Ukususwa kwepeni

Ukususa udakada kusenziwa utyando lokususa udakada onesifo okanye owonakeleyo. Olu tyando lubizwa ngokuba yi-splenectomy.

Ipeni lisengxenyeni ephezulu yesisu, kwicala lasekhohlo phantsi kwembambo. Udakada lunceda umzimba ukuba ulwe neentsholongwane kunye nosulelo. Inceda nasekucoceni igazi.

I-spleen iyasuswa ngelixa uphantsi kwe-anesthesia (ukulala kunye nentlungu). Ugqirha unokwenza i-splenectomy evulekileyo okanye i-laparoscopic splenectomy.

Ngexesha lokususa udakada:

• Ugqirha usika (ukusika) embindini wesisu okanye kwicala lasekhohlo lesisu ngaphantsi kweembambo.
• I-spleen ikhona kwaye isuswe.
• Ukuba unyangwa umhlaza, kuvavanywa ii-lymph node esiswini. Banokususwa kwakhona.
• Incision ivaliwe kusetyenziswa imithungo okanye istaples.

Ngexesha lokususwa kwepleparoscopic spleen:

• Ugqirha wenza i-3 okanye i-4 encinci yokusika esiswini.
• Ugqirha ufaka isixhobo esibizwa ngokuba yi-laparoscope ngenye yokusikeka. Ubungakanani bunekhamera encinci kunye nokukhanya esiphelweni, esivumela ugqirha ukuba abone ngaphakathi kwesisu. Ezinye izixhobo zifakwa ngokusikwa kwezinye.
• Irhasi engenabungozi ifakwa esiswini ukuyandisa. Oku kunika igumbi lotyando ukuba lisebenze.
• Ugqirha usebenzisa ubungakanani kunye nezinye izixhobo ukususa udakada.
• Umda kunye nezinye izixhobo ziyasuswa. Ukuvalwa kuvaliwe kusetyenziswa imithungo okanye ukutya okutyheli.

Ngoqhaqho lwe-laparoscopic, ukubuyela kwimeko yesiqhelo kudla ngokukhawuleza kwaye kubuhlungu kancinci kunokuhlinzwa. Thetha nodokotela wakho ogqirha malunga nokuba loluphi uhlobo lotyando olulungele wena okanye umntwana wakho.

Imiqathango enokufuna ukususwa kwepeni ibandakanya:

• Ithumba okanye umjikelo kudakada.
• Ihlwili legazi (thrombosis) kwimithambo yegazi yethambo.
• I-Cirrhosis yesibindi.
• Izifo okanye ukuphazamiseka kweeseli zegazi, ezinje nge-idiopathic thrombocytopenia purpura (ITP), isherocytosis yelifa, i-thalassemia, i-hemolytic anemia, kunye ne-elliptocytosis yelifa. Zonke ezi ziimeko ezinqabileyo.
• Hypersplenism (udakada).
• Umhlaza wenkqubo ye-lymph efana nesifo seHodgkin.
• Ileukemia.
• Amanye amathumba okanye umhlaza ochaphazela udakada.
• Isifo seanemia.
• I-Splenic artery aneurysm (inqabile).
• Umothuko kudakada.

Umngcipheko we-anesthesia kunye notyando ngokubanzi zezi:

• Impendulo kumayeza
• Iingxaki zokuphefumla
• Ukopha, amahlwili egazi, usulelo

Iingozi zolu tyando zibandakanya:

• Igazi elijiyileyo kwi-portal vein (umthambo obalulekileyo ohambisa igazi uye esibindini)
• Umphunga owileyo
• IHernia kwindawo yokusika yotyando
• Ukwanda komngcipheko wosulelo emva kwe-splenectomy (abantwana basemngciphekweni omkhulu kunabantu abadala kusulelo)
• Ukwenzakala kumalungu akufuphi, njengepancreas, isisu kunye nekholoni
• Ukuqokelela i-Pus phantsi kovalo

Iingozi zifana nokususwa kwepleen kunye ne-laparoscopic.

Wena okanye umntwana wakho uya kuba neendwendwe ezininzi kunye nabanikezeli bezempilo kunye neemvavanyo ezininzi ngaphambi kokuhlinzwa. Unokuba:

• Uvavanyo olupheleleyo lomzimba
• Ugonyo, olunjenge pneumococcal, meningococcal, Haemophilus influenzae, kunye namachiza omkhuhlane
• Ukuvavanya uvavanyo lwegazi, uvavanyo olukhethekileyo lokucinga, kunye nolunye uvavanyo ukuze uqiniseke ukuba usempilweni ngokwaneleyo ukuba ungatyandwa
• Ukumpontshelwa ukufumana iiseli ezibomvu zegazi kunye neeplatelets, ukuba uyazifuna

Ukuba uyatshaya, kuya kufuneka uzame ukuyeka. Ukutshaya kwandisa umngcipheko weengxaki ezinjengokuphola kancinci. Buza umboneleli wakho ngoncedo lokuyeka.

Xelela umboneleli:

• Ukuba ukhona, okanye unokukhulelwa.
• Ngawaphi amayeza, iivithamini kunye nezinye izongezo ozithathayo okanye ezenziwa ngumntwana wakho, nkqu nezo zithengwe ngaphandle kommiselo kagqirha.

Ngexesha leveki ngaphambi kotyando:

• Wena okanye umntwana wakho unokufuna ukuyeka okwethutyana ukuthoba igazi. Oku kubandakanya i-aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), ivithamin E, kunye ne-warfarin (Coumadin).
• Buza ugqirha ukuba ziphi iziyobisi wena okanye umntwana wakho omele uzithathe ngosuku lotyando.

Ngomhla wotyando:

• Landela imiyalelo malunga nokuba wena okanye umntwana wakho uyeke ukutya okanye ukusela.
• Thatha la mayeza ugqirha akuxelele wona okanye umntwana wakho ukuba awasele kunye nokusela okuncinci kwamanzi.
• Fika esibhedlele ngexesha.

Wena okanye umntwana wakho niza kuchitha ixesha elingaphantsi kweveki esibhedlele. Ukuhlala kwesibhedlele kunokuba ziintsuku ezi-1 okanye ezi-2 emva kwesprenectomy ye-laparoscopic. Ukuphilisa kuya kuthatha iiveki ezi-4 ukuya kwezi-6.

Emva kokuya ekhaya, landela imiyalelo ngokuzikhathalela wena okanye umntwana wakho.

Iziphumo zolu tyando zixhomekeke kwisifo okanye ukonzakala wena okanye umntwana wakho. Abantu abangenalo olunye ukonzakala kakhulu okanye iingxaki zonyango bahlala bechacha emva kolu tyando.

Emva kokuba udakumba ususwe, umntu usenokwenzeka ukuba abe nosulelo. Thetha nomboneleli malunga nokufumana ugonyo olufunekayo, ngakumbi ugonyo lonyaka lomkhuhlane. Abantwana banokufuna ukuthatha ii-antibiotics ukuthintela usulelo. Uninzi lwabantu abadala aludingi zintsholongwane ixesha elide.

Ubushushu; I-Laparoscopic splenectomy; Ukususwa kwepeni-laparoscopic

• Ukususwa kwethambo kwilaparoscopic kubantu abadala-ukukhutshwa
• Vula ukususwa kwendoda kubantu abadala - ukukhupha
• Ukususwa kwepeni-ukukhutshwa komntwana
• Unonophelo lwenxeba lotyando - luvulekile
• Xa unesicaphucaphu nokugabha

• Iiseli ezibomvu zegazi, ekujolise kuzo iiseli
• Ukususwa kwepeni-uthotho

IBrandow AM, iCamitta BM. I-Hyposplenism, splenic trauma, kunye ne-splenectomy. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, ii-eds. Incwadi kaNelson yeNcwadi yePediatrics. Umhla wama-21. IPhiladelphia, PA: Elsevier; 2020: isahl 514.

UMier F, uMzingeli JG. I-Laparoscopic splenectomy. Ku: UCameron JL, uCameron AM, ii-eds. Unyango lwangoku lonyango. Umhla we-12. IPhiladelphia, PA: Elsevier; Ngo-2017: 1505-1509.

IPoulose BK, iHolzman MD. Udakada. 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 56.