Ðewohĩ ɖɔkta gblɔ na wò alo ame aɖe si nènya be ehiã be woawɔ dɔ na yewo si woyɔna be ‘proctocolectomy’. Esɔ be nàvɔ̃ vie eye nàtsi dzodzodzoe ne èse nya sia. Anɔ eme be nyabiase geɖewo le ta me na wò, abe "Nukae nye amekoko sia? Nukatae mehiã esia? Aleke nye agbenɔnɔ anɔ le esia megbe?" Mega tsi dzi o. Mina míaƒo nu tso nusiawo katã ŋu le mɔ bɔbɔe aɖe ŋutɔ nu, afɔɖeɖe ɖesiaɖe, abe alesi nàƒo nu kple xɔ̃wò ene.
Kpuie ko la, nukae nye Proctocolectomy?
Proctocolectomy nye amekoko si ɖea wò dɔgbo gã (dɔgbo) kple dɔgbo ƒe akpa aɖe alo wo katã ɖa.
Azɔ mina míagaɖe nya sia me vie. Akpa aɖe le míaƒe nuɖuɖumeŋusẽ si woyɔna be dɔgbo gã la ŋu. Akpa etɔ̃e le eme: dɔgbo, dɔgbo, kple dɔgbo. Bu eŋu be enye mɔ̃ didi aɖe.
- Dɔgbo: Esiae nye mɔ̃ sia ƒe akpa gãtɔ. Afisiae gbeɖuɖɔ siwo susɔna ne míeɖu nuɖuɖu si míeɖuna vɔ la, woxɔna eye wotrɔna zua nu sesẽ aɖe, si woyɔna be aɖuɖɔ.
- Aɖuɖɔtoe: Esia nye dɔgbo gã la ƒe akpa kpui si dzraa aɖuɖɔ ɖo hena ɣeyiɣi aɖe hafi wòdona le ŋutilãa me.
- Aɖuɖɔtoe: Esiae nye ʋɔtru si me aɖuɖɔ dona le ŋutilãa me.
Le proctocolectomy amekoko me la, "procto" fia dɔgboa eye "colectomy" fia dɔgbo ƒe ʋuʋu. Eyata , proctocolectomy nye amekoko si ɖea dɔgbo kple dɔgbo siaa ɖa. Ɣeaɖewoɣi la, ne dɔgboa koe woɖe la, woyɔnɛ be colectomy. Ne woɖe aɖuɖɔtoea ko la, woyɔnɛ be proctectomy. Èse vovototo si le wo dome gɔmea?
Nukatae wòhiã be woawɔ dɔ sia ƒomevi na wò?
Ne susu vevi aɖe li ko hafi ɖɔktawo kafui be woawɔ dɔ gã aɖe abe esia ene. Zi geɖe la, wowɔa amekoko sia ne nɔnɔme aɖe si le dɔgboa alo dɔgbo me xe mɔ na dɔgbo alo dɔgbo me dɔ nyuie, alo ne nɔnɔmea de ame ƒe agbe afɔku me.
Susu vevi aɖewoe nye esi:
- Dɔgbo ƒe Dɔléle Siwo Dzroa Dɔgboe (IBD): Esiawo nye nɔnɔme siwo nana dɔgboa xɔa abi eye wòxɔa abi ɣeyiɣi didi. Ulcerative Colitis kple Crohn ƒe Dɔléle nye esia ƒe kpɔɖeŋu vevitɔwo. Ele be woaɖe ame aɖewo ƒe dɔgbo ƒe akpa siwo ŋu dɔléle le la ɖa ne womate ŋu atsɔ atike aɖu wo dzi o.
- Dɔdzẽ si le dɔgboa me kple nɔnɔme siwo do ŋgɔ na kansa: Ne kansa lãmenugbagbeviwo va le dɔgboa alo dɔgbo me, alo ne polyp siwo ate ŋu azu kansa va do (nɔnɔmewo abe Familial Adenomatous Polyposis ), atikewɔwɔ nyuitɔe nye be woaɖe teƒe siwo dɔlélea le ɖa keŋkeŋ.
- Susu bubuwo tae:
- Ischemia dzɔna ne ʋu ƒe sisi yi dɔgboa me bu eye lãkusiwo ku.
- Diverticulitis ƒe nɔnɔme sesẽwo.
- Nuveviwɔame si nu sẽ le dɔgboa ŋu le afɔku gã aɖe ta.
- Dɔmeɖui sesẽ si womate ŋu atsɔ atike adae o.
Nu vevitɔ kekeakee nye be wole amekoko sia wɔm be woatsɔ aɖe wò agbe eye wòana nànɔ agbe si nyo wu, si me dzidzeme le wu.
Aleke nèwɔna toa aɖuɖɔ me le amekoko vɔ megbe?
Esiae nye nyabiase gãtɔ kekeake si le amesiame ƒe susu me. Ne woɖe dɔgbo kple dɔgbo siaa ɖa vɔ la, mɔ si sɔ si dzi aɖuɖɔ tona dona la megali o. Aleke nèwɔa aɖuɖɔe ɣemaɣi?
Esia ƒe ŋuɖoɖo nɔ te ɖe proctocolectomy ƒomevi si wɔm nèle dzi. Wò ɖɔkta anɔ te ɖe wò atikewɔwɔ kple susu si ta wowɔ dɔa dzi anya amekoko si ƒomevi anyo na wò. Mina míalé ŋku ɖe ƒomeviawo ŋu.
Nukawoe nye proctocolectomy amekoko ƒomeviwo?
Mɔ vovovowo li siwo dzi woato awɔ amekoko sia. Wò ɖɔkta atia mɔnu si nyo na wò.
| Amekoko ƒomevi | Nusi le dzɔdzɔm ŋuti numeɖeɖe bɔbɔe aɖe |
|---|---|
| Proctocolectomy kple Ileostomy ɖeɖeɖa (kple ileostomy) . | Le dɔ sia wɔwɔ me la, woɖea dɔgbo kple dɔgbo ƒe dɔgbo ɖa keŋkeŋ. Emegbe woɖea dɔgbo suea ƒe akpa mamlɛtɔ si woyɔna be ileum , doa goe to ƒodoa ƒe ŋutigbalẽ me eye wowɔa ʋuƒo (stoma). Aɖuɖɔa dona to ʋuƒo sia me. Wotsɔa akplo aɖe dea eƒe gota. Ele be ame aɖewo nado esia tegbee, gake ɣeyiɣi kpui aɖe koe wòle be ame bubuwo nado. |
| Proctocolectomy si wotsɔ gbugbɔa nu dzrana ɖo kple Ileoanal Pouch (Amekoko si wowɔna tsɔ ɖɔa li wo nɔewo) . | Le dɔ sia wɔwɔ me la, woɖea dɔgbo kple dɔgbo hã, gake wogblẽa aɖuɖɔtoea ɖe teƒea. Eyome wowɔa kotoku ememetɔ tso dɔgbo suea (ileum) ƒe nuwuwu. Akplo sia, abe aɖuɖɔtoe gbãtɔ ene, kpena ɖe ame ŋu wòléa aɖuɖɔ hena ɣeyiɣi aɖe. Emegbe wotsɔa kotoku sia doa ka kple akɔta (ileoanal anastomosis).Esia wɔnɛ be nàte ŋu aɖe aɖuɖɔ le mɔ si sɔ nu. Woate ŋu awɔ esia le amekoko ɖeka alo eve me. |
| Subtotal Proctocolectomy ƒe dɔwɔwɔ (ɖe akpa aɖe ɖa) . | Esia bia be woagblẽ dɔgboa alo dɔgbo ƒe akpa aɖe ɖi. Le kpɔɖeŋu me, Hartmann ƒe dɔdamɔnu aɖe ɖea dɔgboa ƒe akpa mamlɛtɔ (sigmoid colon) kple dɔgboa ƒe akpa mamlɛa ko ɖa. Ne wowɔ esia la, woate ŋu agbugbɔ dɔgboa ƒe akpa susɔe siwo le lãmesẽ me la aɖo kadodo me (anastomosis) , ale be nàte ŋu awɔ dɔgbo ƒe ʋuʋu nyuie. Ɣeaɖewoɣi la, woate ŋu awɔ colostomy (dɔgboa ƒe ʋuʋu) hena ɣeyiɣi aɖe vaseɖe esime abi la nahaya. |
Nukae wòle be nàwɔ hafi awɔ dɔ na wò?
Ne menye amekoko kpatae o la, ke ɣeyiɣi geɖe asu asiwò nàtsɔ adzra ɖo.
- Kwasiɖa ʋɛ aɖewo do ŋgɔ: Ðo dze kple wò ɖɔkta tso amekokoa, eƒe ƒomeviwo, afɔku siwo le eme, kple viɖe siwo le eme ŋu. Bia nya ɖesiaɖe si le asiwò.
- Kwasiɖa eve do ŋgɔ: Ne èle ʋumenugbagbeviɣitikewo zãm la, wò ɖɔkta aɖo aɖaŋu na wò be nàdzudzɔ wo alo aɖe wo dzi akpɔtɔ. Azɔ hã, dze agbagba nàna wò dɔgbo nanɔ lãmesẽ me to fibre geɖe ɖuɖu kple tsi geɖe nono le ɣeyiɣi sia me.
- Gaƒoƒo 24 do ŋgɔ: Gbesigbe do ŋgɔ na amekokoa la, woana dɔgbo ƒe dzadzraɖo na wò be wòakɔ wò dɔgbowo ŋu keŋkeŋ. Gbemagbe koe woaɖe mɔ na wò be nàno tsi siwo me kɔ, abe tsi kple mɔli ene. Woate ŋu ana dɔlékuiwutikewo hã wò be nàxe mɔ ɖe dɔlékuiwo xɔxɔ nu le amekoko vɔ megbe.
Nukae dzɔna le amekokoa wɔɣi?
Ne èyi kɔdzi la, woatsɔ amekokowu ado wò. Woade IV-ka aɖe wò ʋuka me eye woana saline kple atike ɖesiaɖe si hiã wò. Emegbe woakplɔ wò ayi amekokoxɔa me.
Atikewɔla si naa alɔ̃dɔdɔ ame la atsɔ wò ade atike si naa alɔ̃dɔdɔ ame katã me. Màse naneke le amekokoa wɔɣi o. Woatsɔ wò aƒo ka na mɔ̃ (yagbɔgbɔmɔ̃) be wòakpe ɖe ŋuwò nàgbɔ ya.
Amekoko le Gaglãgbe? Amekoko si Wozãna le Laparoscopic mea?
Fifia la, wowɔa dɔ akpa gãtɔ siwo woɖena le dɔgboa me to dɔgbo me . Esia fia be le esi teƒe be woaɖe dɔ gã aɖe le ƒodoa me la, wowɔa dɔa to do sue ʋɛ aɖewo me, siwo me wotsɔa fotoɖemɔ̃ kple amekokodɔwɔnu sue ŋutɔwo dea eme. Mɔnu sia nana wòhayana kabakaba, vevesese dzi ɖena kpɔtɔna, eye abi suesuesuewo nɔa eŋu. Gake mɔnu sia mesɔ na amesiame o. Le nɔnɔme sesẽwo alo nɔnɔme kpatawo me la, ehiã be woawɔ dɔ na ame le gaglãgbe si wowɔna le kɔnu nu.
Le amekokoa me la, amekolaa ɖea dɔgbo kple dɔgbo si ŋu dɔlélea le la ɖa nyuie. Emegbe abe alesi míegblɔe va yi ene la, wowɔa ileostomy/colostomy alo wogatsɔa dɔgboa doa ka kple wo nɔewo (anastomosis).
Nukae dzɔna le amekokoa megbe?
Le amekokoa megbe la, ahiã be nànɔ kɔdzi abe kwasiɖa ɖeka ene. Le ɣeyiɣi sia me la, woava nɔ nuɖuɖu siwo me tsi le la zãm vivivi eye emegbe woava nɔ nuɖuɖu sesẽwo zãm vivivi.
Ne wowɔ ostomy (ileostomy/colostomy) na wò la, Dɔnɔdzikpɔla si Kpɔa Abi ƒe Tome Nu (WOCN) akpe ɖe ŋuwò. Woafia nusianu si wòle be nànya tso ostomy kotokua zazã kple wò stoma (si ʋuna le wò dɔgbo me) ƒe dzadzɛnyenye ŋu wò. Togbɔ be enye ostomy hena ɣeyiɣi aɖe hã la, axɔ ɣleti geɖe hafi miate ŋu adzro afɔɖeɖe siwo kplɔe ɖo (eɖeɖe alo kotoku si le eme wɔwɔ) me kple wò ɖɔkta.
Afɔku kple kuxi kawoe do ƒome kple amekoko sia?
Abe alesi wòle le amekoko ɖesiaɖe gome ene la, afɔku aɖewo le eme, gake esiawo mebɔ kura o.
| Kuxi ƒomevi aɖe | Nusiwo ate ŋu adzɔ |
|---|---|
| Afɔku siwo bɔ le amekoko me | Nusiwo wòwɔna ne atike si wua alɔ̃dɔdɔ, ŋutinu siwo ƒo xlãe ƒe gbegblẽ, ʋu si dona fũu akpa, kple dɔlékuiwo xɔxɔ. |
| Kuxi siwo dona tso amekoko koŋ me | - Dɔgbo ƒe mɔxexe: Abi ƒe lãkusi si tso amekoko me ate ŋu ana dɔgboa naxe. - Lãmetsiŋusẽ ƒe gbegblẽ: Aɖuɖɔtoedɔ ate ŋu agblẽ nu le lãmeka siwo kpɔa gome le gbɔdɔdɔ ƒe dɔwɔwɔ alo aɖuɖɔtoe me ŋu. Zi geɖe la, amesiawo hayana le ɣeyiɣi aɖe megbe. |
| Ostomy (Ileostomy/Colostomy) Kuxi siwo do ƒome kplii | - Ŋutilã ƒe nulɔdɔ: Ŋutilã si ƒo xlã stoma ate ŋu azu dzĩ eye wòave ne eƒo aɖuɖɔ. - Tɔtrɔ le stoma me: Stoma ateŋu anyrɔ ɖe eme tso ŋutigbalẽ ƒe kɔkɔme (retraction) alo ado ɖe gota akpa (prolapse). - Phantom Rectum: Ne woɖe aɖuɖɔtoea ɖa hã la, ame aɖewo ate ŋu ase le wo ɖokui me kokoko be yewoaɖe aɖuɖɔ. Esia aɖiɖi le ɣeyiɣi aɖe megbe. |
| Kuxi Siwo Do Ƒome Kple Akplo Ememetɔ | - Pouchetis: Dzoxɔxɔ le kotoku yeye si wowɔ ƒe eme. Wotsɔa dɔlékuiwutikewo daa esia. - Anastomotic leak: Tsi si dona le afisi dɔgbo ƒe kadodo le. Esia nye nɔnɔme si mebɔ o gake nu sẽ ŋutɔ. - Aɖuɖɔtoe dzi ɖuɖu sesẽna hena ɣeyiɣi aɖe: Le gɔmedzedzea me la, ate ŋu asesẽ be woaɖu aɖuɖɔtoe dzi le esi akɔta ƒe lãmeka siwo gbɔdzɔ ta. Esia anyo ɖe edzi ne míele kame dem hele ɣeyiɣi zãm. |
Aleke beléle na ame le amekoko megbe le?
Ate ŋu axɔ ɣleti geɖe hafi wòahaya keŋkeŋ. Le ɣeyiɣi sia me la, ele vevie ŋutɔ be nàwɔ ɖe wò ɖɔkta ƒe mɔfiamewo dzi nyuie.
- Abidzikpɔkpɔ: Ðɔkta alo dɔnɔdzikpɔla afia alesi nàkɔ abia ŋu ahatrɔ abi la wò.
- Ostomy beléle na ame: Àsrɔ̃ alesi nàkɔ ostomy kotokua me zi geɖe gbesiagbe eye nàna ŋutigbalẽ si ƒo xlã stoma la nanɔ dzadzɛ.
- Nuɖuɖu: Ne ègbɔ tso kɔdzi vɔ la, tsɔ nuɖuɖu sesẽwo vɛ vivivi. Le esi teƒe be nàɖu nu gbogbo aɖe zi ɖeka la, ɖu nu suesuesuewo zi geɖe gbesiagbe. Mia wò nuɖuɖu nyuie.
- Tsidede: Esia le vevie ŋutɔ. Esi woɖe wò dɔgbo ƒe akpa gã aɖe ɖa ta la, wò ŋutilã maxɔ tsi boo aɖeke o. Eyata ele vevie be nàno tsi kple tsi geɖe le ŋkekea me katã.
Ɣekaɣie wòle be woakpɔ ɖɔkta
Ne ètrɔ gbɔ tso amekoko me vɔ la, ne dzesi siwo gbɔna dometɔ aɖe dze ŋuwò , yɔ wò ɖɔkta enumake alo yi kɔdzi si te ɖe ŋuwò ƒe Dɔwɔƒe si Kpɔa Nudzɔdzɔ Kpatawo Gbɔ (ETU).
- Dzesi siwo dzena le dɔgbo ƒe xexe ŋu dometɔ aɖewoe nye dɔgbo ƒe ʋuʋu, ƒodo ƒe vevesese, ʋuʋudedi, kple ʋuʋudedi.
- Dzesi siwo fia be dɔléle aɖe le ame ŋu abe ƒodo ƒe vevesese sesẽ, vuvu, ʋuʋudedi si le dodom tso abi la me, kple dzoxɔxɔ ene.
Proctocolectomy nye amekoko vevi aɖe. Gake ate ŋu akpe ɖe ŋuwò nàkpɔ gbɔdzɔe tso nɔnɔme aɖe si anɔ anyi ɣeyiɣi didi me eye wòana wò agbenɔnɔ nanyo ɖe edzi. Ne wozã egbegbe mɔ̃ɖaŋununya la, woate ŋu ana ostomy kotokuwo nanye esiwo womate ŋu akpɔ o eye woanɔ bɔbɔe ŋutɔ. Ðo dze kple wò ɖɔkta tso wò tiatiawɔblɔɖe ŋu eye nàwɔ nyametsotso si anyo na wò.
Gbedasi si Wotsɔ Yi Aƒeme
- Proctocolectomy nye amekoko si xɔa ame ɖe agbe si me woɖea dɔgbo kple dɔgbo le. Wowɔa esia zi geɖe na nɔnɔme sesẽwo abe IBD kple kansa ene.
- Mɔnu si dzi woato aɖe dɔgboa le amekoko vɔ megbe la ato vovo. Tiatia aɖewo li abe ileostomy (gotagome kotoku) alo ememe kotoku (ememe kotoku).
- Ðo dze kple wò ɖɔkta gaglãa tso amekoko si ƒomevi sɔ na wò ŋu eye nàna woaɖo wò biabiawo katã ŋu.
- Exɔa ɣeyiɣi hafi amekoko nahaya. Le ɣeyiɣi sia me la, wɔ ɖe wò ɖɔkta ƒe mɔfiamewo dzi nyuie, vevietɔ le nuɖuɖu kple tsinono gome.
- Togbɔ be agbenɔnɔ kple ostomy adze nu sesẽ le gɔmedzedzea me hã la, ne wona hehee nyuie eye wodo alɔe la, ate ŋu anye agbenɔnɔ si sɔ ƒe akpa aɖe.
- Ne èkpɔ dzesi aɖewo siwo mebɔ o (vevesese sesẽ, dzoxɔxɔ, ʋuʋudedi) le amekokoa megbe la, di atikewɔlawo ƒe aɖaŋuɖoɖo enumake.
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