Heller Myotomy ni iki? Reka tubiganireho mu buryo bworoshye.

Ese wumva ikibyimba mu muhogo cyangwa mu gituza iyo urya cyangwa unywa? Ese hari igihe wumva utinya kurya kuko wumva ibiryo byawe bitagabanuka? Ibi bishobora guterwa n'indwara idakunze kugaragara yitwa Achalasia. Kubana n'iyi ndwara ntibyoroshye. Biragoye kumira ibiryo, kandi kutarya neza bishobora no gutera kubura intungamubiri. Uyu munsi rero tugiye kuvuga ku kubagwa kwitwa Heller Myotomy, bikorwa nk'ubuvuzi kuri ibi.

Kubaga Heller Myotomy ni iki?

Muri make, Heller Myotomy ni ukubaga gato gakozwe mu kuvura Achalasia . Achalasia ni indwara idakunze kugaragara ifata umwobo wacu, cyangwa imiyoboro y'ibiribwa. Ibi bibaho iyo inzira yo kohereza ibiryo n'amazi bivuye mu mwobo bijya mu nda idakora neza.

Ijambo "myotomy" risobanura gukata imitsi. Muri Heller Myotomy, umuganga ubaga akora uduce duto twinshi mu mpande z'imitsi iri hasi mu muhogo wawe, twitwa Lower Esophageal Sphincter (LES) . LES ni imitsi minini iri hagati y'igice cyo hasi cy'umuhogo wawe n'igice cyo hejuru cy'igifu cyawe. Ni nk'agahu.

Iyo ufite akalaziya, imitsi ya LES ntifungura cyangwa ngo ifungwe neza. Ibi bibuza ibiryo kuva mu muhogo kugera mu gifu. Kubaga Heller Myotomy bifasha mu kuruhuka imitsi ya LES no kuyifungura.

Ubu buryo bwo kubaga akenshi bukorwa hamwe n'ubundi buryo bwitwa fundoplication . Ibi bisaba ko umuganga afata igice cy'igifu cyawe akagipfunyika ku muhogo wawe. Ibi bigabanya ibyago byo kugaruka kwa aside yo mu gifu mu muhogo wawe (reflux).

Witegura ute mbere yo kubagwa?

Kugira ngo umuganga wawe amenye neza ko ukwiriye kubagwa, azagutegeka ibipimo byinshi mbere yo kubagwa. Urugero, gupima amaraso, gupima X-ray mu gituza, na ECG.

Mbere yo kubagwa, umuganga w’ikinya uzagutera ikinya azakubwira. Azakubaza ibibazo nk'ibi:

• Ese wigeze ufata ikinya mbere kandi uburambe bwari bumeze bute?
• Ni ibihe bimera, imiti, cyangwa vitamine ukoresha?
• Ese ukoresha itabi, inzoga, cyangwa ibindi biyobyabwenge?

Hari ibintu bike ugomba gukora kugira ngo witegure kubagwa. Ibi bigomba kuganirwaho no kwemezwa na muganga wawe.

Kubagwa bikorwa gute?

Noneho reka turebe ibibera mu kubaga. Akenshi, ibi bikorwa hakoreshejwe laparoscope . Ni ukuvuga hifashishijwe telesikope. Aha, umuganga ubaga akoresha igikoresho gito gifite kamera ifatanye nacyo kugira ngo arebe imbere mu muhogo wawe n'ibikoresho bito cyane kugira ngo abage.

• Ubwa mbere, umuganga w’ikinya azashyira umurongo wa IV (nk’umuyoboro utanga saline) mu mutsi uri mu kuboko kwawe maze aguhe umuti wo kugusinzira. Nta kintu na kimwe uzumva mu gihe cyo kubagwa.
• Hanyuma, umuganga ubaga azaguciramo uduce duto cyane mu nda yawe (mu nda).
• Hanyuma, mu nda yawe huzuyemo umwuka wa dioxyde de carbone. Ibi bikorwa kugira ngo byoroshye kwimura ibikoresho byo kubaga no gutanga ishusho nziza y'umuyoboro w'amaraso n'igice cyo hejuru cy'igifu.
• Ubu muganga ashyiramo kamera n'ibikoresho bito byo kubaga binyuze muri ibyo bice .
• Hakoreshejwe ibi bikoresho, urwego rw'imitsi ruri hasi mu muhogo rucibwa mu buryo burambuye hanyuma LES igafungurwa.
• Hanyuma, hakorwa igikorwa cyitwa fundoplication. Ibi bisaba gufata igice cyo hejuru cy'igifu ukagipfundikira ku muhogo. Ibi bibuza aside yo mu gifu kuzamuka.
• Amaherezo, kamera n'ibikoresho birakurwaho, maze ibyo bice bito biradodwa.

Ubu buryo bwose bwo kubaga busanzwe bufata amasaha abiri.

Ni iki kibaho nyuma yo kubagwa?

Ubunararibonye nyuma yo kubagwa bushobora gutandukana gato bitewe n'umuntu ku wundi. Ariko ubusanzwe, uzarara mu bitaro ijoro ryose. Muri icyo gihe, uzahabwa amazi n'indyo binyuze mu muyoboro wa IV. Nyuma y'ibyo, igihe cyo gukira kiratangira.

Ikipe yawe y'abaganga izagusobanurira ibi, ariko gahunda isanzwe y'imirire ni iyi ikurikira.

Ni izihe nyungu n'ingaruka z'ubu buvuzi?

Ibyiza

Abantu benshi bafite ikibazo cyo kuvurwa indwara ya achalasia bitabira Heller Myotomy iyo ubundi buryo bwo kuvura butari ubwo kubaga bwananiwe. Akamaro gakomeye k'ubu buryo ni uko ibimenyetso bya achalasia bishira nyuma yo kubagwa.

Isesengura riherutse gukorwa ryerekanye ko hagati ya 87% na 92% by'abantu bakorewe ubu buvuzi ibimenyetso byabo byagiye bishira. Ariko, nk'uko twabivuze mbere, ibi ntibikiza burundu akalasia. Ibimenyetso bishobora kugaruka rimwe na rimwe nyuma y'imyaka 5-10 babazwe.

Ingaruka

Nkuko bigenda mu kubagwa gukomeye kose, Heller Myotomy ifite ibyago. Ingaruka rusange zirimo kuva amaraso menshi no kwandura indwara. Byongeye kandi, ingorane zihariye zishobora kubaho zirimo:

• Umuhogo wa Barrett
• Indwara zo mu nda
• GERD (indwara yo kuzura mu gifu)
• Guturika k'umuyoboro w'amaso

Igihe cyo kubonana na muganga

Niba ufite kimwe muri ibi bimenyetso bikurikira nyuma yo kubagwa, hamagara muganga wawe ako kanya, cyangwa ujye mu ishami rishinzwe ubutabazi bwihuse (ETU) ry’ibitaro biri hafi yawe.

• Niba aho babazwe hatukura kandi habyimbye.
• Niba hari amabyi aturuka mu gikomere cyo kubagwa.
• Niba udashobora no kumira ibinyobwa.
• Niba imiti igabanya ububabare itangwa na muganga idatuma ububabare bugabanuka.

Itandukaniro riri hagati ya Heller Myotomy na POEM surgery

Ushobora kuba warumvise ibyerekeye uburyo bwitwa POEM. POEM ni ijambo rihinnye rya Peroral Endoscopic Myotomy . Kimwe na Heller Myotomy, ubu ni uburyo bwo kuvura indwara ya Achalasia.

Itandukaniro riri hagati y’ibyo byombi ni uko mu kubaga POEM, nta gukata igifu bikorerwamo. Ahubwo, muganga wawe ashyiramo endoscope (umuyoboro ufite kamera) binyuze mu kanwa kawe no mu muhogo. Hanyuma imitsi ya LES iracibwa imbere. Muri Heller Myotomy, ibi bikorwa inyuma binyuze mu gukata uduce duto mu nda yawe.