Ka nui o ka proctocolectomy a me ka ʻeke ileal-anal

ʻO ka huina o ka proctocolectomy a me ka ileal-anal pouch ʻoki ʻo ka lawe ʻia ʻana o ka ʻōpū nui a me ka hapa nui o ka pololei. Hana ʻia ke ʻoki i hoʻokahi a i ʻole ʻelua mau pae.

E loaʻa iā ʻoe ka anesthesia laulā ma mua o kou ʻoki kino. ʻO kēia ka mea e hiamoe ai ʻoe me ka ʻeha ʻole.

Loaʻa iā ʻoe ke kaʻina hana i hoʻokahi a i ʻole ʻelua mau pae:

• E ʻokiʻoki kāu kaukipō i kāu ʻōpū. A laila e lawe aku kāu kauka lāʻau i kou ʻōpū nui.
• ʻO ka mea aʻe, e hoʻoneʻe kāu mea lapaʻau i kāu kiko. E waiho ʻia kou anus a me ka sphincter anal ma kahi. ʻO ka sphincter anal ka mākala e wehe i kou anus ke loaʻa iā ʻoe kahi ʻōpū.
• A laila e hana kāu kauka hana i kahi ʻeke mai nā iniha he 12 (30 kenimika) hope loa o kou ʻōpū liʻiliʻi. Kui ʻia ka ʻeke i kou nūnū.

Hana kekahi o nā kauka i kēia hana me ka hoʻohana ʻana i ka pahupaʻikiʻi. Kapa ʻia kēia ʻoki laparoscopy. Hana ʻia me kekahi mau ʻoki liʻiliʻi liʻiliʻi. I kekahi manawa hana ʻia kahi ʻoki ʻoi aku ka nui i hiki i ke kaukipō ke kōkua ma ka lima. ʻO nā pōmaikaʻi o kēia ʻoki kino ka hoʻōla wikiwiki, ka liʻiliʻi o ka ʻeha, a he mau ʻoki liʻiliʻi wale nō.

Inā loaʻa iā ʻoe kahi ileostomy, e pani ana kāu mea kauka iā ia i ka wā hope loa o ke kaha.

Hana ʻia kēia kaʻina hana no:

• Ulcerative colitis
• Polyposis ʻohana

Nā pilikia o ka anesthesia a me ke kahakaha ʻana ma:

• Nā hopena i nā lāʻau
• Nā pilikia hanu
• Kahe ʻana o ke kahe, kahe koko
• Maʻi kīnā

ʻO nā pilikia o kēia ʻoki ʻana:

• Hoʻopili i kaʻiʻo ma o keʻoki, i kapa ʻia he hernia incisional
• Poino i nā mea pili kokoke i ke kino a me nā aʻalolo i ke pelvis
• ʻO nāʻiʻo scar i hana ʻia i loko o ka ʻōpū a lilo i wahi o ka ʻōpū liʻiliʻi
• Kahi kahi e humuhumu ʻia ai ka ʻōpū liʻiliʻi i ka anus (anastomosis) hiki ke hāmama, e hōʻeha ana i ka maʻi a i ʻole abscess, i hiki ke hoʻoweliweli i ke ola
• Wahi hāmama
• Ka maʻi hōʻeha

E haʻi mau i kāu mea mālama ola i nā lāʻau āu e lawe nei, a me nā lāʻau, nā mea hoʻopiha, a i ʻole nā ​​mea kanu āu i kūʻai ai me ka ʻole o ka lāʻau.

Ma mua o kou ʻoki ʻana, e kamaʻilio me kāu mea hoʻolako e pili ana i kēia mau mea:

• Ka pilina a me ka moekolohe
• Hapai keiki
• Pāʻani
• Hana

I loko o 2 mau pule ma mua o kou ʻoki kino:

• ʻElua mau pule ma mua o ke kahakaha ʻana, e noi ʻia paha ʻoe e haʻalele i ka lawe ʻana i nā lāʻau e paʻakikī ai i ke kō ʻana o kou koko. Hoʻopili kēia i ka aspirin, ibuprofen (Advil, Motrin), Naprosyn (Aleve, Naproxen), a me nā mea ʻē aʻe.
• E nīnau i nā lāʻau āu e lawe ai i ka lā o kou ʻoki ʻana.
• Inā puhi ʻoe, hoʻāʻo e kū. E noi i kāu mea hāʻawi mai i kōkua.
• E hoʻomaopopo mau i kāu mea hoʻolako e pili ana i kekahi anuanu, flu, fever, breakout herpes, a i ʻole nā ​​maʻi ʻē aʻe āu e loaʻa ai ma mua o kāu ʻoki.

ʻO ka lā ma mua o kou ʻoki ʻana:

• E noi ʻia ʻoe e inu wale i nā wai akā, e like me ka broth, wai momona, a me ka wai ma hope o kekahi manawa.
• E hāhai i nā ʻōkuhi i hāʻawi ʻia iā ʻoe e pili ana i ka wā e haʻalele ai i ka ʻai ʻana a me ka inu ʻana.
• Pono paha ʻoe e hoʻohana i nā enemas a i ʻole nā ​​laxatives e hoʻomaʻemaʻe i kou ʻōpū. E hāʻawi kāu mea hāʻawi iā ʻoe i nā ʻōkuhi pehea e hoʻohana ai iā lākou.

I ka lā o kou ʻoki kino:

• E lawe i nā lāʻau i kauoha ʻia iā ʻoe e lawe me kahi wahi wai ʻuʻuku.
• E haʻi ʻia ʻoe i ka wā e hōʻea ai i ka haukapila.

Ma ka haukapila ʻoe no 3 a 7 mau lā. I ka lua o ka lā, hiki paha iā ʻoe ke inu i nā wai holoi. Hiki iā ʻoe ke hoʻohui i nā wai mānoanoa a laila ʻai nā mea palupalu i kāu papaʻai ke hoʻomaka hou kāu ʻōpū e hana hou.

ʻOiai ʻoe i ka haukapila no ka pae mua o kāu ʻoki ʻana, e aʻo ʻoe pehea e mālama ai i kāu ileostomy.

E loaʻa paha iā ʻoe he 4 a 8 mau ʻōpū o ka ʻōpū i kekahi lā ma hope o kēia ʻoki ʻana. Pono ʻoe e hoʻoponopono i kou nohona no kēia.

Ola hou ka hapa nui o ka poʻe. Hiki iā lākou ke hana i nā hana he nui a lākou e hana nei ma mua o kā lākou ʻoki ʻana. Hoʻopili kēia i ka hapa nui o nā haʻuki, ka huakaʻi, ka māla, ka piʻi wāwae, a me nā hana waho ʻē aʻe, a me ka nui o nā ʻano o ka hana.

Hoʻolaha hoʻoliʻiliʻi; ʻO Ileal-anal resection; ʻEke ʻIleal-anal; J-ʻeke; S-ʻeke; Puke pelvic; ʻEke ʻIleal-anal; Ileal kieke-anal anastomosis; IPAA; ʻOki kino ʻIleal-anal

• Papaʻai Bland
• ʻO Ileostomy a me kāu keiki
• Ileostomy a me kāu papaʻai
• Ileostomy - mālama i kāu stoma
• Ileostomy - ke hoʻololi nei i kāu ʻeke
• Ileostomy - hoʻokuʻu
• Ileostomy - he aha e nīnau aku ai i kāu kauka
• Noho me kāu ileostomy
• ʻAiʻai haʻahaʻa
• Huina colectomy a i ʻole proctocolectomy - hoʻokuʻu
• Nā ʻano o ka ileostomy
• Ulcerative colitis - hoʻokuʻu

Mahmoud NN, Bleier JIS, Aarons CB, Paulson EC, Shanmugan S, Fry RD. Kolona a me ka pololei. I: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. ʻO Sabiston Textbook of Surgery. 20 ouk. Piladelapia, PA: Elsevier; 2017: chap 51.

Raza A, Araghizadeh F. Ileostomies, colostomies, pou, a me anastomoses. I: Feldman M, Friedman LS, Brandt LJ, eds. ʻO Sleisenger a me Fordtran's Gastrointestinal a me ka maʻi ate. 11th hua. Piladelapia, PA: Elsevier; 2021: chap 117.