Ndiani chiremba uyu wemazino? Ngationei chaizvo!

Ungashamisika zvishoma paunonzwa zita rekuti 'Colorectal Surgeon', uchifunga kuti, "Ndiani uyu? Vanoita sei?" Usazvidya moyo, hazvina kuoma. Muchidimbu, uyu chiremba wezvekurapa ane hunyanzvi mukurapa zvirwere uye kuita maoparesheni muura hwako hukuru, rectum , uye anus . Saka ngatitaurei nezvazvo zvakadzama, sekunge uri kutaura neshamwari, zvakanaka here?

Ndiani chiremba uyu wemazino? Aimbonzi proctologist here?

Ehe, pamwe wakambonzwa izwi rekuti 'proctologist'. Kutaura zvazviri, kare, vanachiremba vairapa mhando idzi dzezvirwere vainzi proctologists. 'Colorectal surgeon' ndiro zita remazuva ano rebazi rezvekurapa iroro.

Pane musiyano mudiki pazvinoreva mazita maviri aya. Patinoti 'proctologist', zvinonyanya kureva rectum ne anus. Asi patinoti 'colorectal', zvinosanganisira ura hwemukati nerectum. Unoziva, maviri aya ndiwo mativi makuru eura hukuru. Zvisinei, mukuita, zvisinei nekuti ndeapi mazita maviri aya, nyanzvi idzi dzinobata mativi ese aya zvakanyanya . Saka hapana chekufunga nezvazvo zvakanyanya.

Sei tichifanira kuona chiremba we colorectal?

Fungidzira uine kusanzwa zvakanaka kana kuti chiratidzo mudumbu rako rezasi, kureva kuti, nzira yako yekugaya chikafu (GI). Wobva watanga waenda kunoona chiremba mukuru kana gastroenterologist.

Kana chiremba, mushure mekukuongorora, akaona kuti chirwere chako chinoda kuvhiyiwa , achakutumira kuna chiremba anovhiya dumbu.

Zvimwe zvirwere zve colorectal zvinogona kuda kuvhiyiwa zvinosanganisira:

• Kenza uye polyposis : Izvi zvinoreva zvirwere zvegomarara muura kana tumapundu tudiki (polyps) izvo zvinogona kuita kenza.
• Chirwere cheIBD: Uku kuzvimba kwenguva refu kwemukati meura. Mienzaniso inosanganisira zvirwere zvakaita seCrohn's disease uye ulcerative colitis .
• Ischemia: Apa ndipo apo chikamu cheura chinobudaKuderera kweropa rinobuda mumuviri kana kurasikirwa naro . Kana izvozvo zvikaitika, chikamu ichocho chinogona kutofa.
• Zvikanganiso zvemuumbi: Semuenzaniso, fistula - kubatana kusina kujairika pakati peura nechimwe chinhengo, hernias - kubuda kwechikamu cheura nepanzvimbo isina simba, uye kubuda kwechikamu chemuviri, senge rectum.

Vanachiremba vekurapa dumbu vanongorapa ura chete here?

Kwete, izvo hazvisi zvechokwadi. Kunyange zvazvo vanachiremba vekurapa dumbu vachinyanya kurapa ura hukuru , vakadzidziswawo kuvhiya kwakajairika .

Kunze kwezvo, dambudziko riri munhengo imwe yemuviri wedu rinogona kukanganisa dzimwe nhengo, handiti? Nokudaro, nyanzvi idzi dzinofanira kurapa dzimwe nhengo dzine chekuita zvakananga neura kana kuti dzine chirwere chimwe chete. Nhengo dzakadai ndedzi:

• Utumbu Hudiki
• Tsandanyama dzepasi pechiuno (idzi dzinobatsira kudzora ura nedundira)
• Sisitimu yeweti
• Sisitimu Yekubereka Yevakadzi

Ndezvipi zvinodiwa kuti uve chiremba wekuvhiya colorectal?

Iyi ipfungwa inokosha zvikuru. Chiremba wemazino emukati medumbu munhu ane hunyanzvi uye ruzivo rwakanyanya . Semuenzaniso, munyika yakaita seUnited States, kuti uve chiremba wemazino emukati medumbu, munhu anofanira kudzidziswa sachiremba wemazino emukati medumbu kwemakore mashanu. Mushure meizvozvo, munhu anofanira kudzidziswa gore rimwe kana kupfuura muchipatara chemazino emukati medumbu.

Mushure mekudzidziswa uku, vanopasa bvunzo dzakanyorwa nedzemuromo uye vanova nyanzvi dzakanyoreswa nebhodhi kubva kumabhodhi ekurapa akakodzera (semuenzaniso, American Board of Colorectal Surgery). Saka sezvamunoona, rwendo urwu harusi nyore, ndosaka tichigona kuvimba neruzivo rwavo nehunyanzvi hwavo.

Chii chinonyanya kudzidzwa nachiremba wemazino kupfuura chiremba mukuru wemazino?

Nyanzvi idzi dzinodzidza zvakadzama nezve physiology yemudumbu neanorectal , kureva kuti, mashandiro anoita nhengo idzi uye kuti dzinodyidzana sei.

Nekuda kweruzivo urwu rwakadzama, matambudziko anomuka muura nemudumbuVane hunyanzvi hwakasiyana hwekuongorora matambudziko akaomarara emuviri uye kupa mishonga inorema inodiwa. Kutaura zvazviri, ndivo nyanzvi munyaya iyi.

Chii chaizvo chinoitwa nachiremba we colorectal surgeon?

Vanachiremba vekurapa dumbu vanoshandisa nzira dzese dzekurapa dumbu (endoscopic) uye nzira dzekuvhiya kuti varape kugaya kwako. Izvi zvinoreva kuti vane zvese zvavanoda pakurapa zvirwere zvakaoma.

Vanogona kukurapa pasina kuvhiyiwa (semuenzaniso, kuburikidza ne endoscopy), nekuvhiyiwa kusingapindi zvakanyanya , kana, kana zvichidikanwa, nekuvhiyiwa kwakavhurika .

Dzimwe nzira dzinoshandiswa nevanovhiya colorectal dzinosanganisira:

• Colonoscopy: Izvi zvinosanganisira kuisa chubhu yakatetepa, inochinjika (endoscope) ine kamera uye chiedza chinopinda nemuhuro kuti uongorore ura hwese hukuru . Izvi zvinogona kushandiswa kubvisa mapolyps madiki uye kutora sampuli dzenyama (biopsy).
• Enteroscopy: Iyi inzira yekuongorora ura hudiki uchishandisa endoscope.
• Sigmoidoscopy: Iyi inoongorora chikamu chekupedzisira cheura hukuru (sigmoid colon), rectum, uye anus.
• Laparoscopy: Kuchekwa kudiki kwazvo kunoitwa mudumbu, uko kamera yakakosha (laparoscope) inopinzwa kuti iongorore nhengo dzemukati medumbu.
• Kuvhiyiwa kweLaparoscopic: Kunozivikanwawo se "keyhole surgery," iyi inzira inosanganisira kucheka zvidimbu zvidiki mudumbu uye kushandisa laparoscope nezvimwe zvinhu zvakakosha. Izvi zvinoita kuti kuvhiyiwa uku kuitwe pasina kucheka kukuru, izvo zvinoderedza nguva yekupora.
• Kuvhiyiwa kweRobhoti: Uku zvakare rudzi rwekuvhiyiwa kwe laparoscopic. Zvisinei, pano chiremba anovhiya anodzora ruoko rwerobhoti achishandisa kombiyuta. Izvi zvinobvumira kuvhiyiwa kwakaoma uye kwakaoma .

Mamwe mavhiyirwo nemaitiro anoitwa nevanovhiya colorectal anosanganisira:

• Kubviswa kwepolypectomy: Kubviswa kwepolyps (mapundu madiki) muura kuburikidza ne endoscopy.
• Kubviswa kwemucosal mucosal ne endoscopic (EMR) / kubviswa kwemucosal ne endoscopic (ESD): Nzira dzepamusoro dzekubvisa bundu riri mukati meura rakaoma kubviswa ne endoscopic.
• Kuvhiyiwa kweTransanal endoscopic microsurgery: Kuvhiyiwa uko mudziyo wakakosha (proctoscope) unopinzwa kuburikidza neanus kubvisa bundu guru kana zvipingamupinyi mu rectum.
• Kuvhiyiwa kwekubvisa ura: Kubviswa kwechikamu cheura kana ura hwese, zvichienderana nemamiriro ezvinhu.
• Kuvhiyiwa kweOstomy: Izvi zvinosanganisira kushandura nzira inobuda tsvina mumuviri uye kugadzira stoma nekubatanidza mugumo mumwe weura neganda redumbu. Izvi zvinonzi colostomy kana ileostomy.
• Kuvhiyiwa kweAnastomosis: Kubatanidzazve zvikamu zviviri zveura nekubvisa ostomy yakagadzirwa kare.
• Kubviswa kweappendectomy: Kubviswa kweappendectomy kana yazvimba (appendicitis).
• Kugadziriswa kwetsvina: Kugadzirisa kana kuchinja chimiro chetsvina.
• Rectopexy: Kudzorera kudonha kwerectal nekuvhiyiwa.
• Sacrocolpopexy: Kugadziriswa kwekudonha kwenhengo dzechiuno.
• Kugadzirisa hernia: Kugadzirisa hernias muura (semuenzaniso inguinal hernia, incisional hernia) uchishandisa nzira dze laparoscopic kana robotic.
• Kuvhiyiwa kweCecostomy / antegrade colonic enema (ACE): Chubhu inopinzwa muura kuti ipe mushonga we enema senzira yekurapa mamwe mamiriro ezvinhu, akadai sekuvimbiwa.

Vanoitawo zvinhu zvakaita seizvi kuti vaongorore mashandiro enzira yako yemukati medumbu nepamusana:

• Kuongororwa kwedhijitari kwerectal: Kuongororwa uko chiremba anoisa chigunwe chine girovhosi murectum.
• Anoscopy / Proctoscopy: Kuisa chinhu chidiki kuti uone anus nerectum yepazasi.
• Defecography: Kuongorora kufamba kwedumbu uchishandisa X-ray kana MRI.
• Ultrasound yemudumbu: Kuongororwa kwerectum nenyama dzakapoteredza nekuisa ultrasound probe kuburikidza nerectum.
• Anorectal manometry: Kuyera kumanikidzwa uye mashandiro emhasuru dziri mu rectum ne anus.

Ndezvipi zvirwere zvinorapwa nevanovhiya colorectal?

Kune zvirwere zvakawanda zvinoda kushanyirwa kuna chiremba wemazino. Ngatitarisei zvimwe zvacho mumapoka:

Mienzaniso yegomarara remudumbu:

• Kenza yemudumbu
• Kenza yemudumbu
• Kenza yekumashure
• Kenza yekuwedzera
• Peritoneal carcinomatosis - kupararira kwegomarara kusvika mudumbu
• Matumbu emudumbu (GIST)
• Matumbu eNeuroendocrine
• Zvimwe zvirwere zvegomarara zvinogara nhaka, zvakaita segomarara regomarara risingapfuuri nepolyposis (HNPCC) kana kuti Lynch syndrome.

Mienzaniso ye colorectal polyps uye inherited polyposis syndromes:

• Familyal adenomatous polyposis syndrome (FAP) - Izvi zvinogona kukonzera mazana kana zviuru zvema polyps muura.
• Lynch syndrome - (inotaurwawo pasi pegomarara)
• MUTYH-associated polyposis (MAP)
• Serrated polyposis syndrome
• Matumbu eDesmoid
• Chirwere chePeutz-Jeghers
• chirwere cheJuvenile polyposis
• PTEN hamartoma syndrome

Mienzaniso yezvirwere zvakaoma zvemudumbu (kuzvimba kwemudumbu):

• Diverticulitis - Kutapukirwa kana kuzvimba kwezvikwama zvidiki (diverticula) mumadziro eura.
• Ulcerative colitis
• Chirwere cheCrohn
• Microscopic colitis
• Pseudomembranous colitis - Chirwere chinowanzoitika mushure mekushandisa mishonga inorwisa mabhakitiriya.
• Appendicitis - Kuzvimba kweappendix.
• Kubata kweropa mudumbu - Chirwere chakakomba chinokanganisa vacheche vachangoberekwa.
• Ischemic colitis - Kuzvimba kunokonzerwa nekushomeka kweropa rinoenda muura.

Zvirwere zvemudumbu, mienzaniso:

• Kusashanda zvakanaka kwepasi pechiuno - chirwere chinokonzera kuoma kwekuita tsvina.
• Kusakwanisa kudzora tsvina (Fecal incontinence)
• Kubvisa tsvina yakavharika
• Anismus - Kusakwanisa kusunungura tsandanyama dzemudumbu zvakanaka panguva yekuzvibatsira.

Zvikanganiso zvemuumbirwo, mienzaniso:

• Kuvharika kwematumbu makuru
• Fistula yekubuda netsvina yekubuda netsvina - Kuumbwa kwenzira isiri yechisikigo pakati peganda neura pedyo netsvina yekubuda netsvina.
• Rectovaginal fistula - kubatana kusiri kwemuzvarirwo pakati pe rectum nemukadzi.
• Hernia yeperineal
• Pumbu rePerianal
• Kupera kwemusana
• Kudonha kwenhengo dzechiuno

Mimwe mamiriro asina njodzi emudumbu, mienzaniso inosanganisira:

• Kubuda ropa mudumbu / kubuda ropa muhuro
• Makwenya ekumashure
• Mapundu ekumashure
• Mamota
• Maronda emudumbu
• Kuzvimba uye kubatwa netsvina

Chiyeuchidzo chidiki nezveura hwako hwemukati nehurongwa hwekugaya chikafu hwepazasi

Ura hwako hukuru chikamu chikuru chedumbu rako rezasi . Chikafu chatinodya chinofamba nemudumbu rako, uye izvi ndizvo zvinoita kuti marara abviswe mumuviri wako. Saka, kana uchiona zviratidzo zvakaita sekurwadziwa mudumbu rezasi kana shanduko mumarara ako (semuenzaniso, kubuda ropa, manyoka, kuvimbiwa), zvingangove dambudziko nedumbu rako rezasi.

Apa ndipo panotanga kukosha mazano nekurapwa nachiremba wemazino emudumbu. Haasi ese mamiriro ezvinhu anoda kuvhiyiwa . Zvisinei, kana kuvhiyiwa kuchidikanwa, kuona nyanzvi yakaita seiyi kunogona kukubatsira kuwana kurapwa kwakanakisisa. Chiremba wako kana chiremba wezvekudya achakutumira kuna chiremba wemazino emudumbu kana vachifunga kuti nyanzvi iyi inogona kugadzirisa dambudziko rako.

Pakupedzisira, ndinofanira kukuudzai... (Mharidzo Yekuenda Nayo Kumba)

Ndinovimba wava neruzivo rwakakwana rwekuti chiremba wemazino ndiani, zvavanoita, uye rudzii rwezvirwere zvavanorapa.

Chinhu chakakosha ndechekuti nyanzvi idzi dzivepo kuti dzikubatsire . Dzine hunyanzvi nekudzidziswa zvinodiwa pahutano hwako.

• Kana uine zviratidzo zvisingawanzoitika zvine chekuita neura hwako, rectum, kana anus (semuenzaniso, kurwadziwa mudumbu nguva dzose, ropa mutsvina yako, kuchinja kwemaitiro emudumbu, kudzikira kwehuremu kusingatsananguriki), usazviregeredza . Tsvaga rubatsiro rwechiremba nekukasika.
• Kana chiremba wako akakutumira kuna chiremba wemazino, usatya . Zvinongoreva kuti ungangoda kurapwa kwakakosha .
• Rangarirai, nesainzi yekurapa yemazuva ano, zvirwere zvakawanda zvine chekuita neiyi ndima zvinogona kurapwa zvinobudirira .

Saka, unofanira kugara uine hutano hwakanaka! Kana uine matambudziko, chinhu chakakosha kuwana mazano akakodzera kubva kunzvimbo chaiyo.

Chiremba wepamuromo wegumbo , zvirwere zvepamuromo wegumbo, chiremba wepamuromo wegumbo regumbo, kenza yemuura, colonoscopy, nzira yekugaya chikafu, kuvhiyiwa