Iyo muganga wawe akubwiye ko ugomba kubagwa amara menshi, ni ibisanzwe kumva ufite ubwoba bwinshi n'imihangayiko. Iyo wumvise izina nka "proctocolectomy," bishobora kugorana kurushaho. Ariko ntugahangayike. Ubu ni uburyo bwo kubaga bushobora kugufasha kubaho neza binyuze mu kugabanya ibimenyetso by'uburwayi bwawe. Tuzaganira kuri byose mu buryo bworoshye ushobora gusobanukirwa.
Proctocolectomy ni iki mu by'ukuri?
Muri make, proctocolectomy ni ukubaga kurandura amara yawe n'igice cya nyuma cy'umura wawe.
Reka tubisobanureho gato. Urura runini ni igice kirekire cy’igogora ryacu. Gifite ibice bitatu by’ingenzi:
1. Utunyangingo tw'imbere: Iki ni cyo gice kinini cyane. Kinyunyuza amazi mu myanda yasigaye mu byo turya maze kikayahindura imiterere ikomeye, yitwa intebe.
2. Agace k'inyuma: Aka ni agace gato k'inyuma gakurikira amara. Niho umwanda ubikwa by'agateganyo mbere yuko usohoka.
3. Inyo: Umwobo unyuramo imyanda isohoka mu mubiri.
Rero, muri proctocolectomy, amara n'inyuma byombi birakurwaho, cyangwa igice cyabyo. "Procto" bivuga rectum. "Colectomy" bivuga gukuraho amara.
Kuki ukeneye kubagwa nk'ubu?
Hari impamvu nyinshi zishobora gutuma igikorwa nk'iki kibagwa cyane. Impamvu nyamukuru ni uko indwara yo mu mara ibuza icyo gice cy'umubiri gukora neza cyangwa ko iyo ndwara ishobora gushyira ubuzima mu kaga.
| Indwara | Ibisobanuro byoroshye |
|---|---|
| Indwara z'amara ziterwa no kubyimba | Iyo imbere mu mara hakomeje gukomereka no kubyimba bitewe n’indwara nka Ulcerative Colitis na Crohn's disease , kubagwa bishobora kuba ngombwa niba iyo ndwara idashobora gukemurwa n’imiti. |
| Kanseri y'inkondo y'umura n'indwara ziterwa na kanseri | Kugira ngo hakomezwe ikwirakwira ry'uturemangingo twa kanseri y'amara cyangwa mu bihe nk'ibyo bita Familyal Adenomatous Polyposis (FAP) , ari indwara umuntu avukana mu mara itera amagana y'uturemangingo dushobora guhinduka kanseri. |
| Izindi mpamvu | Ingorane nko gupfa kw'imitsi yo mu mara bitewe no kubura amaraso (ischemia), impatwe ikomeye, ibikomere bikomeye mu mara, cyangwa diverticulitis . |
Ni gute wiyuhagira nyuma yo kubagwa?
Iki ni cyo kibazo gikomeye abantu benshi bibaza. Iyo umwobo w'amara n'umura bikuweho, inzira isanzwe yo gusohora imyanda irabura. Wakora iki kugira ngo wiyongere? Igisubizo kuri ibi giterwa n'ubwoko bwa proctocolectomy wakoze. Muganga wawe ni we uzaguhitiramo uburyo bukwiye bitewe n'uburwayi bwawe.
Hari uburyo bwinshi bw'ingenzi:
1. Uburyo bwo gukora imyitozo ngororamubiri ya Ileostomy
Ibi bikubiyemo guhuza igice cya nyuma cy'amara yawe mato, cyitwa ileum, n'umwenge muto (stoma) ukorerwa mu ruhu rw'inda yawe. Hanyuma agafuka k'isuku kaba gafatanye n'umwenge kugira ngo gakusanyirize umwanda. Ibi bishobora kuba ibya burundu cyangwa iby'igihe gito . By'agateganyo bikorwa gusa kugeza umubiri wawe ukize. Ibi bishobora guhindurwa nyuma hamwe no kubagwa ukundi.
2. Ileoanal Pouch (gukora ipaki y'imbere)
Ubu buryo bushimishije cyane. Nanone bwitwa Restorative Proctocolectomy. Hafatwa igice cy'amara yawe mato (ileum) maze hagakorwamo agapfunyika gato. Tekereza ko ari igice gishya cy'umubiri wawe gishobora gufata umwanda wawe by'agateganyo, kimwe n'inyuma y'umura wawe. Hanyuma, agapfunyika gasubizwa mu kibuno cyawe. Nyuma y'ubu buryo, uzaba ushobora kujya mu musarani no kwituma nk'uko bisanzwe nyuma y'igihe runaka. Uburyo bukunze gukoreshwa muri ubu buryo bwitwa J-pouch .
3. Gukuraho Proctocolectomy (kugabanya igice cy'amaraso)
Muri ibi, igice cy'amara manini kirasigara. Iyo bishoboka, igice gisigaye cy'amara gishobora kongera guhuzwa n'anus cyangwa igice gisigaye cy'amara (anastomose). Ariko, rimwe na rimwe, hashobora gukenerwa ko habaho umwenge w'agateganyo mu nda no gushyirwamo agapfunyika k'imyenge (colostomy) kugeza igihe aho bahuriye hakize.
Igikuru ni uko muganga wawe azaganira nawe kuri ubu buryo bugukwiriye. Bityo, ganira na muganga wawe ku kibazo cyangwa impungenge ufite.
Ibibaho mbere, mu gihe cyo kubagwa, na nyuma yaho
Mbere yo kubagwa
Niba atari ukubagwa byihutirwa, uzaba ufite umwanya wo kwitegura.
- Ibyumweru bike mbere: Muganga wawe azagusobanurira uko kubagwa, ingaruka zako, n'amahitamo yawe.
- Ibyumweru bibiri mbere: Niba ufata imiti igabanya amaraso, bazakubwira kuyireka cyangwa kuyigabanya. Bazakugira inama yo kurya indyo irimo fibre nyinshi no kunywa amazi menshi.
- Amasaha 24 mbere: Uzahabwa imyitozo ngororamubiri yo gusukura amara yawe neza. Uzabwirwa kandi kurya ibinyobwa gusa ku munsi. Ushobora kandi guhabwa imiti yica udukoko kugira ngo wirinde kwandura nyuma yo kubagwa.
Mu gihe cyo kubaga
Uzasinzira ukoresheje ikinya, bityo ntuzumva ikintu icyo ari cyo cyose. Kubagwa bishobora gukorwa mu buryo bubiri bw'ingenzi:
- Kubaga mu buryo busanzwe: Uburyo gakondo, bukorwa binyuze mu gukata igice kinini mu nda.
- Kubaga Laparoscopic: Bizwi kandi nka "keyhole", ibi bikorwa hakoreshejwe gukata uduce duto mu nda no gushyiramo kamera n'ibikoresho byoroshye. Ubu buryo butuma umuntu akira vuba kandi ububabare buke.
Hanyuma umuganga ubaga akuraho neza igice cy’amara cyarwaye maze agakora ibikorwa bikenewe (ileostomy, pouch, cyangwa re-connect) nk'uko byavuzwe mbere.
Nyuma yo kubagwa
Uzakenera kumara icyumweru kimwe mu bitaro. Muri iki gihe, uzagenda uhinduka buhoro buhoro uva ku biryo by'amazi ujya ku biryo bikomeye. Niba ufite agakapu ko gukaraba (umufuka), umuforomo wabyigiye (WOCN - Wound Ostomy Continence Nurse) azakwigisha uburyo bwo kugakoresha no kugumisha uruhu rwawe rusukuye.
Ni izihe ngorane zishobora guterwa n'iki kibazo?
Nkuko bigenda mu kubagwa kose, hari ibyago n'ingorane bishobora kubaho, ariko akenshi ibi biba ari iby'igihe gito.
| Ubwoko bw'ingorane | Ibisobanuro |
|---|---|
| Ingorane zikunze kugaragara mu kubaga | Ingaruka zo kugira ikinya, kuva amaraso imbere mu mubiri, kwandura indwara, kuziba amara, n'ibindi. |
| Ingorane zijyanye no gusohora intanga (agakapu) | Indwara z'uruhu zikikije stoma, zinjira cyangwa zisohoka mu stoma.Indwara yitwa phantom rectum nayo ishobora kubaho. Iyi ni imitekerereze yo kwituma nubwo rectum yakuweho. Ibi bizagabanuka uko igihe kigenda gihita. |
| Ingorane zijyanye n'agafuka k'imbere ka Ileoanal (agafuka k'imbere) | Pouchitis , kuva amaraso mu nda, no kunanirwa kwifata mu gihe cy'amabyi. Byinshi muri ibi biravurwa. |
Ni ibihe bibazo byihutirwa bisaba kujya kwa muganga?
Niba ubonye kimwe muri ibi bimenyetso bikurikira nyuma yo kubagwa, hamagara muganga wawe ako kanya cyangwa ujye kwa muganga wita ku barwayi ba ETU (ETU) .
- Kubyimba, kubabara mu gifu, isesemi, no kuribwa mu nda (ibi bishobora kuba ibimenyetso by'uko amara azibamye).
- Kubabara cyane mu nda, umuriro, amabyi ava mu gisebe (ibi ni ibimenyetso by'ubwandu).
Wibuke ko niba wumva ikintu kidasanzwe, ntukirengagize. Ni byiza gushaka inama kwa muganga.
Ubutumwa bwo kujyana mu rugo
- Nubwo kubagwa kwa proctocolectomy ari igikorwa gikomeye, bishobora kuvura indwara zishobora gushyira ubuzima mu kaga no gutuma ubaho ubuzima bwiza.
- Hari uburyo butandukanye bwo kwiyuhagira nyuma yo kubagwa. Hari abantu babana n'agasakoshi k'isuku, abandi bafite ubundi buryo butuma biyuhagira bisanzwe. Muganga wawe ni we uzaguhitiramo ikikubereye.
- Bifata igihe kugira ngo ukire. Ushobora gusubira mu buzima busanzwe mu mezi make. Ni ngombwa cyane kwihangana no gukurikiza amabwiriza ya muganga muri iki gihe.
- Ntugatinye kuganira n'umuganga wawe ku bwoba bwawe bwose, gushidikanya kwawe, n'ibibazo byawe byose. Bizaguha imbaraga zo mu mutwe.
- Nubwo kubana n'agakapu ko mu mubiri bishobora kugorana mu ntangiriro, iyo umaze kumenyera, ushobora gukomeza gukora neza. Hari ibikoresho byinshi n'uburyo bwinshi buhari muri iki gihe bwo kubigufashamo.
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