Ukuthengiswa okukhulu kwamathumbu

Ukuthengiswa kwamathumbu amakhulu kutyando lokususa yonke into okanye inxenye yesisu sakho esikhulu. Olu tyando lukwabizwa ngokuba yi-colectomy. Amathumbu amakhulu abizwa ngokuba lithumbu elikhulu okanye ikholoni.

• Ukususwa kwekolon yonke kunye ne-rectum ibizwa ngokuba yi-proctocolectomy.
• Ukususwa kwayo yonke ikholoni kodwa ingeyiyo i-rectum ebizwa ngokuba yi-subtotal colectomy.
• Ukususwa kwenxalenye yekholoni kodwa hayi i-rectum ibizwa ngokuba yi-colectomy.

Amathumbu amakhulu adibanisa ithumbu elincinci ukuya kwi-anus. Ngokwesiqhelo, isitulo sidlula kwisisu esikhulu ngaphambi kokushiya umzimba nge-anus.

Uya kufumana i-anesthesia ngokubanzi ngexesha lotyando lwakho. Oku kuyakukugcina ulele kwaye ungabi nazintlungu.

Olu tyando lunokwenziwa nge-laparoscopically okanye ngotyando oluvulekileyo. Kuxhomekeka kuloluphi na utyando onalo, ugqirha wotyando uya kwenza ukusikwa okukodwa okanye nangaphezulu (ukusikwa) esiswini sakho.

Ukuba utyando lwe-laparoscopic:

• Ugqirha wenza i-3 ukuya kwi-5 yokusika okuncinci esiswini sakho. Isixhobo sonyango esibizwa ngokuba yi-laparoscope sifakwa kwesinye sezicucu. Ubungakanani yityhubhu encinci, ekhanyisiweyo kunye nekhamera ekugqibeleni. Ivumela ugqirha abone ngaphakathi kwesisu sakho. Ezinye izixhobo zonyango zifakwa kwezinye izinto ezisikayo.
• Ukusikwa malunga nee-intshi ezi-2 ukuya kwezi-3 (i-5 ukuya kwi-7.6 iisentimitha) kungenziwa kwakhona ukuba ugqirha wakho kufuneka abeke isandla sakhe esiswini sakho ukuze uve okanye ususe isilonda esigulayo.
• Isisu sakho sigcwele irhasi engenabungozi ukusandisa. Oku kwenza ukuba kube lula ukubona indawo nokusebenza kuyo.
• Ugqirha uvavanya amalungu asesiswini sakho ukujonga ukuba akukho ngxaki na.
• Inxalenye yesifo samathumbu akho amakhulu ibekwe kwaye isuswe. Ezinye i-lymph nodes nazo zingasuswa.

Ukuba utyando luvulekile:

• Ugqirha usika ii-intshi ezi-6 ukuya kwezi-8 (i-15.2 ukuya kwi-20.3 iisentimitha) kwisisu sakho esezantsi.
• Amalungu esiswini sakho ayavavanywa ukujonga ukuba akukho ngxaki na.
• Inxalenye yesifo samathumbu akho amakhulu ibekwe kwaye isuswe. Ezinye i-lymph nodes nazo zingasuswa.

Kuzo zombini iintlobo zotyando, amanyathelo alandelayo ngala:

• Ukuba kukho intsalela eyaneleyo yamathumbu asempilweni aseleyo, iziphelo ziyothungwa okanye zidityaniswe ngokudityaniswa. Oku kubizwa ngokuba yi-anastomosis. Uninzi lwezigulana zikwenzile oku.
• Ukuba awanelanga amathumbu aphilileyo ukuba adibanise kwakhona, ugqirha wotyando wenza ukuvulwa okubizwa ngokuba yi-stoma kulusu lwesisu sakho. Ikholoni iqhotyoshelwe eludongeni lwangaphandle lwesisu sakho. I-Stool iya kuhamba nge-stoma ibe yingxowa yokuhambisa amanzi ngaphandle komzimba wakho. Oku kubizwa ngokuba yicolostomy. I-colostomy inokuba yeyethutyana okanye esisigxina.

I-Colectomy ihlala ithatha phakathi kwe-1 kunye neeyure ezingama-4.

Ukuthengiswa kwamathumbu amakhulu kusetyenziselwa ukunyanga iimeko ezininzi, kubandakanya:

• Ukuvaleka emathunjini ngenxa yezihlunu ezibomvu
• Umhlaza wamathumbu
• Isifo esahlukileyo (isifo sesisu esikhulu)

Ezinye izizathu zokuthengiswa kwamathumbu zi:

• I-polyposis eyaziwayo (iipolyps kukukhula kumaleko ekholoni okanye kwi-rectum)
• Ukulimala okonakalisa amathumbu amakhulu
• Ukungena ngaphakathi (xa elinye icala lamathumbu lityhala kwelinye)
• Iipolyps ezinobunzima
• Ukopha ngamandla emathunjini
• Ukujija kwamathumbu (volvulus)
• Ukudumba okwenziwa sisilonda sikabhobhosi
• Ukopha kumathumbu amakhulu
• Ukungabikho komsebenzi we-nerve kumathumbu amakhulu

Umngcipheko we-anesthesia kunye notyando ngokubanzi zezi:

• Impendulo kumayeza
• Iingxaki zokuphefumla
• Amahlwili egazi, ukopha, usulelo

Iingozi zolu tyando zezi:

• Ukopha ngaphakathi esiswini sakho
• Izicubu ezibandayo ngokusikwa kotyando, okubizwa ngokuba yi-henictional hernia
• Ukonakaliswa kwamalungu akufuphi emzimbeni
• Umonakalo kwi-ureter okanye bladder
• Iingxaki nge-colostomy
• Izicwili ezibomvu ezenzeka esiswini kwaye zibangele ukuvaleka kwamathumbu
• Imiphetho yamathumbu akho athungwe kunye iyavuleka (i-anastomotic leak, enokubusongela ubomi)
• Ukuvuleka kwenxeba
• Usulelo lwenxeba
• I-Peritonitis
  

Xelela ugqirha wakho okanye umongikazi ukuba ngawaphi amayeza owasebenzisayo, nditsho neziyobisi, izongezo, okanye amayeza owathengileyo ngaphandle kommiselo.

Thetha nogqirha wakho okanye umongikazi malunga nokuba utyando luya kuchaphazela njani:

• Ukusondelelana kunye nokwabelana ngesondo
• Ukukhulelwa
• Imidlalo
• Umsebenzi

Ngexesha leeveki ezi-2 ngaphambi kotyando lwakho:

• Unokucelwa ukuba uyeke ukuthatha iziyobisi ezincinci zegazi. Oku kubandakanya i-aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn) kunye nezinye.
• Buza ugqirha ukuba ngawaphi amayeza ekufuneka uwathathe ngemini yotyando lwakho.
• Ukuba uyatshaya, zama ukuyeka. Ukutshaya kwandisa umngcipheko weengxaki ezinjengokunyanga kade. Buza ugqirha wakho okanye unesi ukuba akuncede uyeke.
• Xelela ugqirha ngokukhawuleza ukuba unokubanda, umkhuhlane, umkhuhlane, ukuphuma kwe-herpes, okanye esinye isifo ngaphambi kotyando lwakho.
• Unokucelwa ukuba uhambe ngokulungiselela amathumbu ukucoca amathumbu akho kuzo zonke izitulo. Oku kunokubandakanya ukuhlala kukutya okungamanzi iintsuku ezimbalwa kunye nokusebenzisa laxatives.

Usuku ngaphambi kotyando:

• Unokucelwa ukuba usele kuphela ulwelo olucacileyo olufana nomhluzi, ijusi ecacileyo kunye namanzi.
• Landela imiyalelo malunga nokuba uyeke nini ukutya nokusela.

Ngomhla wotyando:

• Thatha la mayeza ugqirha wakho akuxelele ukuba uthathe ngesiphuzo esincinci samanzi.
• Fika esibhedlele ngexesha.

Uya kuba sesibhedlele iintsuku ezi-3 ukuya kwezi-7. Kuya kufuneka uhlale ixesha elide ukuba i-colectomy ibilulungelelwaniso olungxamisekileyo.

Kuya kufuneka ukuba uhlale ixesha elide ukuba inani elikhulu lamathumbu akho makhulu lisuswe okanye uneengxaki.

Ngosuku lwesibini okanye lwesithathu, uya kuba nakho ukusela ulwelo olucacileyo. Ulwelo olutyebileyo kunye nokutya okuthambileyo kuya kongezwa njengoko amathumbu akho eqala ukusebenza kwakhona.

Emva kokuba ugodukile, landela imiyalelo yendlela yokuzikhathalela njengoko uphilisa.

Uninzi lwabantu abane-resection resection enkulu ephila ngokupheleleyo. Nokuba une-colostomy, uninzi lwabantu luyakwazi ukwenza imisebenzi ebebeyenza ngaphambi kotyando lwabo. Oku kubandakanya uninzi lwezemidlalo, ukuhamba, ukwenza igadi, ukunyuka intaba, eminye imisebenzi yangaphandle, kwaye uninzi lweentlobo zomsebenzi.

Ukuba unesifo sexesha elide (esingapheliyo), njengomhlaza, isifo seCrohn, okanye i-ulcerative colitis, unokufuna unyango oluqhubekayo.

Ukunyuka kwecolectomy; Ukuhla kwecolectomy; Colectomy enqamlezileyo; I-hemicolectomy yasekunene; I-hemicolectomy yasekhohlo; Ukuthengiswa okuphantsi kwangaphambili; Sigmoid colectomy; I-colectomy engaphantsi; Proctocolectomy; Ukuthengiswa kwakhona kweColon; I-laparoscopic colectomy; Colectomy - inxenye; Ukuthengiswa kwakhona kwesisu esiswini

• Ukhuseleko kwigumbi lokuhlambela kubantu abadala
• Ukutya kweBland
• Ukutshintsha ingxowa yakho ye-ostomy
• Ileostomy nomntwana wakho
• Ileostomy kunye nokutya kwakho
• Ileostomy - ukukhathalela i-stoma yakho
• Ileostomy-ukutshintsha ingxowa yakho
• Ileostomy - ukukhutshwa
• Ileostomy - yintoni oza kuyibuza ugqirha wakho
• Ukuthengiswa kwakhona okukhulu kwamathumbu - ukukhutshwa
• Ukutya okune-fiber encinci
• Ukuthintela ukuwa
• Unonophelo lwenxeba lotyando - luvulekile
• Iindidi zeileostomy
• Xa unesicaphucaphu nokugabha

• Amathumbu amakhulu
• IColostomy-Uthotho
• Ukuthengiswa kwakhona kwamathumbu amakhulu-uthotho

UBrady JT, iAlthans AR, iDelaniy CP. I-Laparoscopic colon kunye nokuhlinzwa kotyando. Ku: UCameron JL, uCameron AM, ii-eds. Unyango lwangoku lonyango. Umhla we-12. IPhiladelphia, PA: Elsevier; Ngo-2017: 1520-1530.

UMahmoud NN, uBleier JIS, uAarons CB, uPaulson EC, uShanmugan S, uFry RD. Ikholoni kunye ne-rectum. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, ii-eds. Incwadi yeSabiston yoNyango: Isiseko sebhayiloji yoQeqesho lwangoku. Umhla we-20. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 51.