Kunzwisisa Ngozi dzeSleeve Gastrectomy
Iyo nzira yekugadzira gumbo, iyo inonziwo sleeve gastrectomy, inoburitsa iyo inoderedza ukuru hwemudumbu kukurudzira kuora kwekuora. Inenge 80 muzana yemudumbu inobviswa chirwere, ichisiya chikamu-sechikamu chemukati munzvimbo, nekubvisa zvachose zvachose. Mvura yakasara inogona kutanga inobata maawa mana kana 120 milliliters, kuderera kukuru kubva kuhukuru hwemuviri wepamu.
Izvi zvinoderera mukukura kwemuviri zvinoreva kuti munhu anongodya chete hafu yekapu panguva imwechete, uye anodzivirira kuwanda kwezvokudya zvinogona kudyiwa, izvo zvinotapudzawo makirasi anogona kutorwa, zvichiita kuti kuora kurasike.
Pasinei nekuderera kwekukura kwemuviri, chirwere ichi chigadziri uye chinoda kuti munhu aite kutevera mirayiridzo, kurega kudya kwekudya, uye kutevera chirongwa chinopiwa nechiremba. Zvinokwanisika kudyisa uye kuve nekurema kuderedza kurasikirwa mushure mekuvhiyiwa. Zvinogonawo kuva nechinetso chakakomba mushure mekuvhiyiwa, saka nzira yacho inofanira kutorwa zvakanyanyisa, sekuvhiyiwa chero kupi zvako.
Zvinetso Zvenguva refu YeGastric Sleeve
Kune mhando mbiri dzezvinetso zvekugadzira sleeve sleeve: yakaoma uye isingaperi. Matambudziko akaoma ndeaya anoitika nguva pfupi mushure mekuvhiyiwa uye nyaya dzisingagumi ndezvokuti dzinomuka kana dzinopfuurira mwedzi mitanhatu mushure mezuva rekuvhiyiwa. Zvinetso zvakanyanya zvinosanganisira kubuda ropa, kurwadziwa, neropa.
Gastric sleeve, iyo yose, inonzi yakachengeteka kana ichienzaniswa nemamwe mavhivhi anowanzoitwa. Kufa kunobva kuhutano hakunakwanisi, uye kana ukaitwa nechiremba anovhiya ane chiremba, nzira yacho ine zviduku zvinetso. Izvozvo zvakati, zvinetso, kana zvikaitika, zvinogona kubva pane zviduku zviduku kusvika kune zvakakosha uye zvingangoita nyaya dzinochinja upenyu.
Zvakakoshawo kuziva kuti ichi chirwere chitsva. Chimwe chezvinhu zvinokosha izvo kutsvakurudza masayendisiti kutarisa ndezvakaitika kwemakore gumi. Muchiitiko ichi, ruzivo urwu nderokuti varwere vari kuchengetedza sei kuora kwavo, izvo hutano hwavo hwose hunoita sei, uye chero matambudziko angave aive nawo nekuda kwekuvhiyiwa. Kuva yakarongeka zvitsva, kune dhesi yemakore gumi-diki kupfuura kune mamwe mavhivhi, akadai saRoux En Y, uye mamwe matambudziko akawanda kwenguva refu anogona kuwedzerwa kune urongwa urwu munguva yemberi.
Kukundikana kwokutanga kurasikirwa: Ichi chinetso chakakomba apo kuvhiyiwa hakubatsiri kushaya kurasikirwa. Iyo homwe inogona kunge yakakura kwazvo, murwere angave asina hanya nekurairwa kwemirayiridzo, kana imwe nyaya ingave iripo iyo inodzivirira kuora kwekuora.
Kuvhiringidzika kwezvokudya: Chimwe chezvibatsiro zvemuitiro uyu ndechokuti zvikafu zvose zvinogona kudyiwa mushure mekugadzirisa, asi mamwe mavhiatric ekuvhiya anoda kuti urege kudya zvakakwana. Izvozvo hazvirevi kuti muviri unotsungirira marudzi ose ezvokudya, zvinongoreva kuti hapana zvokudya zvinorambidzwa mushure mekuita.
Sleeve dilation: Mumazuva okutanga mushure mekuvhiyiwa, chirongo chemuviri chinoramba chiri chiduku zvikuru uye chichabata hafu yekapu yezvokudya panguva imwechete.
Nokufamba kwenguva, bhegi racho rinotambanudza uye rinokwanisa kugadzirisa zviyero zvakakura zvezvokudya mune imwe chete. Izvi zvinobvumira kudya kwakakura kunopedzisira uye kunogona kutungamirira pakurema kurasikirwa kumira kana kuwedzera pfuma kutanga.
Dyspepsia: Indigestion, kana kushungurudzika mumimba, inogona kuva kazhinji kacho mushure mekuvhiyiwa kwemasuo echingwa .
Dhiyabhorosi Kutengesa: Ichi ndicho chinoshamisa chinoitika nevamwe vanhu pavanenge vasisakwanisi kushandisa zvokudya senzira yekuzvipa-mishonga manzwiro avo. Somuenzaniso, mushure mekuoma kwezuva kubasa, hazvikwanisi kuenda kumusha uye kunyorera pane chigadziko chose che ice cream, hachingakwanikwi mudumbu.
Mamwe maitiro ekudhakwa anowedzera kuwedzerwa sezvaanenge achikwanisa nekamudiki masimba ekudhakwa-kudhakwa zvinodhaka, kushandiswa kwezvinodhaka, uye kushungurudza zvepabonde kuva pakati pezvinowanzoitika mushure mekuvhiyiwa.
Kurambana: Kunyange zvazvo isiri dambudziko rezvemuviri mushure mekuvhiyiwa, kurambana zvechokwadi kunogona kusanganisa kunofanira kufungwa. MuUnited States, avhareji ye50 muzana yemichato inoguma mukurambana, asi mamwe magwaro anoratidza kuti chiyero chokurambana mushure mekuvhiyiwa kwainzi bariatric inopfuura 80 muzana.
Gastroesophageal Reflux Disease (GERD): Kushungurudza, pamwe chete nezvimwe zviratidzo zvegastro esophageal reflux zvirwere zvinosanganisira kubvongodza, kusuruvara, kunzwa kwekuzara, kushungurudzika mudumbu, kwakajairika mushure mekuvhiyiwa ichi uye kazhinji kunoda mishonga.
Kugadzikana kwechirwere: Kupisa uye kuderera kwechirwere chemuviri, chinonziwo stenosis, kunogona kuita kuti zvive zvakaoma kana kusabvira kugadzira zvokudya. Izvi zvinowanzogadziridzwa nechiremba anovhiya uyo "anotambanudza" kana kuti kuvhiya anogadzirisa nzvimbo yave yanyatsopera.
Kushushikana: Chikamu chinosanganiswa chezvinhu zvinotapukira (pus) zvinoumba mumuviri mune imwe nzvimbo yehomwe. Muchiitiko ichi chekuvhiyiwa kwemajoka emakumbo, mapfupa akave akawanikwa mune chirwere, zvimwe zvinoda kuti spleen ibudiswe, asi izvi hazviwanzoitiki.
Delayed Leak: Most suture line deaks, inozivikanwa sekuti suture line kuvhiringidzika kana SLD, inowanikwa mushure mekuvhiyiwa. Mune zvimwe zviitiko nzvimbo yemudumbu yakange yakasimbiswa pamwe chete ichatanga kumhanya kwemwedzi kana kunyange makore mushure mekuvhiyiwa. Izvi zvinotevera kubuda kunopfurikidza zvakanyanya kudarika izvo zvakaongororwa nguva pfupi mushure mekuvhiyiwa asi zvinogona kunge zvakaoma uye zvinogona kudikanwa mishonga, hospitali, kana chirwere kugadzirisa.
Chironda chepondach: Zvironda zveponda, zvinonzi sepptic ulcers kana peptic ulcer chirwere (PUD), zvinonyanya kuonekwa mushure mekuvhiyiwa kwemaoko, uye zvinowanzoongororwa panguva yepamusoro endoscopy mushure mekunge chirwere ichibuda ropa (chinonzi serima, tarry stool kana ropa kurutsa) kana kurwadziwa mudumbu.
Nausea: Nausea ndechimwe chezvinhu zvinowanzosangana nevarwere mushure mekugadzirisa sleeve gastrectomy. Kune vakawanda, nyaya dzinovandudza mushure mokunge dzichidzoka kubva pakuvhiyiwa, asi kune vamwe dambudziko racho rinopfuurira kwemwedzi kana kunyange kwenguva refu. Mishonga inowanikwa nokuda kwekushungurudza, izvo zvingabatsira kune vamwe.
Gallstones: Gallstones inowanzova yakawanda pashure pemhando dzose dzekuvhiyiwa kwebhanatric, zvichiita kuti cholecystectomy (kuvhiyiwa kubvise gorovladder) inowanzove yakawanda pakurapa kurasikirwa nevarwere. Vakadzi veCaucasian vanopfuura makore makumi mana vanopfuura kudarika, vane kana pasina upiyona, vanowanzodikanwa kuvhiyiwa chirwere munguva yehupenyu hwavo kana pasina chirongwa che chirongwa chechiraatric.
Dhairrhea: Kune vamwe varwere, chirwere chetachiona chinetso chakakomba chingaenderera mberi mushure mekuvhiyiwa. Mumamiriro ezvinhu anogara kwenguva yakareba, chiremba kana chirwere chegastroenterologist chinogona kubatsira kubvisa mararamiro, izvo zvinogona kutungamirira kuora mvura uye kusagadzikana.
Chido chekugadzirisa zvinokonzera utano: Vazhinji vanovhiyirwa varwere vanoda zvirongwa zvevhitamini nemaminera mushure mekuvhiyiwa. Kusiyana nevakawanda vanoita chirwere chegumbo, varwere vane chirongwa chemuviri wegumbo havakwanisi kuchinja mukukwanisa kwavo kunwa mishonga mumatumbo, asi kuderera kunoshamisa kwekudya kunogona kuita kuti matambudziko awane kudya kwakakwana. Izvi zvinogona kubatsirwa nokudya zvokudya zvakakwana kudya, asi kunyange kudya kwakakodzera hakugone kukwana kupa zvese zvinodikanwa zvemuviri.
Dzorerazve: Chimwe chezvinetso izvo varwere vemajoka vane gumbo vanozvidya mwoyo pamusoro pekurasikirwa kwega kwega nekusazvigadzirisa kuwedzera uremu zvakare. Kurasikirwa uremu mushure mekuvhiyiwa chete kuti uwane zvimwe kana kuti zvose zvadzo zvekare zvinotanga mugore rechitatu mushure mekuvhiyiwa. Bariatric maitiro ndiwo chinhu chikuru chekurasikirwa kwemazivi, asi kana tsika dzisingashandurwi uye dzakachengetwa zvinokwanisika kuwana zvimwe kana kuwanda kwehuwandu hwekudzoka zvakare.
Permanency: Kuvhiyiwa, kwepamusoro kana yakaipisisa, kushandura nekusingaperi kwemudumbu. Kusiyana negastric band maitiro, apo bhanhire rinogona kubviswa kana pane dambudziko, chikamu chemuviri hachigoni kuchinjwa kana pane zvinetso kana nenyaya nekudya.
Kusapera kuderedza kurasikirwa pane dzimwe nzira: Vanhu vane chirwere chepamuviri chepamusoro vanorasikirwa norema uye vanoramba vachiwedzera huwandu hwehuwandu hunorema kwenguva yakareba kana vachienzaniswa nekugadzirwa kwemaoko. Izvozvo zvakati, kuvhiyiwa uku kunogona kuunza nenzira dzakasiyana uye dzakaoma nyaya dzenguva refu. Chisarudzo chekuvhiya isarudzo yega yega yakanakisisa yakagadzirwa nemurwere uye chiremba wavo, kubva pane zvavanoda.
Chirwere cheshuga , huwandu hwehutachiona , nezvimwe zvinhu zvisingaperi hazvigadzirise: Kune vamwe, kubvisa zvirwere zvisingagumi zvehutano ndicho chikonzero chekuvhiyiwa. Mune vamwe vanhu, zvinetso izvi hazvibviri mushure mekuvhiyiwa, kana kuti vangaenda kwenguva duku mumwedzi yekutanga kana makore apera kuvhiyiwa, uye dzoka zvakare.
Kuchengetedza ganda: Izvi zvinowanzosiyana nemhando dzose dzekurema kurasikirwa uye kune chikonzero cheganda rinotarisana panguva yekuderedza. Kuvhiya kunowanikwa kuti ubvise ganda rakawandisa, asi vanachiremba vakawanda vanofarira kumirira kusvikira mutoro wechirwere wakagadzikana kwemakore maviri kusvika maviri asati abvisa ganda rakawandisa.
Kusakwanisa kutora zvakakwana zvezvokudya: Kurasika kurema kunogona kutaridzika sechibereko chakanaka kumunhu anoda kupera mapaundi zana kana kupfuura, asi chokwadi chiri chakasiyana zvakasiyana. Zvinogoneka kuti chikwama chemukati chive chiduku zvikuru, kana zvimwe zvekuita kuti chikwama chidiki kudarika chinangwa, chinotungamirira kusakundikana kudya huwandu hwezvokudya zvakakura zvakakwana kuchengetedza muviri kupfuura kwenguva. Nyaya iyi ingasave yakajeka mumwedzi yekutanga mushure mekuvhiyiwa asi ichava pachena uye yakaoma kana murwere asingakwanisi kuchengeta chinangwa chekuyera uye kuva kunyanya kuderera.
Kusagadzikana kwezvokudya zvinovaka muviri: Nyaya iyi inouya nenzira dzakasiyana-siyana. Ikoko kunogona kuve nekuderera kuderera mumaminerari uye mavitamini anotungamirira kushayiko rwezvinhu zvinokosha zvinokosha. Ikoko kunogona kusakwanisa kutora makorikwani akakwana. Ikoko kunogona kuva nechinetso nekuwana makakori akakwana uye mishonga, nekuda kwemashoko akadai sezuva, chirwere, kana zvimwe zvinhu. Kusagadzikana kwezvokudya kunogona kuva kwakakomba uye kunogona kutora zvigadzirwa, mishonga, uye mamwe mazano kuitira kuti murwere ave akanaka kwenguva refu.
Incisional hernia : A hernia inogona kuiswa panzvimbo yechinhu chipi zvacho chokuvhiya. Iyi njodzi inoderedzwa ne minimally invasive (laparoscopic) maitiro ekuvhiya, asi chinonzi hernia chinogona kuumbwa mumwedzi nemakore mushure mekuvhiyiwa. Kazhinji, ichi chinoratidzika sechidiki chiduku panzvimbo yekushandiswa kwekuvhiya.
Mikana yepamuviri: Nhengo nematumbu zvemuviri zvinowanzosvetedza, zvichiita kuti vafambe uye vashandurane pane imwe nguva panguva yekutama, kufungidzira, nekufamba. Mushure mekuvhiyiwa, kupora kunogona kuita kuti mishonga iyi "inamatira" kune mumwe nemumwe, uye izvi zvinokonzera kushungurudzika kunogona kukonzerwa nekugumbura kunorwadza nekufamba.
> Sources:
> Laparoscopic sleeve gastrectomy yakaenzaniswa nedzimwe bariatric yokuvhiya: chirongwa chekuongorora maitiro akaoma. https://www.ncbi.nlm.nih.gov/pubmed/23993246
> Kurumidza kugadzirisa kana kurapa kwenguva refu? Pros uye nhamo ye chirongwa chebhaatric. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3470459/#!po=29.3103
> Kudzokorora kwemazuva mashoma ekurasikirwa kwemigumisiro mushure mekunyora kwesaroscopic sleeve gastrectomy. https://www.ncbi.nlm.nih.gov/pubmed/24507083