ʻO ka nui o ka proctocolectomy me ka ileostomy

ʻO ka total proctocolectomy me ka ileostomy kahi ʻoki e wehe i nā kolone a pau (ka ʻōpū nui) a me ka pololei.

E loaʻa iā ʻoe ka anesthesia ākea ma mua pono o kou ʻoki kino. E hiamoe kēia a ʻeha ʻoe.

No kāu proctocolectomy:

• E ʻokiʻoki kāu kaukipoki i kou ʻoki lalo.
• A laila e lawe aku kāu kauka lāʻau i kou ʻōpū nui a me kou pelu.
• Nānā paha kāu kauka lāʻau i kāu mau lymph node a hoʻoneʻe paha i kekahi o lākou. Hana ʻia kēia inā ke hana ʻia kāu ʻoki e wehe i ka maʻi ʻaʻai.

ʻO ka mea aʻe, e hana kāu kauka lāʻau i kahi ileostomy:

• E ʻokiʻoki kou kaukipoki i kou ʻoki liʻiliʻi. ʻO ka hapanui pinepine hana ʻia kēia ma ka ʻaoʻao ʻākau i lalo o kou ʻōpū.
• Huki ʻia ka ʻaoʻao hope o kou ʻōpū liʻiliʻi (ileum) ma o kēia ʻokiʻoki. Nīhi ʻia ia ma luna o kou ʻōpū.
• ʻO kēia wehe i kou ʻōpū i hoʻokumu ʻia e kāu ileum i kapa ʻia ʻo stoma. E puka mai ka Stool mai kēia wehe a ʻohiʻohi i kahi ʻeke hoʻokahe e hoʻopili ʻia iā ʻoe.

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

Hana ʻia ka huina proctocolectomy me ke kahakaha ileostomy ke kōkua ʻole nā ​​lāʻau lapaʻau ʻē aʻe i nā pilikia me kou ʻōpū nui.

Hana pinepine ʻia ia i ka poʻe i loaʻa i ka maʻi ʻōpū. Hoʻopili pū kēia me ka ulcerative colitis a i ʻole ka maʻi Crohn.

Hana ʻia kēia ʻokiʻoki inā loaʻa iā ʻoe:

• Ka maʻi ʻaʻai kolona a i ʻole rectum cancer
• Polyposis ʻohana
• Kahe i kou ʻōpū
• Nā kīnā hānau i hoʻopōʻino i kou ʻōpū
• Poino ʻōpū mai kahi ulia a ʻeha paha

ʻOi aku ka palekana o ka nui o ka proctocolectomy me ka ileostomy. E hilinaʻi kou makaʻu i kou olakino laulā. E noi i kāu mea mālama ola e pili ana i kēia mau pilikia kūpono.

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:

• Hoʻopōʻino i nā mea kokoke ma ke kino a i nā aʻa i ka pelvis
• ʻO ka maʻi, e komo pū ana me nā akemāmā, ka mimi, a me ka ʻōpū
• Hiki ke hana i nāʻiʻo scar i loko o kou ʻōpū a hiki i ka paʻa ʻana o ka ʻōpū liʻiliʻi
• E haki paha kou ʻeha a hoʻōla maikaʻi ʻole paha
• Ka maikaʻi o ka lawe ʻana o nā meaʻai mai ka meaʻai
• Phantom rectum, kahi manaʻo aia mau kou palahima ma laila (e like me ka poʻe i ʻokiʻoki i kahi lālā)

E haʻi mau i kāu mea hoʻolako i nā lāʻau āu e lawe nei, a me nā lāʻau, nā mea hoʻopili, a i ʻole nā ​​mea kanu āu i kūʻai ai me ka ʻole o ka lāʻau. E nīnau i nā lāʻau āu e lawe ai i ka lā o kou ʻoki ʻana.

E kamaʻilio me kāu mea hoʻolako e pili ana i kēia mau mea ma mua o kāu hana ʻoki ʻana.

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

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

• E noi ʻia paha ʻoe e haʻalele i ka lawe ʻana i nā lāʻau e paʻakikī ai ke kō ʻana o kou koko. Hoʻopili kēia i ka aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), Naprosyn (Aleve, Naproxen), a me nā mea ʻē aʻe.
• Inā puhi ʻoe, hoʻāʻo e kū. E noi i kāu mea hāʻawi mai i kōkua.
• E haʻi mau i kāu mea hāʻawi inā loaʻa ʻoe i ke anu, flu, fever, breakout herpes, a i ʻole nā ​​maʻi ʻē aʻe ma mua o kou ʻoki ʻana.

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 no kēia.

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. Hiki paha iā ʻoe ke noho lōʻihi inā ua loaʻa ʻoe i kēia ʻoki ma muli o kahi ulia pōpilikia.

Hāʻawi ʻia ʻoe i nā ʻāpana hau e hoʻoliʻiliʻi i kou make wai i ka lā like me kāu ʻoki. I ka lā aʻe, ʻae ʻia paha ʻoe e inu i nā wai paʻa. Hiki iā ʻoe ke hoʻohui mālie i nā wai a laila nā meaʻai palupalu i kāu papaʻai ke hoʻomaka hou kāu ʻōpū e hana hou. ʻAi paha ʻoe i ka papaʻai palupalu 2 mau lā ma hope o kou ʻoki ʻana.

ʻOiai ʻoe i ka haukapila, e aʻo ʻoe pehea e mālama ai i kāu ileostomy.

E loaʻa iā ʻoe kahi ʻeke ileostomy e pono ai nou. E mau ka hoʻokahe i kāu ʻeke. Pono ʻoe e ʻaʻa i ka ʻeke i nā manawa āpau.

ʻO ka hapa nui o ka poʻe i loaʻa i kēia ʻoki e hiki 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.

Pono paha ʻoe e mālama i ka lāʻau lapaʻau inā loaʻa ʻoe i kahi maʻi mau, e like me:

• Maʻi Crohn
• Ulcerative colitis

• Ka palekana i ka lumipaku no nā mākua
• 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
• Pāleʻa ka pale ʻana
• Huina colectomy a i ʻole proctocolectomy - hoʻokuʻu
• Nā ʻano o ka ileostomy
• Ke loaʻa ka nausea a me ka luaʻi

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.