Ukuthengiswa kwamathumbu amakhulu

Ukuthengiswa kwamathumbu amakhulu ukuhlinzwa ukususa konke noma ingxenye yamathumbu akho amakhulu. Lokhu kuhlinzwa kubizwa nangokuthi i-colectomy. Amathumbu amakhulu abizwa nangokuthi amathumbu amakhulu noma ikholoni.

• Ukususwa kwekholoni yonke kanye ne-rectum kubizwa ngokuthi yi-proctocolectomy.
• Ukususwa kwawo wonke amakholoni kepha hhayi i-rectum kubizwa ngokuthi yi-subtotal colectomy.
• Ukususwa kwengxenye yekholoni kepha hhayi i-rectum kubizwa ngokuthi yi-colectomy eyingxenye.

Amathumbu amakhulu axhumanisa amathumbu amancane nendunu. Imvamisa, indle idlula emathunjini amakhulu ngaphambi kokushiya umzimba nge-anus.

Uzothola i-anesthesia ejwayelekile ngesikhathi sokuhlinzwa kwakho. Lokhu kuzokugcina ulele futhi ungabi nezinhlungu.

Ukuhlinzwa kungenziwa nge-laparoscopically noma ngokuhlinzwa okuvulekile. Ngokuya ngokuthi yikuphi ukuhlinzwa onakho, udokotela ohlinzayo uzosika (ukusika) okukodwa noma ngaphezulu esiswini sakho.

Uma ngabe uhlinzwa nge-laparoscopic:

• Udokotela ohlinzayo usika (ukusikeka okuncane) oku-3 kuye kwayi-5 esiswini sakho. Umuthi wezokwelapha obizwa ngokuthi yi-laparoscope ufakwa ngenye yokusikeka. Ububanzi buyishubhu encane, ekhanyisiwe enekhamera ekugcineni. Ivumela udokotela ohlinzayo abone ngaphakathi kwesisu sakho. Ezinye izinsimbi zezokwelapha zifakwa ngokusebenzisa okunye ukusikeka.
• Ukusikwa okungamasentimitha ama-2 kuye kwayi-3 (amasentimitha ama-5 kuye kwayi-7.6) kungenziwa futhi uma udokotela wakho ohlinzayo edinga ukufaka isandla sakhe esiswini sakho ukuzwa noma ukususa isisu esigulayo.
• Isisu sakho sigcwele igesi engenabungozi ukusikhulisa. Lokhu kwenza indawo ibonakale kalula futhi isebenze kuyo.
• Udokotela ohlinzayo uhlola izitho esiswini sakho ukuze abone ukuthi azikho yini izinkinga.
• Ingxenye egulayo yamathumbu akho amakhulu itholakala futhi isusiwe. Amanye ama-lymph node nawo angasuswa.

Uma uhlinzwa uvulekile:

• Udokotela ohlinzayo usika amasentimitha ayi-6 kuye kwayi-8 (15.2 kuye kuma-20.3 centimeters) esiswini sakho esingezansi.
• Izitho ezisesiswini sakho ziyahlolwa ukubona ukuthi azikho yini izinkinga.
• Ingxenye egulayo yamathumbu akho amakhulu itholakala futhi isusiwe. Amanye ama-lymph node nawo angasuswa.

Kuzo zombili izinhlobo zokuhlinzwa, izinyathelo ezilandelayo yilezi:

• Uma kusele amathumbu amakhulu anempilo anele, amaphethelo athungwa noma ahlanganiswe ndawonye. Lokhu kubizwa nge-anastomosis. Iziguli eziningi zikwenzile lokhu.
• Uma lingekho ithumbu elikhulu elanele lokuphinda lixhume, udokotela ohlinzayo wenza imbobo ebizwa ngokuthi i-stoma ngesikhumba sesisu sakho. Ikholoni linamathele odongeni olungaphandle lwesisu sakho. I-Stool izodabula i-stoma iye esikhwameni sokukhipha amanzi ngaphandle komzimba wakho. Lokhu kubizwa nge-colostomy. I-colostomy ingaba yesikhashana noma ehlala njalo.

I-Colectomy imvamisa ithatha phakathi kwehora eli-1 nele-4.

Ukuthengiswa kwamathumbu amakhulu kusetshenziselwa ukwelapha izimo eziningi, kufaka phakathi:

• Ukuvaleka emathunjini ngenxa yezicubu ezibomvu
• Umdlavuza wamakholoni
• Izifo ezahlukahlukene (isifo sesisu esikhulu)

Ezinye izizathu zokuthengiswa kwamathumbu yilezi:

• I-polyposis ejwayelekile (ama-polyps yizikhukhula ezingxenyeni zekholoni noma i-rectum)
• Ukulimala okulimaza isisu esikhulu
• I-intussusception (lapho enye ingxenye yamathumbu idlulela kwenye)
• Ama-polyps anomdlavuza
• Ukopha okukhulu kwamathumbu
• Ukusonteka kwamathumbu (i-volvulus)
• I-ulcerative colitis
• Ukopha emathunjini amakhulu
• Ukuntuleka kokusebenza kwemizwa emathunjini amakhulu

Izingozi ze-anesthesia nokuhlinzwa ngokujwayelekile yilezi:

• Ukusabela emithini
• Izinkinga zokuphefumula
• Amahlule egazi, ukopha, ukutheleleka

Izingozi zalokhu kuhlinzwa yilezi:

• Ukopha ngaphakathi kwesisu sakho
• Izicubu ezibandayo ngokusika okuhlinzekwayo, okubizwa ngokuthi i-hernia yokugaya
• Ukulimala kwezitho zomzimba eziseduze
• Ukulimala kwe-ureter noma isinye
• Izinkinga nge-colostomy
• Izicubu ezibomvu ezakha esiswini futhi zibangele ukuvimba kwamathumbu
• Amaphethelo emathumbu akho ahlanganiswe ndawonye ayavuleka (ukuvuza kwe-anastomotic, okungasongela impilo)
• Kuvuleka isilonda
• Ukutheleleka kwesilonda
• I-Peritonitis
  

Tshela udokotela wakho ohlinzayo noma umhlengikazi ukuthi imiphi imithi oyiphuzayo, ngisho nezidakamizwa, izithasiselo, noma amakhambi owathengile ngaphandle kwencwadi kadokotela.

Khuluma nodokotela wakho ohlinzayo noma umhlengikazi ngokuthi ukuhlinzwa kuzokuthinta kanjani:

• Ukusondelana nobulili
• Ukukhulelwa
• Ezemidlalo
• Sebenza

Phakathi namasonto ama-2 ngaphambi kokuhlinzwa kwakho:

• Ungacelwa ukuthi uyeke ukusebenzisa imishanguzo emincane yegazi. Lokhu kufaka phakathi i-aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), nezinye.
• Buza udokotela ohlinzayo ukuthi yiziphi izidakamizwa okufanele usaziphuza ngosuku lokuhlinzwa kwakho.
• Uma ubhema, zama ukuyeka. Ukubhema kwandisa ubungozi bezinkinga ezinjengokuphulukiswa kancane. Buza udokotela wakho noma umhlengikazi usizo lokuyeka.
• Tshela udokotela ohlinzayo ngokushesha uma unomkhuhlane, umkhuhlane, umkhuhlane, ukuphuma kwe-herpes, noma esinye isifo ngaphambi kokuhlinzwa kwakho.
• Ungacelwa ukuthi uhambe ngokulungiswa kwamathumbu ukuhlanza amathumbu akho kuzo zonke izihlalo. Lokhu kungabandakanya ukuhlala ekudleni oketshezi izinsuku ezimbalwa nokusebenzisa ama-laxatives.

Ngosuku olungaphambi kokuhlinzwa:

• Ungacelwa ukuthi uphuze kuphela iziphuzo ezicacile ezifana nomhluzi, ujusi ocacile namanzi.
• Landela imiyalo yokuthi ungakuyeka nini ukudla nokuphuza.

Ngosuku lokuhlinzwa:

• Thatha izidakamizwa udokotela wakho ohlinzayo akutshele ukuthi uziphuze kancane.
• Fika esibhedlela ngesikhathi.

Uzohlala esibhedlela izinsuku ezintathu kuya kwezi-7. Kungadingeka ukuthi uhlale isikhathi eside uma i-colectomy ingukuhlinzwa okuphuthumayo.

Ungadinga futhi ukuhlala isikhathi eside uma inani elikhulu lamathumbu akho amakhulu lisusiwe noma uba nezinkinga.

Ngosuku lwesibili noma lwesithathu, cishe uzokwazi ukuphuza iziphuzo ezicacile. Uketshezi olujiyile bese ukudla okuthambile kuzongezwa njengoba isisu sakho siqala ukusebenza futhi.

Ngemuva kokuya ekhaya, landela imiyalo yokuthi ungazinakekela kanjani njengoba usalulama.

Iningi labantu abane-resection enkulu yamathumbu ilulama ngokuphelele. Noma nge-colostomy, abantu abaningi bayakwazi ukwenza imisebenzi ababekwenza ngaphambi kokuhlinzwa kwabo. Lokhu kufaka ezemidlalo, ezokuvakasha, izingadi, izintaba, neminye imisebenzi yangaphandle, nezinhlobo eziningi zomsebenzi.

Uma unesimo sesikhathi eside (esingapheli), njengomdlavuza, isifo seCrohn, noma i-ulcerative colitis, ungadinga ukwelashwa okuqhubekayo.

Ukukhuphuka kwe-colectomy; Ukwehla kwe-colectomy; I-colectomy eguqukayo; I-hemicolectomy yangakwesokudla; I-hemicolectomy yangakwesobunxele; Ukuthengiswa kwangaphakathi okuphansi; I-Sigmoid colectomy; I-subtotal colectomy; Proctocolectomy; Ukuthengiswa kabusha kwamakholoni; I-laparoscopic colectomy; I-Colectomy - ingxenye; Ukuthengiswa kabusha kwesisu esiswini

• Ukuphepha kwamakamelo abantu abadala
• Ukudla kweBland
• Ukushintsha isikhwama sakho se-ostomy
• Ileostomy nengane yakho
• Ileostomy nokudla kwakho
• Ileostomy - ukunakekela i-stoma yakho
• Ileostomy - ukushintsha isikhwama sakho
• Ileostomy - ukukhishwa
• Ileostomy - yini ongayibuza udokotela wakho
• Ukukhishwa kwamathumbu amakhulu - ukukhishwa
• Ukudla okuphansi kwe-fiber
• Ukuvimbela ukuwa
• Ukunakekelwa kwesilonda sokuhlinzwa - kuvulekile
• Izinhlobo ze-ileostomy
• Lapho unesicanucanu nokuhlanza

• Amathumbu amakhulu
• IColostomy - Uchungechunge
• Ukuthengiswa kwamathumbu amakhulu - Uchungechunge

UBrady JT, i-Althans AR, iDelaney CP. I-Laparoscopic colon ne-rectal surgery. Ku: UCameron JL, uCameron AM, ama-eds. Ukwelashwa Kwamanje. Umhla ka-12. IPhiladelphia, PA: Elsevier; 2017: 1520-1530.

Mahmoud NN, Bleier JIS, Aarons CB, Paulson EC, Shanmugan S, Fry RD. Ikholoni ne-rectum. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ISabiston Incwadi Yokuhlinzwa: Isisekelo Sebhayoloji Sokuzijwayeza Kwamanje Kokuhlinzwa. Umhla ka-20. IPhiladelphia, PA: Elsevier; 2017: isahluko 51.