Kua pāngia koe, tetahi rānei e mōhio ana koe, e arohaina ana e koe, e mataku ana, e taumaha ana hoki tō ngākau i te wā i kōrerotia ai e te tākuta tēnei momo pokanga, tika? He mea noa te mataku ina rongo koe i tētahi ingoa nui pēnei i te "Laparoscopic Abdominoperineal Resection." Kaua e mataku. I tēnei rā, ka kōrero tātou mō te momo pokanga tēnei, te take e mahia ai, me ngā mea ka tupu i muri i te pokanga i roto i tētahi huarahi tino māmā ka taea e koe te mārama.
He whakarāpopototanga, he aha tēnei pokanga?
He pokanga tēnei e mahia ana e te taote pokanga. Ka tangohia tō pūreirei, tō pūreirei, me te wāhanga o raro o tō whekau nui (te koroni sigmoid) . Ka mahia tēnei pokanga mā roto i ētahi kōhao iti i roto i tō puku, kaua mā roto i tētahi tapahi nui. Ka kiia tēnei tikanga ko te laparoscopy, ko te "pokanga kōhao kī" rānei.
Ko te tikanga, ka tūtohutia tēnei pokanga mēnā kei roto rawa te matepukupuku i te pūkahukahu, i te taha rānei o te nono. He mea nui rawa tēnei pokanga mēnā kei te tata rawa te matepukupuku ki ngā uaua o te sphincter e whakahaere ana i te haere o te tūtae, nā te mea he mea tika tēnei pokanga hei tango katoa i ngā pūtau matepukupuku me aua uaua.
Ko te mea nui ko te tango katoa i te matepukupuku i te tinana. Mā tēnei pokanga e mahi.
I roto i tēnei pokanga, ka hangaia he pūaha hou hei putanga mai i ngā paru (ngā paru) ki waho o tō tinana. Ka kiia tēnei he stoma . Kei te kiri o tō puku tēnei stoma. Mā roto i tēnei ka honoa te whekau nui. Ka kiia hoki tēnei tikanga e ngā tākuta he "colostomy".
He aha te stoma? Me wehi ahau i a ia?
Kāore rawa. He wāhanga nui te stoma o tō pokanga whakaora ora. Whakaarohia pēnei, pērā i tō tātou nono, he ara hou tēnei mō ngā para ki te puta.
Engari kotahi te rerekētanga. Kāore i te stoma ngā uaua sphincter e whakahaere ana i te haerenga o te tūtae, pērā i ngā mea kei roto i tō tātou nono. Nō reira, kāore e taea e tātou te whakahaere i te haerenga o te tūtae i te wā e hiahia ana tātou. Nā reira, me mau tātou i tētahi putea motuhake (pēke) hei kohi i ngā paru e puta mai ana.
Tērā pea he āhua rerekē te taunga ki tēnei i te tīmatanga. Engari i roto i te wā, ka noho hei wāhanga noa o tō oranga. Hei āwhina i a koe ki tēnā, kei reira ngā nēhi kua whiwhi whakangungu motuhake mō tēnei. Mā rātou koe e ako i ngā mea katoa.
Me pēhea te mahi i te pokanga i te taahiraa i te taahiraa
He mea noa te mataku ina whakaarohia he pokanga nui pēnei. Engari ina mārama koe ki te āhua o te mahi, ka tino heke tō mataku.
| Wāhanga o te Pokanga | He aha te mea ka tupu |
|---|---|
| 1. Whakamamae | Tuatahi, ka whakamoea katoatia koe. Ko te tikanga tēnei kāore koe e rongo i tetahi mea tae noa ki te mutunga o te pokanga, ā, ka moe rawa koe. |
| 2. Te tīmatanga o te laparoscopy | I a koe e moe ana, ka tapahia e te taote pokanga he tapahi iti (tata ki te 1/2 inihi) e tata ana ki tō puku, ā, ka whakaurua he taputapu iti rite ki te kāmera (laparoscope) mā roto. Mā tēnei kāmera ka taea e koe te kite i roto i tō puku. Kātahi ka hangaia he kōhao iti e 4, e 5 rānei ki roto i tō puku hei whakauru i ngā taputapu e hiahiatia ana hei mahi i te pokanga. |
| 3. Te whakarite mō te tango i te puku | Ka tapahia, ka katihia ngā oko toto matua e tuku toto ana ki te wāhanga o te koroni e tangohia ana. Kātahi ka wetekina te wāhanga o te koroni e tangohia ana (te koroni sigmoid) mai i te kiko e karapoti ana, ā, ka wehea mai i te whekau nui e toe ana. Ka wetekina hoki te rectum mai i te kiko e karapoti ana i te ara kotahi. |
| 4. Te tango i te nono | Kia wetekina ngā wāhanga o te whekau, ka mahi tētahi atu mema o te tīma pokanga i te pokanga i waenganui i ō waewae (rohe perineal) ā, ka tangohia katoatia te nono, te rectum, me te wāhanga o te koroni e pāngia ana. |
| 5. Te Waihanga o te Stoma | I muri i te tango i te kiko matepukupuku, ka hangaia e te taote pokanga he stoma mā roto i tētahi kōhao iti i hangaia i mua. Ko te tikanga ka hangaia tēnei ki te taha maui o te puku. Ka whakaputaina te pito toenga o te koroni mā roto i te kōhao, ka honoa ki te kiri, ā, ka tuia kia kati. |
| 6. Te otinga o te pokanga | Hei whakamutunga, ka horoia pai te kōhao puku (i roto i te puku), ā, ka whakatakotoria he ngongo wai iti hei tango i ngā wai kāore e hiahiatia kua kohia pea i roto. Mā tēnei ka tere ake te ora o te patunga. Kātahi ka tuia ngā tapahi kē atu o te puku. |
He aha ngā mea hei tumanakohia i te wā o te whakaoranga?
I muri i te pokanga, me noho koe ki te hōhipera mō ētahi rā, tata ki te wiki. I tēnei wā, ka tiakina koe e ngā tākuta me ngā nēhi.
He aha ngā mea ka tupu i te hōhipera?
Ina ara ake koe i muri i te pokanga, ka tāpirihia he putea ki tō stoma hei kohi para. Ka roa pea ētahi rā kia tīmata anō te mahi a tō pūnaha nakunaku, arā, ngā whekau. Kia pērā, ka hoatu he wai hei inu māu i te tuatahi . I a koe e ora haere ana, ka taea e koe te neke ki ngā kai totoka noa .
Te ako ki te tiaki i tō stoma
Koinei te wāhanga tino nui. I a koe i te hōhipera, mā te nēhi kua whakangungua motuhake ki te tiaki stoma (Enterostomal Therapist, ET nurse rānei) koe e āwhina.
- Ma rātou koe e whakaatu ki te whakawhiti i tō pēke stoma.
- Ka ako mātou i a koe me pēhea te pupuri i te kiri huri noa i te stoma kia ma, kia ora hoki.
- Kia hoki koe ki te kāinga, ka whakaharatau koe ki te mahi i ēnei mea ko koe anake.
He huringa nui te noho me te colostomy tuturu. Hoatu he wā ki a koe kia taunga ai koe ki tēnei. Kaua e manukanuka ki tetahi mea. Ko tō nēhi ET te tangata pai rawa atu hei pātai atu i ō pātai me te tiki āwhina mai i a koe.
Mena he āwangawanga, he pātai rānei āu i tētahi wā, kaua e wehi ki te kōrero ki tō tākuta, ki tō nēhi ET rānei . Kei reira rātou hei āwhina i a koe.
Karere Tangohia ki te Kāinga
- He pokanga nui tēnei (Laparoscopic Abdominoperineal Resection) ka taea te whakaora i te mate pukupuku o te rectum.
- Nā te mea ka whakamahia te tikanga "kī kōhao" (Laparoscopy) hei whakahaere i tēnei, kāore he tapahi nui, nō reira he tere te wā whakaora.
- I muri i te pokanga, me whakamahi koe i tētahi pūaha tuturu i roto i tō puku (stoma) hei tuku i ngā para kia puta ki waho, me tētahi pēke (pēke) hei kohi i ngā para.
- Ahakoa he uaua te ako ki te whakahaere i te stoma i te tīmatanga, he ngawari noa iho te whakahaere mā te awhina a ngā nēhi kua whakangungua motuhake.
- He panonitanga nui tēnei, ā-tinana, ā-hinengaro hoki. Nō reira, kia tuwhera, kia pono hoki ki ō tākuta, ki ō nēhi, me tō whānau e tautoko ana i a koe. Kāore koe i te mokemoke.
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