ʻO ke ʻoki kino APR: Laparoscopic Abdominoperineal Resection no ka maʻi ʻaʻai rectal ma nā ʻōlelo maʻalahi

Ke haʻi aku kāu kauka iā ʻoe e pono ʻoe e hana i kahi ʻoki ʻana o ka ʻōpū, a i ʻole APR, e hopohopo nui paha ʻoe. Nui paha nā nīnau i loko o kou manaʻo, e like me "He aha ke ʻano o kēia ʻoki ʻana?", "E ʻeha nui anei?", "Pehea lā koʻu ola ma hope o ke ʻoki ʻana?" He mea maʻamau loa ia. No laila, i kēia lā, e kamaʻilio kākou e pili ana i ke ʻano o kēia ʻoki ʻana o ka ʻōpū APR, pehea e hoʻomākaukau ai no ia, a me nā mea e hana ʻia ma hope o ke ʻoki ʻana. ʻO ka ʻike maopopo ʻana i kēia mau mea e kōkua i ka hoʻēmi ʻana i kou makaʻu i kahi nui.

He aha ke ʻano o ke ʻoki ʻana o ka Abdominoperineal Resection (APR)?

I ka ʻōlelo maʻalahi, pili kēia i ka wehe ʻana i kou anus, rectum, a me ka ʻāpana haʻahaʻa o kou ʻōpū nui (sigmoid colon) . ʻO ke kumu nui o kēia ʻoki kino no nā maʻi ʻaʻai e ulu haʻahaʻa loa i loko o ka rectum, kokoke loa i ka anus.

I ka hapanui o nā hihia, ua loaʻa paha iā ʻoe kekahi mau pōʻai o ka radiation a/a i ʻole chemotherapy e kāohi i ke kanesa ma mua o kēia ʻoki kino. Ma hope o ka hoʻēmi ʻana o nā lāʻau lapaʻau i nā hunaola kanesa, e wehe ke kauka ʻoki i ka ʻāpana holoʻokoʻa me kēia ʻoki kino.

Pehea e hoʻomākaukau ai au no ke ʻoki kino?

E alakaʻi pono kāu kauka iā ʻoe e hoʻomākaukau no kēia. E nīnau ʻo ia iā ʻoe e pili ana i kāu mōʻaukala olakino piha. E hōʻoia e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau, nā huaora, a i ʻole nā ​​​​mea hoʻohui āu e lawe nei.

Eia kekahi, inā loaʻa iā ʻoe ka apnea hiamoe , pono ʻoe e haʻi mai iā mākou e pili ana i ia mea. Inā ʻoe e hoʻohana i kahi mīkini CPAP no ia mea, e lawe mai i ka haukapila i ka lā o ke ʻoki kino.

Pehea e hana ʻia ai ke ʻoki kino?

Hana ʻia kēia ʻoki kino ma kahi haukapila, ma lalo o ka anesthesia laulā. ʻO ke ʻano kēia, ʻaʻole ʻoe e manaʻo i kekahi mea i ka wā o ke ʻoki kino, a e hiamoe loa ʻoe. Hana ʻia ke ʻoki kino ma kekahi mau ʻanuʻu nui.

1. Ke hoʻomākaukau ʻana i ka ʻōpū no ka wehe ʻana

ʻO ka mea mua, hana ke kauka lapaʻau i kekahi mau ʻoki liʻiliʻi ma ka ʻōpū (laparoscopy), ʻike a ʻokiʻoki i nā kīʻaha koko nui e hoʻolako ana i ke koko i nā ʻāpana o ka kolona e wehe ʻia. A laila, hoʻokuʻu ʻia ka ʻāpana haʻahaʻa o ka kolona (sigmoid colon) a me ka rectum mai nā ʻiʻo a puni. A laila, hoʻokaʻawale ʻia ka ʻāpana e wehe ʻia mai ke koena o ka ʻāpana olakino o ka kolona.

2. Ka wehe ʻana i ka anus

A laila, hana ke kauka ʻokiʻoki i kahi ʻoki ʻē aʻe ma ka ʻāpana perineal a wehe i ka anus. Wehe kēia i ka anus holoʻokoʻa, ka rectum, a me ka colon. A laila humuhumu ʻia ka ʻili ma luna o ka anus.

3. Ke hana ʻana i kahi Colostomy

I kēia manawa ke noʻonoʻo nei paha ʻoe, "Pehea e puka ai ka ʻōpala ma hope o ka wehe ʻia ʻana o ka anus a me ka rectum?" ʻO ia ke kumu i hana ʻia ai kahi colostomy mau loa.

I ka ʻōlelo maʻalahi, pili kēia i ka lawe ʻana mai i kahi ʻāpana olakino o ka ʻaoʻao o luna o kou kolona i ka ʻili o kou ʻōpū a hana i kahi puka hou e wehe ai i waho. Ua kapa ʻia kēia puka hou he 'stoma' . He puka poni maʻamau ia ma waena o 1 a me 1 ½ ʻīniha ka nui.

I kēia manawa, puka mai ka ʻōpala o kou kino, ʻo ia hoʻi, ka feces a me ka ea, mai loko mai o kēia stoma. Pono ʻoe e ʻaʻahu i kahi ʻeke kūikawā (ʻeke ostomy) ma luna o kēia. Hōʻiliʻili kēia ʻeke i ka ʻōpala. No ka mea, ʻaʻohe ou anus, ʻaʻohe ou hiki ke kāohi i ke kahe ʻana o ka feces. No laila, pono ʻoe e ʻaʻahu i kēia ʻeke i nā manawa a pau.

Pehea ka manawa ho'ōla ma hope o ke ʻoki kino?

Ma hope o ke ʻoki ʻana, pono ʻoe e noho i ka haukapila no kekahi mau lā. E kau ʻia kahi ʻeke ostomy ma luna o kou stoma ma hope koke iho o ke ʻoki ʻana. Eia nō naʻe, e hala kekahi mau lā no ka hana hou ʻana o kāu ʻōnaehana hoʻoheheʻe. No laila e hāʻawi mua ʻia ʻoe i nā wai e inu ai. Ke hoʻomaka ka hana ʻana o kou ʻōpū, e hoʻolauna mālie ʻia ʻoe i nā meaʻai paʻa.

He aha nā pōmaikaʻi o kēia ʻoki kino laparoscopically?

Aia kekahi mau pono o ka hana ʻana i kēia ʻoki kino ma o kahi puka kī a i ʻole ke ʻano laparoscopic ma mua o ke ʻoki kino hāmama kuʻuna.

• Ua liʻiliʻi loa nā ʻokiʻoki: Ma kahi o hoʻokahi ʻoki nui, he mau ʻoki liʻiliʻi wale nō i hoʻohana ʻia.
• Hoʻemi ʻia ka ʻeha: He liʻiliʻi loa ka ʻeha i ʻike ʻia ma hope o ke ʻoki ʻana.
• Hoʻemi ʻia ke kahe ʻana o ke koko: ʻEmi ke koko e nalowale ana mai ke kino i ka wā o ke ʻoki ʻana.
• Hoʻemi ʻia ka pilikia o nā pilikia:ʻAʻole nui ka manawa kūpono o nā mea e like me ka maʻi ʻeha.
• Ka ho'ōla wikiwiki ʻana: ʻOi aku ka pōkole o ka noho ʻana ma ka haukapila, a hiki iā ʻoe ke hoʻi koke i ke ola maʻamau.

He aha nā pilikia e hiki mai ana o kēia ʻoki kino?

E like me nā hana ʻoki kino āpau, aia kekahi mau pilikia liʻiliʻi, akā ʻaʻole ʻike pinepine ʻia kēia mau mea.

• Hiki ke loaʻa kahi hernia perineal ma kahi e huki ʻia ai ka ʻili i hope ma hope o ka wehe ʻia ʻana o ka anus. Inā pono, hiki ke hoʻoponopono ʻia kēia me kahi ʻoki kino ʻē aʻe.
• Ke kahe koko nui ʻana.
• Nā pilikia e pili ana me nā ʻoki ʻana (nā ʻeha e pehu ana, ʻaʻole e ho'ōla).
• Ke ho'ōla ʻia ka ʻeha, waiho ʻia kahi lua liʻiliʻi ma ka ʻili (perineal sinus).

Inā kū mai kekahi mea e like me kēia, hoʻoponopono nā kauka iā ia me nā lāʻau lapaʻau e like me ka hāʻawi ʻana i nā antibiotics a i ʻole, inā pono, hana i ke ʻoki kino liʻiliʻi, ma muli o kona koʻikoʻi.

ʻO ka maʻamau , ʻekolu a ʻeono pule e hoʻōla piha ai mai kēia ʻoki kino. Eia nō naʻe, hiki ke loli kēia manawa ma muli o nā mea e like me kou olakino holoʻokoʻa. E nīnau i kāu kauka i ka wā hiki iā ʻoe ke hoʻi i ka hana.

He mea maʻamau ka hopohopo a me ka hopohopo e pili ana i ka hana ʻana i ia ʻoki kino nui. No laila, e kamaʻilio me kāu kauka e pili ana i nā nīnau a hopohopo paha āu e loaʻa ai. Eia kekahi, inā hiki iā ʻoe ke hui pū me nā hui kākoʻo me ka poʻe i hana i ia mau ʻoki kino a ke hoʻōla nei, e loaʻa iā ʻoe ka ikaika noʻonoʻo a me ke koa mai ko lākou mau ʻike.