Opaleshoni ya APR: Kuchotsa mimba m'mimba mwa Laparoscopic kwa khansa ya m'matumbo mwachidule

Dokotala wanu akakuuzani kuti muyenera kuchitidwa opaleshoni ya abdominoperineal resection, kapena APR, mungakhale mukumva mantha ndi nkhawa zambiri. Mungakhale ndi mafunso ambiri m'maganizo mwanu, monga "Ndi opaleshoni yamtundu wanji iyi?", "Kodi idzapweteka kwambiri?", "Kodi moyo wanga udzakhala bwanji nditachita opaleshoniyi?" Ndi zachilendo kwambiri. Lero, tiyeni tikambirane za opaleshoni ya APR iyi, momwe tingakonzekerere, ndi zomwe zimachitika pambuyo pa opaleshoniyi. Kudziwa bwino zinthu izi kudzakuthandizani kuchepetsa mantha anu kwambiri.

Kodi opaleshoni ya Abdominoperineal Resection (APR) ndi chiyani kwenikweni?

Mwachidule, izi zikuphatikizapo kuchotsa anus yanu, rectum, ndi gawo la pansi la matumbo anu akuluakulu (sigmoid colon) . Chifukwa chachikulu cha opaleshoniyi ndi khansa zomwe zimakula pang'onopang'ono mu rectum, pafupi kwambiri ndi anus.

Nthawi zambiri, mwina munalandirapo mankhwala ochizira khansa kangapo musanachite opaleshoniyi. Pambuyo poti mankhwalawo achepetsa maselo a khansa, dokotalayo adzachotsa malo onsewo ndi opaleshoniyi.

Kodi ndiyenera kukonzekera bwanji opaleshoniyi?

Dokotala wanu adzakutsogolerani mosamala kuti mukonzekere izi. Adzakufunsani za mbiri yanu yonse ya matenda. Onetsetsani kuti mwauza dokotala wanu za mankhwala aliwonse, mavitamini, kapena zowonjezera zomwe mukumwa panopa.

Komanso, ngati muli ndi vuto la kupuma movutikira , muyenera kutiuza za vutoli. Ngati mugwiritsa ntchito makina a CPAP, pitani nawo kuchipatala tsiku lochita opaleshoni.

Kodi opaleshoniyi imachitidwa bwanji?

Opaleshoni iyi imachitika kuchipatala, pansi pa mankhwala oletsa ululu. Izi zikutanthauza kuti simudzamva chilichonse panthawi ya opaleshoni, ndipo mudzakhala mukugona tulo tofa nato. Opaleshoniyi imachitika m'magawo angapo akuluakulu.

1. Kukonzekera kuchotsa ziwalo za m'mimba

Choyamba, dokotalayo amaduladula pang'ono m'mimba (laparoscopy), kuzindikira ndikudula mitsempha ikuluikulu yamagazi yomwe imapereka magazi kumadera a m'matumbo kuti achotsedwe. Kenako, gawo la pansi la m'matumbo (sigmoid colon) ndi rectum zimachotsedwa ku minofu yozungulira. Kenako, gawo loti lichotsedwe limalekanitsidwa ndi gawo lotsala la m'matumbo.

2. Kuchotsa mphuno

Kenako, dokotalayo amadulanso malo olumikizirana mafupa ndikuchotsa malo olumikizirana mafupa. Izi zimachotsa malo olumikizirana mafupa onse, malo olumikizirana mafupa, ndi malo olumikizirana mafupa. Khungu lomwe lili pamwamba pa malo olumikizirana mafupa limasokedwa.

3. Kupanga Colostomy

Tsopano mwina mukudabwa kuti, "Kodi ndowe zidzatuluka bwanji pambuyo poti anus ndi rectum zachotsedwa?" Ndicho chifukwa chake colostomy yokhazikika imapangidwa.

Mwachidule, izi zikutanthauza kubweretsa gawo labwino la pamwamba pa m'mimba mwanu pamwamba pa khungu lanu la m'mimba ndikupanga mpata watsopano womwe umatsegulira kunja. Mpata watsopanowu umatchedwa 'stoma' . Nthawi zambiri umakhala mpata wa pinki womwe uli pakati pa mainchesi 1 ndi 1 ½ kukula.

Tsopano zinyalala za thupi lanu, zomwe ndi ndowe ndi mpweya, zimatuluka mu stoma iyi. Muyenera kuvala thumba lapadera (thumba la ostomy) pamwamba pa izi. Chikwama ichi chimasonkhanitsa zinyalala. Popeza mulibe anus, simulinso ndi mphamvu zowongolera njira yodutsa ndowe. Chifukwa chake, muyenera kuvala thumba ili nthawi zonse.

Kodi nthawi yochira imakhala bwanji pambuyo pa opaleshoni?

Pambuyo pa opaleshoni, muyenera kukhala m'chipatala kwa masiku angapo. Chikwama cha ostomy chidzaikidwa pa stoma yanu nthawi yomweyo opaleshoni itatha. Komabe, zimatenga masiku angapo kuti kugaya chakudya chanu kugwirenso ntchito. Choncho mudzapatsidwa zakumwa zoti mumwe poyamba. Pamene matumbo anu akuyamba kugwira ntchito, pang'onopang'ono mudzayamba kudya zakudya zolimba.

Kodi ubwino wochita opaleshoni iyi ndi wotani pogwiritsa ntchito laparoscopically?

Pali ubwino wambiri wochita opaleshoni iyi pogwiritsa ntchito njira ya keyboo kapena laparoscopic kuposa opaleshoni yachikhalidwe yotseguka.

• Mabalawo ndi ang'onoang'ono kwambiri: M'malo mwa kudula kamodzi kakulu, ndi mabalawo ochepa chabe omwe amagwiritsidwa ntchito.
• Kuchepetsa ululu: Ululu womwe umakhalapo pambuyo pa opaleshoni ndi wochepa kwambiri.
• Kuchepa kwa magazi: Magazi ochepa amatuluka m'thupi panthawi ya opaleshoni.
• Kuchepetsa chiopsezo cha mavuto:Pali mwayi wochepa wa zinthu monga matenda a pachilonda.
• Kuchira mwachangu: Nthawi yogona kuchipatala ndi yochepa, ndipo mutha kubwerera ku moyo wabwinobwino mwachangu.

Kodi ndi mavuto otani omwe angakhalepo chifukwa cha opaleshoniyi?

Monga opaleshoni iliyonse, pali zoopsa zazing'ono, koma izi sizimawoneka kawirikawiri.

• Hernia ya perineal ikhoza kuchitika pamene khungu limakokedwa kumbuyo pambuyo poti anus yachotsedwa. Ngati pakufunika, izi zitha kukonzedwa ndi opaleshoni ina.
• Kutuluka magazi kwambiri.
• Mavuto okhudzana ndi mabala odulidwa (mabala otupa, osachira).
• Chilonda chikachira, kabowo kakang'ono pakhungu kamatsala (perineal sinus).

Ngati chinthu chonga ichi chichitika, madokotala amachichiza ndi mankhwala monga kupereka maantibayotiki kapena, ngati kuli kofunikira, kuchita opaleshoni yaying'ono, kutengera kuopsa kwake.

Nthawi zambiri zimatenga milungu itatu mpaka isanu ndi umodzi kuti munthu achire bwino kuchokera ku opaleshoniyi. Komabe, nthawi ino imatha kusiyanasiyana kutengera zinthu monga thanzi lanu lonse. Funsani dokotala wanu nthawi yomwe mungabwerere kuntchito.

Ndizachibadwa kukhala ndi nkhawa komanso kuda nkhawa kuti uyenera kuchitidwa opaleshoni yaikulu ngati imeneyi. Chifukwa chake, lankhulani ndi dokotala wanu za mafunso kapena nkhawa zilizonse zomwe mungakhale nazo. Komanso, ngati mungathe kulowa nawo magulu othandizira anthu omwe adachitidwapo opaleshoni yotereyi ndipo tsopano akuchira, mudzapeza mphamvu zambiri zamaganizo ndi kulimba mtima kuchokera ku zomwe adakumana nazo.