Mu General, J-Pouch Surgery Amagwiritsidwa Ntchito Pochizira Ulcerative Colitis
Pulogalamu yotchedwa Ileoanal pouch anal anastomosis (IPAA) -kachidziwikiratu, opaleshoni ya j-poch- isandulire opaleshoni ya anthu ambiri omwe ali ndi ulcerative colitis ndipo amafuna opaleshoni. Opaleshoni yotereyi iyeneranso kuchitidwa kwa achibale omwe amachititsa kuti adenomatous polyposis (FAP) kapena matenda enaake a khansa yambiri . Komabe, kwa anthu omwe amapezeka kuti ali ndi mtundu wina wa matenda opatsirana (IBD) , Crohn's disease, j-poch nthawi zambiri saganiziridwa ngati njira yabwino.
Kodi J-Pouch ndi Chiyani?
Kuchita opaleshoni ya J-pouch kumachitika kwa anthu omwe ali ndi zilonda zam'mimba ngakhale pamene mankhwala amalephera ndipo zizindikiro zimakhala zosasamvetseka, kapena ngati asanakhale ndi khansa m'matumbo (matumbo akuluakulu) . Mu chiwerengero cha anthu omwe ali ndi zilonda zam'mimba, mankhwala omwe amatha kuchiza IBD sangathe kuwathandiza kuyambitsa kuchotsa kapena kuchepetsa zizindikiro, ndipo umoyo wa moyo ukhoza kukhala wosauka kwambiri kotero kuti opaleshoni imaganiziridwa. Anthu omwe ali ndi ulcerative colitis ali pachiopsezo chachikulu chokhala ndi khansa yamtunda, ndipo kuchotsedwa kwa colon kumatchulidwa nthawi zambiri pamene zotsatira za biopsy zimachokera kuwonetsereka kwa khansa kapena khansa.
Mu opaleshoni ya j-pouch, coloni imachotsedwa, limodzi ndi gawo kapena rectum yonse . Gawo lotsiriza la m'mimba mwaching'ono limagwiritsidwa ntchito kupanga thumba-kawirikawiri pamapangidwe a "J," koma mawonekedwe a "S" ndi "W" amachitanso nthawi zina. Chikwama chomwe chimapangidwa kuchokera m'matumbo ang'onoang'ono ndiye chimagwirizanitsidwa ndi anus (kapena rectum, ngati pali zina zotsala), zomwe zimapangitsa kuchotsa chophimba "zambiri". Kuchita opaleshoni kawirikawiri kumachitidwa muzinyendo ziwiri, komabe zingatheke kuchitapo chimodzi kapena zitatu.
Chifukwa chiyani Opaleshoni Ichi Sizochiritsidwa Kwa Matenda a Crohn?
Ndi matenda opatsirana ndi ulcerative, matendawa, ndi kutupa kofanana, zili m'matumbo akuluakulu. Kuchotsa matumbo ambiri, osati mankhwala a IBD, kumachotsa chiwalo chimene chimakhudzidwa kwambiri ndi matendawa. Ndi matenda a Crohn, mbali iliyonse ya kapangidwe ka zakudya ingakhudzidwe ndi kutupa ndipo ngakhale matumbo akulu achotsedwa, matenda a Crohn akhoza kubwereranso.
Ndipotu, malo omwe anthu ambiri ali ndi kutupa kwa anthu omwe ali ndi matenda a Crohn ndi amthempha komanso matumbo akuluakulu. Lileamu ndilo gawo lomalizira la matumbo aang'ono, ndipo ndilo gawo lomwe likugwiritsidwa ntchito popanga opaleshoni ya IPAA. Cholingalira choyambirira ndi, ngati matenda a Crohn amakhudza thumba, thumba likhoza "kulephera" ndipo pamapeto pake liyenera kuchotsedwa. Palinso odwala omwe atulukira kuti ali ndi ulcerative colitis, anali ndi opaleshoni ya j-poch, ndipo kenako matendawa adasinthidwa ndi matenda a Crohn (ngakhale izi si zachilendo).
Komabe, kufufuza za j-zikopa mwa anthu omwe ali ndi matenda a Crohn, zakhala ndi zotsatira zosiyana. Kafukufuku wina amasonyeza kuti ambiri mwa theka la odwala omwe ali ndi matenda a Crohn ndi j-poch ankadziwa bwino thumba ndipo amafunika kuchitidwa opaleshoni yowonjezereka kuchotsa ndi kulenga ileostomy yosatha . Komabe maphunziro ena amasonyeza kuti odwala ena osankhidwa mosamala ndi mtundu wina wa matenda a Crohn akhoza kulekerera opaleshoni ya j-poch. Pokubwera mankhwala ochiritsira a IBD (monga Remicade , Humira , Cimzia , Tysabri, ndi Entyvio), anthu omwe ali ndi matenda a Crohn ali ndi njira zambiri zothandizira kuposa kale lonse.
Choncho, IPAA SIDZACHITIKE KUKHALA MISONKHANO YA MATENDA A CRRIN?
Monga ndi zinthu zambiri zokhudzana ndi IBD, pali zosiyana.
Pakali pano pali kutsutsana pakati pa atsogoleri ofunika kwambiri ngati odwala ena omwe ali ndi matenda a Crohn angalandire j-poch ndi kuchita bwino. Pali zina za anthu omwe amapezeka ndi Crohn's colitis kapena indeterminate colitis omwe achita opaleshoni ya j-pouch. Komabe, pali chiopsezo chapamwamba cha mavuto omwe amapezeka ndi gulu la odwala. Sindinaphunzirepo kanthu pa j-poch mu odwala a Crohn's disease omwe angapereke umboni wokwanira wokwanira kuti athetse mkangano mwa njira imodzi kapena ina.
Monga momwe zilili ndi nkhani zambiri zotsutsana mu IBD, palibe njira yomwe yatsimikiziridwa kuti ilipamwamba.
Chosankha chilichonse chopanga j-poch kwa odwala omwe ali ndi matenda a Crohn chiyenera kupangidwa ndi magulu apadera omwe ali ndi maphunziro akuluakulu komanso odziwa bwino ntchito zachipatala.
Zotsatira:
Braveman JM, Schoetz DJ Jr, Marcello PW, Roberts PL, Coller JA, Murray JJ, Rusin LC. "Zotsatira za chikwama cha ileal kwa odwala omwe akudwala Crohn's disease." Dera la Dis Colon . 2004 Oct; 47 (10): 1613-1619.
Brown CJ, Maclean AR, Cohen Z, Macrae HM, O'Connor BI, McLeod RS. Matenda a Crohn ndi chifuwa chosatha komanso chikwama cha analomosis: zotsatira ndi zolephera. " Dera la Dis Colon . 2005 Aug; 48 (8): 1542-1549.
Joyce MR, Fazio VW. "Kodi thumba la leal anal anastomosis lingagwiritsidwe ntchito pa matenda a Crohn?" Adv Surg . 2009; 43: 111-137.