Kurasikirwa Kwekureruka Zvokuvhiya: The Duodenal Switch
Iroodenal shanduko yekurasikirwa kurasikirwa kunozivikanwa nemazita akawanda, kusanganisira DS uye biliopancreatic diversion ne duodenal switch. Iyi nzira ndeyekubatanidza malabsorptive nekudzivirira kurasikirwa kwekureruka. Izvi zvinoreva kuti nzira iyi inoderedza kuwanda kwemakorii anokwanisa kubatwa nematumbo nekuderedza chiyero chemukati chinobatana nezvokudya uye kunoderedzawo kuwanda kwezvokudya zvinogona kugadziriswa nedumbu uye kushandiswa nemuviri.
Kuchinja kwedodenal kunobatanidza kusikwa kwechikwata chemukati chechikwata chepamu uye nekupfuura chikamu chemukati mudumbu . Izvi zvinobvumira murwere kuderedza uremu asi pasina kuchinja maitiro avo ekudya - kana achienzaniswa nemamwe marudzi ekurema kurasika. Dumbu rinokwanisa kubata anenge masendimita mashanu kusvika kumatanhatu ezvokudya, nepo dzimwe nzira dzakawanda dzinowanzoita kuti dzikwanise kubata hafu imwe kune imwechete yakazara.
Duodenal Switch Process
Iroodenal switch procedure inowanikwa muchipatara kana nzvimbo yekuvhiya, achishandisa anesthesia yakawanda . A laparoscopic, nzira yekuvhiya inotanga nehafu yakareba masendimita inch yakareba mukati memudumbu uye pakati pemimba.
Dumbu racho rinoramba richibatanidza chikamu chekutanga chemukati mudumbu, iyo duodenum , iyo yakabva yakaparadzana kubva kune imwe musikana muduku. Iyo duodenum inobva yakabatanidzwa kune chikamu chakaderera chemukati mudumbu, ichipfuura chikamu chechipiri nechetatu chikamu chemukati mudumbu.
Izvi zvinoreva kuti zvikamu zvemukati mudumbu zvakapfuura hazvikwanisi kuwana mishonga kubva pakudya, nekuderedza chiyero chemukumbo chinotora zvokudya, zvishoma nezvakori, mineral uye mavhithamini zvinogona kubatwa.
Chiremba anovhiya anosarudza kuti hakuna nzvimbo dziri kubuda, uye ipapo zvigadzirwa zvinodzingwa uye izvo zvingaonekwa zvakasungwa, zvinowanzo ne sutures inogadziriswa kana tape isina kubatwa.
Upenyu Pashure peDodenal Switch
Dhiodenal kuvhiya kwevhenekeri kune migumisiro yakaisvonaka, pamwe nemuviri wevarwere anorasikirwa ne70 kusvika ku80% yehuwandu hwehuwandu hwake mumakore maviri anotevera nzira. Zvisinei, varwere vanosarudza chirongwa ichi chekuvhiya vari pangozi yakakwirira yekushaya kukwana kwehutano kupfuura kune mamwe maitiro ekurasikirwa kurasikirwa. Zvinokonzerwa nekudzivirira kusadya kwemanheru mushure mekuita izvi, asi kuwedzerwa kwezvokudya, kusanganisira mavitamini nemaminerari, zvingangove zvakakosha muupenyu hwemu murwere.
Iyi nzira yaitarisirwa kunge iri kuvandudzwa pane biliopancreatic diversion (BPD), nzira yakwegura. Vanachiremba vaifunga kuti nokuchengetedza pyloric sphincter iyo inovhara pasi pemudumbu, zvokudya zvaizova nemukana wekuvandudzwa zviri nani, kuderedza chiyero chokushaya zvokudya zvinovaka muviri uye kushaya simba kwevhitamini nekudzivirira dumping syndrome mushure mekuvhiyiwa. Kunyange zvakadaro, zvidzidzo zvakaratidza kuti hapana misiyano mumitengo yekushaya zvokudya zvinovaka muviri mushure mekuvhiya maviri.
Nguva refu, varwere vazhinji vanosarudza chirongwa ichi chekuvhiya vanoguma nemigumisiro inogara. Muviri haukwanisi kugadzira zvose zvekudya zvakatorwa, mararamiro emararamiro haafaniri seanokosha sezvaanoita nemamwe marudzi ekuvhiya bhaarric .
Mukuwedzera, varwere vanokwanisa kudya zvikamu zvakakura zvikuru kune avo vane mamwe maitiro ekudzivirira masero ekurasikirwa kurasikirwa, zvichiita kuti varwere vakawanda vagutsikane.
Kunyange zvazvo kubatsirwa kwekudya kudya kwakakura uye kurasikirwa kwemahombekombe hakusi kungoita chete asi kukwanisa kuchengetwa kunokwezva kune vanotarisira varwere, vashoma vanovhiya vanoita izvi, naizvozvo kuita kutevera kushanya kungave kwakaoma mushure mekuvhiyiwa kana murwere achifanira kufamba zvakakosha kure kure kuona chiremba. Unyanzvi hwako hwekuchengeta zvitevedzeri zvekutsvaga mushure mekuvhiyiwa kunofanira kutorwa mukufungisisa paunosarudza chirwere ichi - uye chiremba anovhiya achazviita.
Sources:
> Bariatric Surgery For Severeity Yakawanda. Consumer Information Sheet. National Institute of Diabetes and Digestive and Kidney Diseases. March 2008. http: // http://win.niddk.nih.gov/publications/gastric.htm
> Jones, Nicolas V. Christou, MD, PhD, Didier Tarisai, MD, uye Lloyd D. MacLean, MD, PhD. "Kurema Kunowanikwa Mushure Mokukurumidza-uye Kwema-Limb Gastric Inpass muvarwere Vanoteverwa Kwemarefu Kupfuura Makore 10." Annals of Surgery 2006 November; 244 (5): 734-740.