Le atikewɔwɔ ƒe nɔnɔme aɖewo ta, vevietɔ kuxi siwo le dɔgbo gã la ŋu ta la, ehiã be woawɔ dɔ na ame hafi aɖe akpa ma ɖa. Emegbe, wowɔa ʋuƒo sue aɖe ɖe ƒodoa ƒe ŋutigbalẽ me be gbeɖuɖɔ nate ŋu ado go le ŋutilãa me. Eyata, woƒoa aɖuɖɔa nu ƒu ɖe akplo si wotsɔ bla ɖe ʋuƒo sia ŋu me. Agbenɔnɔ kple akplo sia ate ŋu ana ame aɖewo ƒe dzi nadze eme vie. Ate ŋu ase le eɖokui me abe mɔxenu ene ne èle ha dem kple amewo, do awu, eye nèle gbesiagbedɔwo wɔm. Eyata ne mɔ aɖe li si dzi míato aƒo gbeɖuɖɔ nu ƒu ɖe ŋutilãa me gota kotoku sia manɔmee eye míakɔe ɣesiaɣi si míedi ya ɖe? Ema gbɔ kpɔnue nye Kock kotoku si ŋu míele nu ƒom tsoe egbea.
Kpuie ko la, nukae nye Kock kotoku (K-kotoku) sia?
Bu eŋu kpɔ, le esi teƒe be akplo nanɔ wò ŋutilã godo la, ke ne àte ŋu awɔ kotoku sue aɖe si ate ŋu aƒo gbeɖuɖɔ nu ƒu ahadzrae ɖo ɖe wò ŋutilã me ya ɖe? Emae nye nusi Kock kotokua nye.
Le colectomy megbe la, wotsɔa wò dɔgbo suea ƒe nuwuwu, si nye ileum, vaa ŋutigbalẽ si le wò ƒodo me la tame eye wowɔa ʋuƒo sue aɖe. Woyɔa esia be ileostomy. Woyɔa ʋuʋu sia be stoma. Zi geɖe la, wowɔa esia to gotagome kotoku aɖe dede stoma la ŋu me.
Gake le Kock kotoku ƒe dɔwɔwɔ me la, amekolaa zãa wò ŋutɔ wò dɔgbo sue ƒe akpa aɖe tsɔ wɔa kotoku sue aɖe le wò ŋutilã me . Akplo sia do ƒome kple ʋuƒo (stoma) si le wò ƒodo me tẽ. Eyata mèhiã gotagome akplo be nàtsɔ aƒo wò aɖuɖɔ nu ƒu o. Ne ehiã la, woate ŋu atsɔ mɔ̃ sue aɖe (catheter) ato ʋuƒo sia me eye woate ŋu akɔ gbeɖuɖɔ siwo ƒo ƒu ɖe kotokua me la ɖa.
Esia le abe "akɔta ememetɔ" si le ŋutilãa me si míate ŋu akɔ ƒuƒlu ɣesiaɣi ene. Amekola Nils Kock ƒe ŋkɔe wotsɔ nɛ.
Nukawoe nye Kock kotoku zazã?
Wozãa mɔnu sia koŋ na amesiwo wòle be woanɔ agbe kple `ileostomy` si nɔa anyi ɖaa gake womedi be yewoazã gotagome aɖuɖɔkotoku o. Viɖe gãtɔ kekeake si le esia ŋue nye be woate ŋu akpɔ aɖuɖɔ ƒe zɔzɔ dzi.
Le ileostomy si sɔ me la, aɖuɖɔ ate ŋu aƒo ƒu ɖe kotokua me ɣesiaɣi. Míate ŋu aɖu edzi o. Gake woyɔa ileostomy si me Kock kotoku le be continence ileostomy. Ema fia be "woate ŋu aɖu edzi." Le go sia me la, aɖuɖɔ ƒoa ƒu ɖe kotoku si le eme la me, tsɔ wu be wòado go, eyata ablɔɖe le asiwò be nàkɔe ɣesiaɣi si nèdi.
- Nyatakaka bubuwo: Le gɔmedzedzea me la, wowɔ Kock kotokua be wòanye akplo si le eme be woatsɔ aƒo aɖuɖɔ nu ƒu na dɔnɔ siwo woɖe woƒe tsinyegoewo. Wogazãa mɔnu ma egbea, gake woto mɔnu yeye geɖewo vɛ fifia.
Aleke wowɔa amekoko siae?
Wò amekola ate ŋu awɔ Kock kotokua le ɣeyiɣi ɖeka me kple wò ileostomy, alo woate ŋu awɔe le amekoko bubu me emegbe. Esia fia be ne wowɔ ileostomy na wò xoxo la, àte ŋu atrɔ ɖe Kock kotoku ŋu emegbe.
Ne míagblɔe bɔbɔe la, wowɔa amekokoa ale:
1. Akploa wɔwɔ: Ðɔkta la axɔ wò ŋutɔ wò dɔgbo sue ƒe nuwuwu abe sentimeta 18 ene eye wòakloe wòazu "U" ƒe nɔnɔme. Emegbe, woaʋu dɔgboa le agbalẽxatsaxatsa sia titina eye woalɔ̃ eƒe goawo ɖekae. Esia ana woawɔ kotokua.
2. Valve la Wɔwɔ: Esiae nye akpa vevitɔ kekeake. Wozãa dɔgbo si susɔ le akploa ƒe nuwuwu tsɔ wɔa ʋuƒo tɔxɛ aɖe (`mɔ ɖeka dzi ʋuƒo`). Ele abe ʋɔtru si ʋuna ɖe akpa ɖeka ko ene. Ne wotsɔ gbeɖuɖɔwo yɔ eme la, ʋuƒo sia tua le eɖokui si. To mɔ sia dzi la, aɖuɖɔ, tsi, kple ya medoa go o.
3. Kadodo: Mlɔeba la, wotsɔa nuwuwu kple valvɔa blaa ʋuƒo (`stoma`) si wowɔ le wò dɔgbo me. Ðɔktaa alé ŋku ɖe eŋu be nusianu le dɔ wɔm nyuie eye tsi aɖeke mele dodom o hã.
Nukae dzɔna le amekokoa megbe? Ɣeyiɣi didi kae wòxɔna hafi wòhayana?
Le amekokoa megbe la, ahiã be nànɔ kɔdzi abe ŋkeke etɔ̃ va ɖo atɔ̃ ene. Le ɣeyiɣi sia me la, woatsɔ mɔ̃ vovovowo aƒo ƒu ɖe wò ŋutilã ŋu be wòakpe ɖe ŋuwò nàhaya kaba.
- `IV` tube na saline nana
- `IV nutrition` na nunyiame
- Abi ƒe tsidzɔƒe siwo ɖea gbeɖuɖɔ ɖa le abi la ŋu
- Aɖuɖɔtoe me ʋuka
- `Vevesese ƒe pɔmpi` na vevesese dzi ɖuɖu
Mègatsi dzi ɖe nusiawo ŋu o, wo katã nye ɣeyiɣi kpui aɖe ƒe nu.
Woagblẽ ka si wotsɔ de wò dɔgbo me la ɖe teƒea kwasiɖa geɖe. Esia ana gbeɖuɖɔa nado le kotoku yeye si wowɔ me vaseɖe esime abi la nahaya. Dɔnɔdzikpɔla aɖe afia alesi nàlé be na catheter la wò.
Ne èyi aƒeme heɖi ɖe eme kwasiɖa ʋɛ aɖewo vɔ la, wò ɖɔkta aɖe mɔ̃ sia ɖa. Emegbe, dɔnɔdzikpɔla aɖe afia alesi wò ŋutɔ nàzã mɔ̃ (catheter) si wozãna edziedzi atsɔ akɔ akploa me la wò.
Gbã la, ahiã be nàkɔ tsinyegoe me abe zi 8 ene gbesiagbe. Gake mègatsi dzi o, le ɣleti ʋɛ siwo gbɔna me la, kotoku yeye sia si le wò ŋutilã me la alolo ɖe edzi vivivi. Le ema megbe la, ɖewohĩ zi 2-4 koe wòahiã be nàkɔe ƒuƒlu gbesiagbe.
Viɖe siwo le Kock kotoku me kple kuxi siwo ate ŋu ado tso eme
Abe atikewɔwɔ ɖesiaɖe ene la, viɖe kple afɔku siaa le eŋu. Na míalé ŋku ɖe wo ŋu.
| Viɖe | Kuxi siwo ate ŋu ado mo ɖa |
|---|---|
| Mehiã be nàtsɔ gotagome akplo o: Mehiã be nàdo gotagome ileostomy akplo alo akpɔ edzi o. | Valve ƒe kuxiwo: Ɣeaɖewoɣi la, valve la ate ŋu adzo eye wòana aɖuɖɔ nado. Alo ate ŋu axe mɔ na ʋuƒoa eye womate ŋu ade mɔ̃a me o. Dɔgbo ƒe xexe keŋkeŋ nye nusi dzɔna kpata. Ne edzɔ alea la, ele be nàyi ETU (Emergency Treatment Unit) enumake. |
| Ablɔɖe kple ame ŋutɔ ƒe nyawo gbɔ kpɔkpɔ geɖe wu: Woate ŋu atsɔ nu sue aɖe abe gaze ene atsyɔ stoma la dzi. Esia madze le gota o. | Fistulas: Mɔ̃ siwo mesɔ o ate ŋu adzɔ tso kotokua me ayi ŋutigbalẽa alo ŋutinu bubuwo me. Esia ate ŋu ana ame nase veve eye wòaxɔ dɔlékuiwo. |
| Ale Si Nàte Ŋu Aɖu edzi: Àte ŋu akɔ tsinyegoe me ɣesiaɣi kple afisiafi si nèdi, evɔ aɖuɖɔ manɔ dodom le ŋkekea me o. | Pouchitis: Akploa ƒe dɔdzẽ alo dɔlékui aɖe. Esia nye nɔnɔme si bɔ. Zi geɖe la, woate ŋu atsɔ dɔlékuiwutikewo adae kaba. |
| Alɔ̃dɔdɔ nyuie: Ele bɔbɔe ŋutɔ be nàdɔ alɔ̃ le zã me. Mahiã be nàfɔ le zã titina hafi akɔ wò akplo me o. | Ʋuʋua ƒe ʋuʋu (Stricture/stenosis): Abi ate ŋu ana stoma la naxe eye wòasesẽ be woatsɔ mɔ̃a ade eme. |
| Parastomal hernia: Dɔgboa ƒe akpa aɖe dona ɖe gota to stoma la me. Esia ate ŋu ahe mɔxenu hã vɛ. |
Ne kuxi siawo do mo ɖa la, ɣeyiɣi aɖewo li siwo me wòahiã be woawɔ dɔ bubu (`revision surgery`) atsɔ aɖɔ wo ɖo. Le Kock kotoku gome la, vevietɔ le valvɔ ƒe kuxiwo ta la, amekoko si wogbugbɔ trɔa asi le alea ƒe agbɔsɔsɔme sɔ gbɔ vie wu mɔnu bubuwo (anɔ abe 30%). Gake wò ɖɔkta aɖe nusiawo katã me na wò nyuie.
Vovototo kae le Kock kotoku kple J-kotoku dome?
Togbɔ be nu siawo evea siaa nye kotoku ƒomevi siwo wowɔ le ŋutilãa me hã la, ale si wowɔa dɔe la to vovo kura.
- Kock Pouch (K-pouch): Wowɔa esia kple `ileostomy`, si nye ʋuʋu (`stoma`) le dɔgboa me. Wokɔa aɖuɖɔ to mɔ̃ (`catheter`) si wotsɔ dea ʋuƒo si le dɔgboa me me.
- J-Pouch: Esia nye mɔnu bubu si woate ŋu azã ɖe ileostomy teƒe. Le afisia la, wowɔa kotoku aɖe tso dɔgbo suea ƒe nuwuwu eye wòdoa ka kple aɖuɖɔ (aɖuɖɔtoe) tẽ. Esia wɔnɛ be mehiã be woawɔ stoma (dɔgbo ƒe ʋuʋu) o. Dɔnɔa ate ŋu ayi nugododeƒe eye wòaɖe aɖuɖɔ le mɔ si sɔ nu.
Zi geɖe la, dɔnɔ siwo di be woaɖe yewoƒe dɔgbo kple dɔgbo siaa ɖa la tiaa J-kotoku ƒe dɔdamɔnua. Gake hafi J-kotoku nakpɔ dzidzedze la, ele be lãmeka siwo le dɔgboa me nanɔ dɔ wɔm nyuie. Le amesiwo mate ŋu akpɔ J-kotoku le susu aɖe ta o, alo na amesiwo si J-kotoku si do kpo nu le la, Kock kotoku nye tiatia nyui aɖe.
Ðe nèdi be yeawɔ tɔtrɔ le yeƒe nuɖuɖu ŋua?
Ẽ, nuɖuɖu si da sɔ eye nunyiame le ɖuɖu le vevie ŋutɔ be nàhaya kabakaba. Ne wò aɖuɖɔwo le kpekpem akpa alo tsi akpa la, àte ŋu awɔ tɔtrɔ suesuesuewo le wò nuɖuɖu ŋu. Ate ŋu aɖe vi ŋutɔ ne èdi aɖaŋuɖoɖo tso nuɖuɖuŋutinunyala gbɔ. Wò ɖɔkta ate ŋu aɖo wò ɖe ame aɖe si sɔ gbɔ.
Gbedasi si Wotsɔ Yi Aƒeme
- Kock kotoku nye tiatia nyui aɖe na amesiwo medi be yewoanɔ agbe kple gotagome ileostomy akplo o.
- Esia akpe ɖe ŋuwò nàɖu wò dɔgbo ƒe ʋuʋu dzi eye wòana ablɔɖe kple akɔfafa geɖe wu ne èle ha dem.
- Gake abe alesi wòle le amekokowo katã gome ene la, afɔku kple kuxiwo li, vevietɔ ʋukawo ƒe kuxiwo.
- Hafi nàtso nya me nenye be mɔnu sia sɔ na wò la, ele vevie ŋutɔ be nàƒo nu kple wò ɖɔkta eye nàse viɖe kple kuxi siwo katã le eme la gɔme nyuie.

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