ʻOki kino hou Ureteral - keiki

ʻO nā ureter nā paipu e halihali i ka mimi mai nā puʻupaʻa i ka pūpū. ʻO ke Ureteral reimplantation kahi ʻoki e hoʻololi i ke kūlana o kēia mau paipu kahi i komo ai lākou i ka paia puhā.

Hoʻololi kēia kaʻina hana i ke ala e hoʻopili ai ka ureter i ka puhā.

Hana ʻia ke kaha ma ka haukapila ʻoiai hiamoe kāu keiki a ʻaʻohe ʻeha. Lawe ke ʻōpala i 2 a 3 mau hola.

Ma ke kahakaha ʻana, e:

• Wehe i ka ureter mai ka pākeke.
• E hana i kahi tunnel hou ma waena o ka paia bladder a me nā mākala i kahi kūlana ʻoi aku i loko o ka ʻōpū.
• E kau i ka ureter i ke ana hou.
• E humuhumu i ka ureter ma kahi a pani i ka bladder me nā humuhumu.
• Inā pono, e hana ʻia kēia i ka ureter ʻē aʻe.
• Pani i kekahi ʻoki i hana ʻia i loko o kou ʻōpū keiki me nā humuhumu a i ʻole staples.

Hiki ke hana i ke ʻoki ma 3 mau ala. E pili ke ʻano hana i ke kūlana o kāu keiki a pehea e hoʻopili hou ai i nā ureter i ka puhā.

• I ka ʻoki hāmama, e hana ke kauka i kahi ʻoki liʻiliʻi ma ka ʻōpū o lalo ma o ka mū a me ka momona.
• I ke kahakaha laparoscopic, e hana ke kauka i ke kaʻina hana me ka hoʻohana ʻana i kahi kāmela a me nā mea hana ʻoki liʻiliʻi ma o 3 a 4 mau ʻoki liʻiliʻi i loko o ka ʻōpū.
• ʻAno like ke ʻōpoki Robotic me ke kahakaha laparoscopic, koe wale nā ​​mea i paʻa ʻia e kahi lopako. Mālama ke kauka i ka lopako.

E hoʻokuʻu ʻia kāu keiki 1 a 2 mau lā ma hope o ke kaha ʻana.

Hana ʻia ke ʻoki e pale ai i ka mimi e kahe ana i hope mai ka puhā i nā puʻupaʻa. Kapa ʻia kēia reflux, a hiki ke kumu i nā maʻi urinary tract a hoʻopōʻino i nā puʻupaʻa.

ʻO kēia ʻano ʻoki kino maʻamau i nā keiki no ka reflux ma muli o kahi kīnā o ka ʻōnaehana urinary. I nā keiki nui, hana ʻia paha e mālama i ka reflux ma muli o ka hōʻeha a maʻi paha.

ʻO nā pōʻino no kēlā me kēia ʻoki kino:

• Hoʻopaʻa ke koko i nā wāwae e hele paha i nā akemāmā
• Nā pilikia hanu
• ʻO ka maʻi, e komo pū ana me ka ʻeha ʻoki, paru (pulumonia), pūpū, a me nā puʻupaʻa
• Lilo ke koko
• Nā hopena i nā lāʻau

ʻO nā pilikia no kēia kaʻina hana:

• Piʻi ka mimi i waho i ka wahi a puni ka ʻai
• Koko i ka mimi
• Maʻi kīnā
• Manuahi spadms
• Ka pale o nā ureter
• ʻAʻole paha ia e hoʻoponopono i ka pilikia

ʻO nā pilikia lōʻihi lōʻihi pū me:

• ʻO ke kahe hope mau o ka mimi i loko o nā puʻupaʻa
• Fistula mimi

Hāʻawi ʻia ʻoe i nā kuhikuhi kikoʻī i ka ʻai ʻana a me ka inu e pili ana i ka makahiki o kāu keiki. E ʻōlelo paha ke kauka o kāu keiki iā ʻoe:

• Mai hāʻawi i kāu keiki i nā meaʻai paʻa a wai ʻole maopopo ʻole, e like me ka waiū a me ka wai ʻalani, e hoʻomaka ana ma ke aumoe ma mua o ke kaha.
• E hāʻawi wale i nā wai maopopo, e like me ka wai ʻāpala, i nā keiki makua a ʻelua mau hola ma mua o ke kaha ʻana.
• Hānai i nā keiki hānai a ʻehā mau hola ma mua o ke kaha ʻana. ʻAi paha nā pēpē hānai ʻia i 6 mau hola ma mua o ke kaha ʻana.
• Mai hāʻawi i kāu keiki i mea inu no 2 mau hola ma mua o ke kaha.
• E hāʻawi wale i kāu keiki i nā lāʻau a ke kauka e koi ai.
  
  

Ma hope o ke kahakaha ʻana, e loaʻa i kāu keiki nā wai i kahi aa koko (IV). Me kēia, hiki ke hāʻawi ʻia i kāu keiki i ka lāʻau e hōʻoluʻolu ai i ka ʻeha a hoʻomaha i ka spadms bladder.

Loaʻa paha i kāu keiki kahi catheter, kahi paipu e hiki mai ana mai ka ʻai o kāu keiki e hoʻowali i ka mimi. Aia kekahi auwai paha i loko o ka ʻōpū o kāu keiki e hoʻokuʻu i nā wai i hope o ke kahakaha ʻana. Lawe ʻia paha kēia mau mea ma mua o ka hoʻokuʻu ʻia ʻana o kāu keiki. Inā ʻaʻole, e haʻi ke kauka iā ʻoe pehea e mālama ai iā lākou a i ka wā hea e hoʻi ai e hoʻoneʻe iā lākou.

Ke puka mai kāu keiki mai ka anesthesia, e uē paha kāu keiki, palaualelo a huikau paha ʻoe, a maʻi a luaʻi paha. Kūleʻa kēia mau hopena a hele aku me ka manawa.

Pono kāu keiki e noho i ka haukapila no 1 a 2 mau lā, ke kaukaʻi ʻia i ke ʻano o ke ʻoki o kāu keiki.

Kūleʻa ke kaha ʻana i ka hapanui o nā keiki.

Ureteroneocystostomy - keiki; ʻOki kino hou Ureteral - keiki; Ureteral reimplant; Reflux i nā keiki - ureteral reimplantation

ʻO Elder JS. ʻO reflux Vesicoureteral. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 554.

Khoury AE, Bägli DJ. ʻO reflux Vesicoureteral. I: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th hua. Piladelapia, PA; Elsevier; 2016: chap 137.

ʻO Pope JC. Ureteroneocystostomy. I: Smith JA Jr, Howards SS, Preminger GM, Dmochowski RR, eds. ʻO Hinman's Atlas of Urologic Surgery. ʻEhā ed. Piladelapia, PA: Elsevier; 2018: chap 33.

Richstone L, Scherr DS. ʻO ke kāpili Robotic a me laparoscopic bladder. I: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th hua. Piladelapia, PA; Elsevier; 2016: chap 96.