezulu.
Ukungakwazi ukuthatha ukudla okwanele: Ukulahlekelwa isisindo esinzima kungabonakala njengomphumela omuhle kumuntu odingeka ukulahlekelwa amapounds angu-100 noma ngaphezulu, kodwa iqiniso lihlukile kakhulu. Kungenzeka ukuthi isikhwama sesisu sibe mncane kakhulu, noma ngezinye izinkinga zokwenza isikhwama esincane kunalokho okuhlosiwe, okuholela ekuhlulekeni kokudla ubuningi bokudla okukhulu ngokwanele ukugcina umzimba ngokuhamba kwesikhathi. Le nkinga ingase ingabonakali ezinyangeni zakuqala emva kokuhlinzwa kodwa izoba yinto ecacile futhi yinkimbinkimbi lapho isiguli singakwazi ukugcina umgomo wabo isisindo futhi sibe mncane kakhulu.
Ukungondleki: Lo magazini uvela emafomu ahlukahlukene. Kungase kube nokudla okunciphise emaminerali kanye namavithamini okuholela ekungabikho kwezakhi ezibalulekile. Kungaba khona ukungakwazi ukuthatha amakholori anele. Kungaba nenkinga ngokuthola amakholori anele kanye nezakhi, ngenxa yezinkinga ezifana nesifo sohudo, isicashu, noma ezinye izinkinga. Ukungondleki kungaba yingozi kakhulu futhi kungathatha izithako, imithi, nokunye okungenelela ukugcina isiguli isikhathi eside.
I-hernia engenalutho : I-hernia ingasungula indawo yokucwaninga. Le nengozi iyancishiswa ngamasu wokuhlinza amancane (laparoscopic), kodwa i-hernia ingakwazi ukwakha ezinyangeni naseminyaka emva kokuhlinzwa. Ngokujwayelekile, lokhu kubonakala njengenqwaba encane esakhiweni sokungenwa kokuhlinzwa.
Ukunamathela kwesisu: Izitho nezicubu zesisu zisuke zishayekile, zivumela ukuba zihambe futhi zihanjane ngaphambi kokunyakaza okufana nokuguqa, ukuguqa nokuhamba. Ngemuva kokuhlinzwa, ukukhwabanisa kungenza lezi thambo "zinamathele" komunye nomunye, futhi lokhu kubangela ukuzwa okubangelwa ukucasula okubuhlungu ngokunyakaza.
> Imithombo:
> I-laparoscopic sleeve gastrectomy iqhathaniswa nezinye izinqubo zokuhlinzeka nge-bariatric: ukubuyekezwa okuhlelekile kokulingwa okungahleliwe. https://www.ncbi.nlm.nih.gov/pubmed/23993246
> Ukulungiswa okusheshayo noma ukwelashwa isikhathi eside? Izinzuzo kanye nokuqhathaniswa kokuhlinzwa kwe-bariatric. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3470459/#!po=29.3103
> Ukubuyekezwa kokulahlekelwa isisindo eside isikhathi eside ngemuva kwe-laparoscopic sleeve gastrectomy. https://www.ncbi.nlm.nih.gov/pubmed/24507083