Ni iki cyitwa kubaga Ileoanal Anastomosis J-Pouch? Intego, Uburyo & Ibivamo

Kubaga Ileoanal anastomosis hamwe na J-pouch ni uburyo bwo gukora inzira nshya yo gukuraho imyanda igihe urugingo rwawe runini rukeneye gukurwaho. Umuganga wawe akuraho urugingo runini rwanduye hanyuma agahuza urugingo ruto rutungana neza n'impyiko zawe akoresheje agafuka gafite ishusho yihariye.

Uku kubaga bituma ugumana imikorere isanzwe y'amara unyuze mu mpinduka zawe, ukirinda gukenera umufuka wa colostomy wa burundu. J-pouch ikora nk'urugomero, ikabika imyanda kugeza igihe witeguye kugira urugendo rw'amara, nk'uko urugingo rwawe rwa mbere rwakoraga.

Ni iki cyitwa kubaga Ileoanal Anastomosis J-Pouch?

Uku kubaga bikubiyemo intambwe ebyiri z'ingenzi: gukuraho urugingo rwawe runini n'urugingo rw'amara, hanyuma ugakora agafuka gafite ishusho ya J kuva mu mara yawe mato. Agafuka kabonye izina ryako kuko asa neza n'inyuguti ya "J" iyo urebye kuruhande.

Mugihe cyo kubaga, umuganga wawe afata iherezo ry'amara yawe mato (yitwa ileum) akarisubiza inyuma kugirango akore urugomero. Iri gafuka rero rihuza neza n'impyiko zawe, bikagufasha kunyura mu gihagararo gisanzwe. Igishushanyo cya J gifasha agafuka gufata imyanda myinshi kandi kigabanya inshuro zo kugira urugendo rw'amara.

Abantu benshi bakeneye uku kubaga kubera indwara ikomeye yo guhura n'amara, cyane cyane ulcerative colitis cyangwa familial adenomatous polyposis (FAP). Izi ndwara ziteza umubyimbire mubi cyangwa gukura kudasanzwe kwa selile bidashobora kugenzurwa n'imiti yonyine.

Kuki kubaga Ileoanal Anastomosis J-Pouch bikorwa?

Muganga wawe agushishikariza uku kubaga igihe urugingo rwawe runini rwanduye cyane ku buryo rudashobora gukora neza cyangwa neza. Intego yambere ni ugukuraho isoko y'indwara yawe mugihe ukomeza ubushobozi bwawe bwo kugira urugendo rusanzwe rw'amara.

Impamvu isanzwe ni ulcerative colitis idasubiza imiti cyangwa itera ibibazo bikomeye nk'amaraso, imyobo, cyangwa ibyago bya kanseri. Bitandukanye na Crohn's disease, ulcerative colitis ifata gusa urugingo rw'amara manini n'impyiko, bigatuma iyi operasiyo iba umuti ushoboka.

Ushobora kandi gukenera iyi operasiyo niba ufite familial adenomatous polyposis, indwara ya genetike itera ibihumbi bya polyps mu mara yawe manini. Izi polyps zizahinduka kanseri nyuma y'igihe gito niba zitakuweho, bityo operasiyo yo gukumira ikaba ngombwa.

Mu buryo butajyenda cyane, abaganga basaba kubaga J-pouch ku bantu bafite imvune ikomeye yo gutinda kw'amara cyangwa ubwoko runaka bwa kanseri y'amara manini. Muri ibi bihe, kubaga birashobora kunoza cyane imibereho n'ubuzima bw'igihe kirekire.

Ni iki operasiyo ya Ileoanal Anastomosis J-Pouch?

Iyi operasiyo ikunda kuba mu byiciro bibiri cyangwa bitatu, bitewe n'uko ubuzima bwawe bumeze n'ubuzima bwawe muri rusange. Abantu benshi bakeneye uburyo bwinshi kugirango bakire neza hagati y'intambwe imwe n'imwe.

Mu cyiciro cya mbere, umuganga ubaga akuraho urugingo rw'amara manini n'impyiko mugihe arinda neza imitsi y'impyiko igenzura imyitwarire y'amara. Bakora J-pouch mu mara yawe mato ariko ntibayihuza n'impyiko yawe. Aho kubikora, bakora ileostomy y'agateganyo, bazana igice cy'amara yawe mato hejuru y'inda yawe.

Icyiciro cya kabiri kibaho nyuma y'ibyumweru 8-12, nyuma ya J-pouch yawe yakize neza. Umuganga ubaga ahuza pouch n'impyiko yawe hanyuma agafunga ileostomy y'agateganyo. Abantu bamwe bakeneye icyiciro cya gatatu niba hari ibibazo bivutse cyangwa niba uburwayi bwabo busaba igihe cyo gukira.

Kubaga kumwe kumara amasaha 3-5, kandi uzahabwa anesthesia rusange. Itsinda ry'abaganga bakoresha uburyo butagira ingaruka iyo bishoboka, bishobora kugabanya igihe cyo gukira n'ibibazo. Uburyo nyabwo buterwa n'imiterere yawe, kubaga kwabanje, n'urugero rw'indwara yawe.

Uko Witegura Kubagwa Icyo Bita Ileoanal Anastomosis J-Pouch?

Kwitegura bitangira mu byumweru byinshi mbere y'itariki yo kubagwa. Muganga wawe azashaka kunoza imirire yawe n'ubuzima bwawe muri rusange kugira ngo byongere ubuzima bwiza kandi bigabanye ingaruka.

Birashoboka ko uzagomba guhagarika imiti imwe n'imwe ishobora kongera ibyago byo kuva amaraso, nk'imiti igabanya amaraso, aspirine, cyangwa imiti irwanya umuvumo. Itsinda ry'abaganga bazaguha amabwiriza arambuye yerekeye imiti ugomba gukomeza cyangwa guhagarika n'igihe cyo gukora izi mpinduka.

Umurimo wo kubagwa urangiye, uzagomba gukora isuku y'amara yawe yose ukoresheje umuti wihariye wo gutegura amara. Ubu buryo busa no kwitegura gukora colonoscopy ariko burambuye. Uzagomba kandi kwirinda kurya ibiryo n'amazi menshi mu masaha menshi mbere y'uburyo.

Tekereza gutegura ubufasha mu rugo mu byumweru byinshi nyuma yo kubagwa, kuko uzakeneye ubufasha mu bikorwa bya buri munsi. Shyiraho imyenda yoroshye, yoroshye kandi yose itsinda ry'abaganga bawe risaba kwita ku byo bita ostomy niba uzagira iy'agateganyo.

Uko Wasoma Ibyavuye mu Kubagwa Icyo Bita Ileoanal Anastomosis J-Pouch?

Intsinzi nyuma yo kubagwa J-pouch ipimwa n'ibintu byinshi, harimo ubushobozi bwawe bwo kugenzura imyitwarire y'amara n'ubuzima bwawe muri rusange. Abantu benshi bagera ku myitwarire myiza, nubwo bifata igihe kugira ngo umubiri wawe wimenyere imiterere mishya.

Mbere na mbere, ushobora kugira imyitwarire y'amara 8-10 ku munsi mugihe igikapu cyawe kiga gufata imyanda neza. Nyuma y'igihe, ibi bikunda kugabanuka ku myitwarire 4-6 buri munsi. Kwihanganira neza birashobora gufata amezi menshi kugirango bigerweho mugihe imitsi yawe y'impyisi ikomera kandi ikamenyera.

Muganga wawe azakugenzura neza kubera ingaruka nk'icyo bita pouchitis (uburwayi bw'igikapu), kigira ingaruka ku bantu bagera kuri 30-40% rimwe na rimwe. Ibimenyetso birimo kongera kenshi, kwihutisha, kuribwa, cyangwa amaraso mu musarani wawe. Ibibazo byinshi byitabira neza kuvurwa na antibiyotike.

Uburyo bwiza bw'igihe kirekire burashimishije, hamwe n'abantu bagera kuri 90-95% bakoresha J-pouch yabo byibuze imyaka 10. Ariko, abantu bamwe bashobora gukenera kubagwa kugira ngo bakosore pouch cyangwa, rimwe na rimwe, guhindurwa kuri ileostomy ihoraho niba ibibazo bitashobora gukemurwa.

Ni gute wakwitwara nyuma yo kubagwa J-Pouch?

Gukira bibaho buhoro buhoro mu gihe cy'amezi menshi, buri cyiciro kizanana imbogamizi n'iterambere rishya. Mu byumweru bike bya mbere byibanda ku gukira kubagwa no kwiga kwita kuri ileostomy yawe y'agateganyo niba ufite imwe.

Nyuma yo kubagwa kwawe kwa nyuma, tegera imyitwarire y'amara idahoraho, idafashe neza mbere na mbere uko pouch yawe yimenyereza uruhare rwayo rushya. Uzafatanya n'ikipe yawe y'ubuzima kugira ngo utegure ingamba zo gucunga ibibazo byihutirwa no kwirinda impanuka. Imyitozo yo hasi ya pelvic irashobora gufasha gukomeza imitsi igenzura imikorere y'amara.

Imirire igira uruhare runini mu gukira kwawe no gutsinda igihe kirekire. Birashoboka ko uzatangira n'ibiryo byoroshye gushonga hanyuma ukongera buhoro buhoro ubwoko bw'ibiryo uko sisitemu yawe yimenyereza. Abantu bamwe basanga ibiryo bimwe bitera gasi nyinshi cyangwa imyitwarire y'amara idafashe neza, bityo uziga binyuze mu bunararibonye icyo bikora neza kuri wewe.

Gusuzuma buri gihe ni ngombwa kugira ngo ukurikirane iterambere ryawe no gufata ibibazo byose hakiri kare. Muganga wawe azakora pouchoscopy ya buri gihe (isuzuma rya pouch) kugira ngo arebe ububyimbirwe cyangwa ibindi bibazo bishobora gukenera kuvurwa.

Ni ikihe kintu gishyira mu kaga ibibazo byo kubagwa J-Pouch?

Ibintu byinshi bishobora kongera ibyago byawe byo kugira ibibazo nyuma yo kubagwa J-pouch. Kubisobanukirwa bifasha wowe n'ikipe yawe y'ubuzima gufata ingamba zo kugabanya ibibazo bishobora kubaho.

Ubuzima bwawe muri rusange bugira ingaruka zikomeye ku bikorwa byo kubaga. Abantu bafite imirire mibi ikabije, diyabete idagenzurwa, cyangwa sisitemu y'ubudahangarwa yagabanutse bahura n'ibyago byinshi byo kwandura no gukira nabi. Ikipe yawe yo kubaga izakora kugira ngo itunganye ibi bintu mbere yo gukomeza.

Imyaka nayo ishobora kugira uruhare ku ngaruka zivamo, nubwo atari inzitizi ihoraho ku kubagwa. Abantu bakuze bashobora gukira gahoro kandi bagahura n’ibibazo byinshi, ariko benshi baracyageraho ibisubizo byiza cyane. Muganga wawe azagereranya inyungu n’ibibazo bitewe n’uko ubuzima bwawe bwifashe.

Kubagwa mu nda kwabayeho mbere bishobora gutuma kubagwa kwa J-pouch bigorana cyane kubera imitsi y’imvune n’imikorere y’umubiri yahindutse. Ariko, abaganga bafite ubunararibonye bakunze gukemura ibyo bibazo neza. Kunywa itabi bikongera cyane ibibazo kandi bikwiriye guhagarikwa mbere yo kubagwa.

Ni ibihe bibazo bishobora kuvuka nyuma yo kubagwa kwa J-Pouch?

Nubwo abantu benshi babaho neza nyuma yo kubagwa kwa J-pouch, ni ngombwa gusobanukirwa ibibazo bishobora kuvuka kugira ngo ubimenye hakiri kare kandi ushake ubuvuzi bukwiye.

Ikibazo gikunze kuvuka ni pouchitis, itera kubyimba imbere muri J-pouch yawe. Ushobora guhura no kwihutisha kwituma, kwihutisha, kuribwa, umuriro, cyangwa amaraso mu mwanda wawe. Ibibazo byinshi bikira neza hamwe n’imiti yica mikorobe, nubwo abantu bamwe bagira pouchitis ihoraho isaba imicungire ikomeza.

Ibibazo by’imashini nabyo birashobora kuvuka, nk’inzitizi yo gusohoka kwa pouch cyangwa gukomera. Ibi bishobora gutera ingorane zo gushyira ubusa pouch yawe burundu, bigatuma utishimira kandi bikongera ibyago byo kwandura. Inzitizi y’urugingo rw’amara ruto irashobora kubaho bitewe no gukora imitsi y’imvune, bisaba imicungire isanzwe cyangwa kubagwa.

Ibibazo bitavuka kenshi ariko bikomeye birimo kunanirwa kwa pouch, aho pouch idakora neza nubwo hageragejwe kuvura. Ibi bishobora gusaba guhindurwa kuri ileostomy ihoraho. Mu buryo butavuka kenshi, abantu bagira kanseri mu gice cy’umubiri gisigaye, niyo mpamvu gukurikiranira hafi ari ngombwa.

Ibibazo byerekeye imibonano mpuzabitsina n'uburumbuke birashobora kuvuka, cyane cyane ku bagore, bitewe n'ububabare bwinshi bujyana n'ubuvuzi bwo mu gatuza. Muganga wawe azaganira kuri ibyo byago neza kandi ashobora kugusaba kujya inama n'inzobere niba uteganya kubyara mu gihe kizaza.

Ni ryari nkwiriye kubona umuganga nyuma yo kubagwa J-Pouch?

Vugana n'umuganga wawe ako kanya niba wumva uburibwe bukomeye mu nda, umuriro mwinshi, ibimenyetso byo kumuka kw'amazi mu mubiri, cyangwa kutabasha gusukura igifu cyawe. Ibyo bimenyetso bishobora kwerekana ibibazo bikomeye bisaba kuvurwa byihutirwa.

Ugomba kandi gushaka ubufasha bw'ubuvuzi niba ubonye impinduka zikomeye mu buryo bwawe bwo kwituma, nk'uko byiyongereye mu buryo butunguranye, amaraso mu mwanda wawe, cyangwa kuribwa gukabije kutagira icyo gufasha. Ibyo bishobora kuba ibimenyetso bya pouchitis cyangwa izindi ngorane zikeneye isuzuma ryihuse.

Ntugashidikanye guhamagara niba ufite impungenge ku iterambere ryawe ryo gukira cyangwa ufite ibibazo byerekeye imicungire ya J-pouch yawe. Itsinda ryawe ry'ubuvuzi riteganya ibyo bibazo kandi rishobora gutanga ubuyobozi kugirango rigufashe kugera ku musaruro mwiza ushoboka.

Ibyemezo bisanzwe byo gukurikiranwa ni ngombwa kugirango ugere ku ntsinzi irambye, kabone n'iyo wumva umeze neza. Muganga wawe azagenzura ibibazo kandi akore ibikorwa byo gukurikirana kugirango afate ibibazo byose hakiri kare mugihe bivurwa neza.

Ibikunze Kubazwa ku bijyanye no kubagwa J-Pouch

Q1: Ese kubagwa J-pouch ni umuti wa ulcerative colitis?

Yego, kubagwa J-pouch birashobora kuvura ulcerative colitis kuko bikuraho imitsi yose y'amara arwaye aho ububyimbirwe bubera. Bitandukanye na Crohn's disease, ishobora kugira uruhare urwo arirwo rwose rw'inzira yo mu gifu, ulcerative colitis ikora gusa mu mara manini no mu rukururano.

Nyuma yo kubagwa J-pouch neza, ntuzongera gukenera imiti wakoreshaga mu kurwanya ulcerative colitis, kandi ntuzongera kugira ibimenyetso by'indwara ikora. Ariko, uzakenera kumenyera kubaho na J-pouch, ikora mu buryo butandukanye n'uko umubiri wawe wari umeze mbere.

Q2: Mbese nshobora kubaho ubuzima busanzwe mfite J-pouch?

Abantu benshi bafite J-pouches babaho ubuzima bwuzuye kandi bufite imbaraga nyuma yo gukira. Urashobora gukora imyitozo, urugendo, akazi, kandi witabire ibikorwa byinshi wari usanzwe ukora mbere yo kubagwa, nubwo ushobora gukenera gukora impinduka zimwe na zimwe.

Birashoboka ko uzajya wituma kenshi kurusha mbere yo kubagwa, akenshi inshuro 4-6 ku munsi. Gutegura aho uzajya kwituma birushaho kuba by'ingenzi, cyane cyane mu mwaka wa mbere igihe pouch yawe ikimenyera. Abantu benshi basanga izi mpinduka zicungwa ugereranyije no kubaho bafite indwara ikomeye yo mu mara.

Q3: Bifata igihe kingana iki kugira ngo ukire nyuma yo kubagwa J-pouch?

Gukira neza bifata amezi agera kuri 6-12, nubwo ibi bitandukanye cyane hagati y'abantu. Guhagarara kwa mbere mu bitaro akenshi bifata iminsi 5-7, kandi buhoro buhoro uzasubira mu bikorwa bisanzwe mu byumweru byinshi.

Niba ufite uburyo bubiri, uzakenera amezi agera kuri 2-3 hagati yo kubagwa kugira ngo ukire neza. Nyuma yo kubagwa kwawe kwa nyuma, tegera amezi menshi kugira ngo pouch yawe yimenyere neza kandi ubashe kugira ubushobozi bwiza bwo kwituma no kugenzura imyitwarire y'amara.

Q4: Ni ibiryo ki ngomba kwirinda mfite J-pouch?

Nubwo imbogamizi z'imirire muri rusange zitari zikomeye nk'uko bimeze ku ndwara yo mu mara, ibiryo bimwe na bimwe bishobora guteza ibibazo abarwayi ba J-pouch. Ibiryo birimo fibre nyinshi, imbuto z'ibiti, imbuto nto, na kawa rimwe na rimwe bishobora gutera ibibazo cyangwa kongera umwuka mubi.

Birashoboka ko uzakenera kwirinda ibiryo biryoshye cyane, inzoga, na cafeine mbere na mbere, kuko ibi bishobora kurakaza pouch yawe cyangwa kongera umubare wo kwituma. Ariko, abantu benshi buhoro buhoro basubiza muri ibi biryo uko pouch yabo yimenyera. Gukorana n'umuhanga mu by'imirire birashobora kugufasha gukora gahunda y'imirire yawe bwite.

Q5: Mbese kubagwa J-pouch birashoboka ko byananirana, noneho bikagenda bite?

Kunanirwa kwa J-pouch bibaho mu byegeranyo biri hagati ya 5-10%, akenshi biterwa na pouchitis idakira ititabira imiti, ibibazo bya mekaniki, cyangwa imikorere mibi ya pouch. Iyo ibi bibaye, muba mukeneye guhindurwa mukaba ileostomy ihoraho.

Nubwo ibi biba biteye agahinda, abantu benshi basanga ileostomy ikora neza itanga ubuzima bwiza kurusha J-pouch inanirwa. Ibikoresho bigezweho bya ostomy n'inkunga bituma iyi mpinduka icungwa neza kurusha mbere.