Ngokuvamile, Ukuhlinzwa Kwe-J-Pouch Kubhekwa Ngokujwayelekile Ukwelapha I-Ulcerative Colitis
Isikhumba se-Ileoanal anal anastomosis (i-IPAA)-noma njengoba sekuvame kakhulu, ukuhlinzwa kwe-j-isikhwama -ba yihlobo oluthandwayo lokuhlinzwa kubantu abaningi abane-ulcerative colitis futhi abadinga ukuhlinzwa. Lolu hlobo lokuhlinzekwa lungenziwa nakwa-familial adenomatous polyposis (FAP) noma amacala athile omdlavuza we- colorectal . Kodwa-ke, kubantu ababhekene nenye indlela yesifo sofuba (IBD) , isifo se-Crohn, i-j-isikhwama ngokuvamile ayicatshangwanga njengendlela enamandla.
Yini i-J-Pouch?
Ukuhlinza nge-J-pouch ngokuvamile kwenziwa kubantu abane-ulcerative colitis noma lapho ukwelapha kwezokwelapha kwehluleka futhi izimpawu zingenakugwenywa, noma uma kunezinguquko zangaphambi komdlavuza emgqonyeni (amathumbu amakhulu) . Enombolweni ethile yabantu abane-ulcerative colitis, imithi etholakalayo yokwelapha i-IBD ingase ingasize ekuqaliseni ukuxolelwa noma ngokunciphisa izimpawu, futhi izinga lempilo lingase libe mpofu kangangokuthi ukuhlinzwa kubhekwa. Abantu abane-ulcerative colitis basengozini enkulu yokuthuthukisa umdlavuza we-colon, futhi ukususwa kwe-colon kuvame ukuphakanyiswa uma imiphumela ye- biopsy evela embukisweni we-colon ngaphambi komdlavuza noma umdlavuza.
Kuhlinzwa kwe-j-pouch, ikholoni isusiwe, kanye nenxenye noma yonke irectum . Ingxenye yokugcina yamathumbu amancane asetshenziselwa ukwenza isikhwama-ngokuvamile esesimweni se "J," kodwa "S" kanye "W" futhi ngezinye izikhathi kwenziwa. Isikhwama esenziwe emathunjini amancane ke sixhunywe kwi- anus (noma i-rectum, uma kukhona kwesokunxele), okwenza ukuqedwa kwesitoreji kube "okuvamile". Ukuhlinzwa kuvame ukuqhutshwa ngezinyathelo ezimbili, kodwa kungenziwa futhi ngezinyathelo ezilodwa noma ezintathu.
Kungani Kungenjalo Ukuhlinzwa Okuvamile Ukwenzelwa Izifo ZaseCrohn?
Ngesifo sofuba esiswini, isifo, nokuvuvukala okuhambisanayo, kutholakala emathunjini amakhulu. Ukususa amathumbu amakhulu, ngenkathi kungelapheki i-IBD, kususa isitho esithinteka kakhulu yisifo. Ngesifo sikaCrohn, noma iyiphi ingxenye yegciwane lokugaya ingathinteka ukuvuvukala ngisho noma isisu sisusiwe, isifo sikaCrohn singasaphindela.
Eqinisweni, izindawo ezivame kakhulu ukuvuvukala kubantu abanesifo sikaCrohn yi-ileum kanye nomathumbu omkhulu. I-ileum iyisigaba sokugcina samathumbu amancane, futhi yingxenye esetshenziselwa ukwenza isikhwama sokuhlinzwa ku-IPAA. Isizathu sokuqala siwukuthi, uma isifo sikaCrohn sithinta isikhwama, isikhwama singase "siphumelele" futhi ekugcineni sidinga ukususwa. Kukhona neziguli eziye zatholakala ukuthi zine-ulcerative colitis, zine-j-pouch ukuhlinzwa, futhi ngokuhamba kwesikhathi ukuxilongwa kwashintsha isifo sikaCrohn (nakuba lokhu kungavamile).
Kodwa-ke, ucwaningo mayelana nama-j-isikhwama kubantu abane-Crohn's disease luye lwaveza imiphumela ehlangene. Ucwaningo oluthile lubonisa ukuthi iningi lesiguli sezifo zika Crohn kanye nesifo se-j-poch esikwazi ukuhluleka isikhwama semfuyo futhi sidinga ukuthi sibe nokuhlinzwa okungaphezulu ukuze sisuse futhi senze i- ileostomy engunaphakade . Kodwa ezinye izifundo zibonisa ukuthi iziguli ezithile ezikhethiwe ngokucophelela ngezinhlobo ezithile ze-Crohn's disease zingase zikwazi ukubekezelela ukuhlinzwa kwe-j-pouch. Ngokufika kwemithi yokwelapha ye-biologic ye-IBD (njenge- Remicade , i- Humira , i- Cimzia , i-Tysabri, ne-Entyvio), abantu abane-Crohn's disease banezinketho zokwelashwa ezingaphezu kwalokho ngaphambili.
Ngakho-ke, I-IPAA AYAKHONZWA KWEZINHLOKO ZESIKHATHI SESIKHUMA
Njengezinto eziningi eziphathelene ne-IBD, kukhona okuhlukile.
Njengamanje kunengxabano phakathi kwabaholi abakhulu bokubheka ukuthi ngabe iziguli eziphethe isifo sikaCrohn zingathola yini i-j-poch futhi zenze kahle. Kunezinye izimo zabantu ezixilongwa nge- colhn's colitis noma indlithithi engapheliyo eye yahlinzwa ukuhlinzwa kwe-j-poch. Kodwa-ke, kukhona ingozi ephezulu yokubhekana nezinkinga kanye nokuhluleka kwesigxoke esilandelayo kuleli qembu leziguli. Akuzange kube khona izifundo ezingenangqondo mayelana ne-j-poch ezigulini zezifo zikaCrohn ezinganikeza ubufakazi obunembile bokuqeda ukuphikisana ngendlela eyodwa noma enye.
Njengazo zonke izihloko eziningi eziphikisanayo ku-IBD, ayikho isu eliye lafakazelwa ukuthi liphakeme.
Noma yisiphi isinqumo mayelana nokudala i-j-pouch yeziguli ezine-Crohn's disease kufanele senziwe kuphela ngamaqembu akhethekile esikhungweni sokunakekelwa kwezikole eziphakeme kakhulu futhi ekhethekile ekuphatheni i-IBD.
Imithombo:
I-Braveman JM, uSchoetz DJ Jr, uMarcello PW, uRoberts PL, uColler JA, uMraray JJ, uRusin LC. "Isiphetho sebhokisi le-lial ku-iziguli ezithuthukisa isifo sikaCrohn." I-Dis Colon Rectum . 2004 Oct; 47 (10): 1613-1619.
I-Brown CJ, i-Maclean AR, i-Cohen Z, i-Macrae HM, i- O'Connor BI, iMcLeod RS. "Isifo sikaCrohn nesifo sochungechunge esingenakulinganiswa nesikhwama se-ileal-anal an analomosis: imiphumela kanye namaphethini okuhluleka." I-Dis Colon Rectum . 2005 Aug; 48 (8): 1542-1549.
UJoyce MR, Fazio VW. "Ingabe isikhwama se-ileal anal anastomosis singasetshenziswa esibhedlela sikaCrohn?" U- Adv Surg . 2009; 43: 111-137.