Mhando dzakasiyana dzeClectlectomy Surgery Iyo Inogona Kuitwa Kugadzira Zvirwere
Kunyatsoisa, kuvhiyiwa kubvisa zvose kana chikamu chekoloni (musikana mukuru) inonzi colectomy. Zvisinei, pane marudzi akasiyana ekuvhiya. Vanhu vane chirwere chinoputika chirwere (IBD) vanogona kunge vane chirwere che colectomy kuti vabate chirwere chavo, asi rudzi rwekuvhiyiwa rwakaitwa, uye kuti yakawanda yekoloni inobviswa, ichave yakasiyana nedzimwe rudzi rwechirwere chiripo, uye sei kuwedzera kukanganisa kuri mumukumbo mukuru.
Kuvhiya kweClectomy kunowanzoiswa kune imwe yezvikamu zvakasiyana-siyana, zvichienderana nekuwanda kweiyo colon inobviswa, kana kuti iyo yose inobviswa.
Zvisinei, zvinofanira kuonekwa kuti kwete kuvhiyiwa kwega kwega kwakagadzirirwa IBD kunowira kune chimwe chezvikamu izvi: kune zvinogona kuchinja. Usati wavhiyiwa kuti ubvise chikamu kana kuti yako yose, taura neboka rako rokuvhiya pamusoro pekuvhiya chaiyo iwe uripo. Shandisa mutungamiri uri pasi apa kuti uzvizive nemamwe emashoko, kuti uzvibatsire zviri nani kunzwisisa chirwere chiri kuitwa nekuda kwako.
Proctocolectomy
Mune chirongwa ichi chekuvhiya kwecholectomy, ikoni inobviswa, pamwe chete ne rectum . "Procto" rinoreva "rectum." Iyo rectum ndiyo chikamu chemuviri uri pamagumo emakoloni ayo anoshandiswa kubata chigaro asati abviswa kubva mumuviri kuburikidza ne anus . Izvo zvose mapoloni uye rectum zvabviswa, muviri unoda nzira itsva yekurasa chigaro.
Kune vanhu vazhinji vane IBD (kana Crohn's disease kana ulcerative colitis), proctocolectomy inorevawo kusikwa kweeostomy . I-ileostomy ndiyo apo chikamu chemukati mudumbu chinounzwa kuburikidza nemumbu kuti uumbe stoma. Chifukidzo chinobva mumuviri wacho kuburikidza ne stoma, uye inounganidzwa mune imwe nhengo ye ostomy inopfeka kunze kwemuviri.
Ichoostomy inogona kuva yekusingaperi kana inogona kunge ichinguva chiduku.
J-Pouch Surgery
Imwe nzira yokuvhiya iyo inoitwa panguva imwe chete kana dzimwe nguva mushure mekunge proctocolectomy ibhokisi realeal-anal anastomosis (IPAA) . Mhando iyi yekuvhiya inowanzozivikanwa sej-pouch chirurgical (kunyange zvikwata zvekare zvakamboitwawo mu "S" kana "W" maumbirwo). Mukuvhiya uku, chikamu chekupedzisira chemukati mudumbu (iyo terminal terminal), inosungirirwa pamwe chete muchimiro che "J" uye inogona kubata chigaro kwenguva, inoshumira se rectum. I-j-pouch yakabatanidzwa kune anus pane imwe chirwere, kakawanda mushure mekunge kwenguva yakareba neostomy kwenguva pfupi. Mushure mekuvhiyiwa kwaitwa kuti ubatanidze tumukati maduku neinus, chigaro chinogona zvakare kubviswa kuburikidza ne anus (pasi). Kuvhiyiwa uku kunowanzoitwa kuonda kwepachirwere, asi mune zvimwe zviitiko zvinogona kuitirwa vanhu vane Crohn's disease .
Ileoanal Anastomosis
Imwe nzira yekuvhiya iyo inoitwa kuti idzore kukwanisa kuendesa chigamba kuburikidza ne anus inonzi "ileoanal anastomosis". Mukuvhiyiwa uku, mushure mokunge colon uye rectum zvabviswa, utumbo muduku hunobatanidzwa zvakananga anus. Pane kazhinji nguva yekumirira pakati pekuvhiya kwe-colectomy uye chirwere-kuburikidza nekuvhiyiwa, apo murwere ane leostomy kwenguva pfupi kubvumira kuporesa.
Hapana kana chikwama chakasikwa kubva pamucheche muduku. Kuvhiyiwa kwaiitwa kakawanda kune vanhu vane ulcerative colitis vasati vasvika 1980, vasati vashandura chirongwa chej-pouch. Chirwere-kuburikidza dzimwe nguva chinowanikwa kune vanhu vane Crohn's disease vasina zvirwere mumukati wavo muduku.
Total Colectomy
A colectomy zvachose zvinoreva kuti yose yekoloni yakabviswa. Izwi iri rinogona kunge rakavhiringidza kana richienzaniswa ne proctocolectomy nokuti mune colectomy yakazara, rectum yasara panzvimbo. Kushandiswa kwekamwechete nevamwe kana kuti yese ye rectum kuruboshwe munzvimbo inogona kuitika mune dzimwe mamiriro ehutachi inouraya kana chirwere cheCrohn.
Zvose zvinokonzerwa nekunyora kweeostomy (ine stoma, umo bhegi inopfeka kune kunze kwemuviri kutora chigaro). Ichoostomy inogona kuva yekusingaperi, asi mune dzimwe nguva ingangodaro ichinguvana. Kuvhiyiwa kwakawanda, zvakadai sokuvhiyiwa kwej-pouch kana chirwere-kuburikidza nekuvhiya-kupfurikidza, kunogona kuitwa kuti "kuyananisira" kamwana kadumbu kune rectum uye kushandura iyoostomy yenguva pfupi. Mushure mekuvhiyiwa kwaitwa kuti ubatanidze tumukati maduku ne rectum, chigaro chinogona zvakare kubviswa kuburikidza ne anus (pasi).
Partial Colectomy
Kushandiswa kwechikamu chisina kukwana kana chikamu chekoloni chibviswa, uye zvinogonawo dzimwe nguva kunzi maitiro e-cotomy colectomy. Mukuvhiya uku, chero chikamu chekoroni chinogona kubviswa. Chimwe chinhu chisina kukwana chingakonzerwa kune vamwe vanhu vane Crohn's disease, uye zvinogona kuitwawo kurapa kenza yekoloni kana kuti diverticulitis . Mushure mechikamu chekoloni icho chirwere chinenge chabviswa, hutano hwakanaka kune rumwe rutivi rwakabatana. A colostomy , iyo chikamu chekoloni chinounzwa kuburikidza nedumbu kuitira kuti chigaro chinogona kubviswa muhomwe yakavharwa pamimba, kazhinji haifaniri kudiwa.
A colectomy zvishoma haina kumbobvira yaitwa kuvanhu vane ulcerative colitis, nokuti chirwere ichi chinowanzodzoka muchikamu chine utano chekoroni yakasara. Muhosha yaCrohn, kunewo mukana wehutachiona huri kudzoka mumakoloni, uye kuvhiyiwa kunodiwa mune dzimwe nguva.
Chisarudzo chokubvisa chikamu chetoni muvanhu vane chirwere cheCrohn ndechimwe chisarudzo chakasarudzwa, uye inofunga kuwanda kwechirwere chiri mumakoroni uye rectum, pamwe chete nemakore uye hutano hwehutano.
Hemicolectomy
Mukuvhiya kwehemicolectomy, kana chikamu chakanaka kana chikamu chechikamu chekoloni chinobviswa. Mukodzero ye hemicolectomy, cecum , kukwira koroni , uye chikamu chemukati wekoni inobviswa, pamwe chete newedzeri , iyo inowirirana nekoni inokwira. Muchikamu chemanheru hemicolectomy, kuburuka kwekoni , uye chikamu chemukati wekoni inobviswa. Iyi nzira inogona kuitwa kuitira kubata chirwere cheCrohn, chivharo chemukoko , kana kenza yekoloni. Kazhinji, zvikamu zvine utano zvekoloni zvakabatana pamwechete uye ostomy haifaniri.
Kunobva:
Munhu B, Khaikin M. "Kuvandudza Kushandiswa kwezvirwere zveCrohn." Clin Colon Rectal Surg . 2007 Nov; 20 (4): 314-321. doi: 10.1055 / s-2007-991031. 22 Dec 2015.