Isibhedlela Esingcono Kakhulu Se-Gastroenterology e-India | Isibhedlela esiphezulu se-Gastro - I-Apollo Institute of Gastroenterology

1. I-Gastroesophageal Reflux Disease (GERD)
I-GERD yisifo esingelapheki sokugaya ukudla okwenzeka lapho i-asidi yesisu igeleza ibuyela emuva (i-refluxes) ingene emmizweni. Le acid reflux ingacasula ulwelwesi lomminzo, ibangele izimpawu ezifana nesilungulela, ubuhlungu besifuba, nobunzima bokugwinya. I-GERD ithinta abantu bayo yonke iminyaka, kusukela ezinsaneni kuya kubantu abadala, futhi ingenye yezinkinga ezivame kakhulu zokugaya ukudla.

I-low esophageal sphincter (LES), indandatho yemisipha esebenza njenge-valve phakathi kommizo nesisu, imvamisa ivimbela i-reflux. Uma le sphincter iba buthakathaka noma ikhululeka ngokungafanele, i-GERD ingenzeka. Izinto ezingaba nomthelela ku-GERD zihlanganisa ukukhuluphala, ukukhulelwa, ukubhema, nokudla okuthile noma iziphuzo.

Ukuphathwa 

• Ukulungiswa kwendlela yokuphila:
  • Phakamisa ikhanda lombhede ngamasentimitha angu-6-8
  • Gwema ukulala phansi amahora angu-3 ngemva kokudla
  • Yidla ukudla okuncane, okuvame kakhulu
  • Gcina isisindo esinempilo
  • Yeka ukubhema
  • Gwema izingubo ezimpintshayo
     
• Izinguquko zokudla:
  • Gwema ukudla okudala ukudla okubabayo, okunamafutha, noma okune-asidi
  • Nciphisa i-caffeine, ushokoledi, notshwala
  • Yehlisa ukusetshenziswa kwesiphuzo se-carbonated

Ukwelashwa 

• Ama-proton pump inhibitors, ama-H2 blockers angase anqunywe.

I-GERD ngokuvamile ingalawulwa ngokuphathwa kwendlela yokuphila kanye nemithi. Ezimweni lapho kungekho khona ukukhululeka, izinketho zokuhlinzwa ezifana ne-Fundoplication, lapho udokotela ohlinzayo egoqa phezulu kwesisu eduze kwe-sphincter ephansi ye-esophageal ukuze aqinise imisipha futhi avimbele i-reflux ingase izame.

Prevention 

• Gcina isisindo esinempilo: Isisindo eseqile sibeka ingcindezi esiswini, siphushe okuqukethwe yisisu kumminzo.
• Landela ukudla okulinganiselayo: Gcizelela izithelo, imifino, okusanhlamvu okuphelele, namaprotheni angenalutho.
• Gwema ukudla okuyizicucu: Izimbangela ezivamile zihlanganisa ukudla okubabayo, okunamafutha, noma okune-acidic, ushokoledi, iminti, nemikhiqizo esekelwe kutamatisi.
• Yidla ngokucophelela: Hlafuna ukudla ngokucophelela futhi udle kancane ukuze usize ukugaya.
• Nciphisa utshwala ne-caffeine: Zombili zingaphumuza i-esophageal sphincter engezansi.
• Yeka ukubhema: Ukubhema kungenza buthaka i-esophageal sphincter.
• Phatha ukucindezela: Ukucindezeleka kungakhuphula ukukhiqizwa kwe-asidi futhi kwandise izimpawu ze-GERD.
• Gqoka izingubo ezixegayo: Izingubo eziqinile zingafaka ingcindezi esiswini sakho kanye ne-low esophageal sphincter.
• Isikhathi sokudla kwakho: Gwema ukudla ukudla okukhulu eduze nesikhathi sokulala.
• Hlala uqondile ngemva kokudla: Linda okungenani amahora amathathu ngemva kokudla ngaphambi kokulala.

Ngokusebenzisa lamasu okuphatha nawokuvikela, abantu abaningi abane-GERD banganciphisa kakhulu izimpawu zabo futhi bathuthukise izinga labo lempilo. 

Funda kabanzi
 

2. I-Irritable Bowel Syndrome (IBS)
I-IBS yisifo esivamile esisebenza emathunjini esibonakala ubuhlungu besisu obuphindelelayo kanye noshintsho emikhubeni yamathumbu. Kuthinta ithumbu elikhulu (ikholoni) futhi kungabangela izinhlobonhlobo zezimpawu ezihlanganisa ukuqunjelwa, ukuqunjelwa, igesi, isifo sohudo, nokuqunjelwa.

I-IBS yisimo esingelapheki esidinga ukuphathwa isikhathi eside, nakuba izimpawu zingase zifike futhi zihambe ngokuhamba kwesikhathi. Isizathu esiqondile asaziwa, kodwa izici ezingase zibe nendima zihlanganisa ukufinyela kwemisipha emathunjini, ukuphazamiseka kwesimiso sezinzwa, ukutheleleka okunzima, kanye noshintsho kumagciwane asemathunjini. Ukucindezeleka, ukudla okuthile, noshintsho lwamahomoni kungabangela noma kube nezimpawu ezimbi kakhulu.

Ukuphathwa 

• Ukuguqulwa kokudla:
  • Landela ukudla okuphansi kwe-FODMAP ngaphansi kokuqondisa kwesazi sokudla
  • Khulisa ukudla kwe-fiber kancane kancane ukuze unciphise ukuqunjelwa
  • Hlala uhlanzekile ngokuphuza amanzi amaningi
  • Nciphisa i-caffeine, utshwala, nokudla okunamafutha
     
• Ukulawula ingcindezi:
  • Zijwayeze izindlela zokuphumula ezinjengokuphefumula okujulile noma ukuzindla
  • Zivocavoce njalo
  • Cabanga nge-cognitive behavioral therapy (CBT) noma i-hypnotherapy
     
• Ama-Probiotics: Ezinye izinhlobo zama-probiotics zingasiza ekudambiseni izimpawu ze-IBS, nakuba ubufakazi buxubile

Prevention 
Nakuba i-IBS ingenakuvinjelwa ngaso sonke isikhathi, amasu amaningana angasiza ekulawuleni izimpawu nokunciphisa ama-flare-ups:

• Khomba futhi ugweme ukudla okuyizicucu: Gcina idayari yokudla ukuze ulandelele ukuthi yikuphi ukudla okwandisa izimpawu.
• Yidla ukudla okuvamile: Gwema ukweqa ukudla noma ukudla ngokushesha kakhulu.
• Hlala u-hydrated: Phuza amanzi amaningi usuku lonke.
• Zivocavoce njalo: Khomba okungenani imizuzu engama-30 yomsebenzi omaphakathi izinsuku eziningi zeviki.
• Phatha ukucindezela: Thuthukisa amasu okulawula ingcindezi asebenzayo njengokuzindla, i-yoga, noma ukuvivinya umzimba okuvamile.
• Lala ngokwanele: Khomba amahora angu-7-9 wokulala kwekhwalithi ubusuku ngabunye.
• Cabanga nge-fiber supplements: Khulisa kancane kancane i-fibre ukuze usize ukulawula ukunyakaza kwamathumbu.
• Gwema i-caffeine notshwala: Lokhu kungashukumisa amathumbu futhi kubhebhethekise isifo sohudo.
• Yeka ukubhema: Ukubhema kungandisa izimpawu ze-IBS.
• Zijwayeze imikhuba emihle yendlu yangasese: Ungazibi isifiso sokukhipha amathumbu futhi uvumele isikhathi esanele sokuvakashela indlu yangasese.
• Cabanga ngama-probiotics: Nakuba ubufakazi buxubene, abanye abantu bathola impumuzo ngama-probiotic supplements.

Funda kabanzi

3. Isifo Samathumbu Esivuvukalayo (IBD)
I-Inflammatory Bowel Disease (IBD) igama elihlanganisa izimo ezimbili eziyinhloko ezingalapheki: Isifo sikaCrohn kanye ne-Ulcerative Colitis. Lezi yizifo ze-autoimmune ezibonakala ngokuvuvukala okungapheli komgudu wamathumbu. Nakuba zabelana ngokufana okuthile, zithinta izingxenye ezihlukene zesistimu yokugaya ukudla.

Isifo sikaCrohn singathinta noma iyiphi ingxenye yomzila wamathumbu kusukela emlonyeni kuya endunu, kodwa ngokuvamile kuhilela ukuphela kwamathumbu amancane kanye nokuqala kwekholoni. Ngakolunye uhlangothi, i-ulcerative colitis inqunyelwe ikholoni kanye ne-rectum. Zombili lezi zimo zingabangela isifo sohudo esinzima, ubuhlungu besisu, ukukhathala, nokuncipha kwesisindo.

Imbangela yangempela ye-IBD ayaziwa, kodwa kukholakala ukuthi ibangelwa ukuxhumana okuyinkimbinkimbi phakathi kofuzo, amasosha omzimba, kanye nezici zemvelo. I-IBD ingathuthuka kunoma yisiphi isikhathi kodwa ivame ukuqala lapho umuntu esemdala.

Ukuphathwa 

• Ukuguqulwa kokudla:
  • Khomba futhi ugweme ukudla okuyizicucu
  • Cabanga ngezidlo ezithile ezifana ne-Specific Carbohydrate Diet noma ukudla okuphansi kwe-FODMAP ngaphansi kokuqondisa kwezokwelapha
  • Qinisekisa ukudla okwanele kanye ne-hydration
     
• Ukulawula ingcindezi:
  • Zijwayeze izindlela zokuphumula
  • Cabangela ukwelashwa kokuziphatha kwengqondo
  • Zivocavoce njalo njengoba kubekezelelwe

Imithi 

Uhlobo lwemithi oyiphuzayo luncike kuzimpawu zakho kanye nendawo yekholoni yakho ethintekile:

• Izidakamizwa ezilwa nokuvuvukala: Lezi ngokuvamile ziyisinyathelo sokuqala se-ulcerative colitis emaphakathi kuya komaphakathi. Izibonelo zifaka ama-aminosalicylates afana ne-mesalamine, i-balsalazide, ne-olsalazine.
• Corticosteroids: Lawa ama-steroid anamandla okulwa nokuvuvukala anikezwa ngemithamo emikhulu bese ehliswa. Kufanele zisetshenziswe isikhathi esifushane kuphela ngenxa yemiphumela emibi kakhulu.
• Ama-immunomodulators: Lokhu kuvimbela ukusabela komzimba okuholela ekuvuvukeni. Izibonelo zifaka i-azathioprine ne-6-mercaptopurine.
• I-Biologics: Lezi zivimba amakhemikhali amasosha omzimba abangela ukuvuvukala. Izibonelo zifaka i-Remicade, i-Inflectra, i-Humira, i-Cimzia, i-Entyvio, i-Stelara, ne-Xeljanz. 
   

Ukuhlinzwa

Lokhu kungenziwa ukuze kukhishwe noma kunwetshwe izindawo zamathumbu ezithinteke kakhulu. Ngokuvamile kucatshangelwa ngemva kokuba ezinye izindlela zokwelapha zehlulekile. 

Prevention 
 Nakuba i-IBD ingenakuvinjelwa ngokuphelele, amasu amaningana angasiza ukunciphisa ingozi noma ukuphatha lesi simo:

• Gcina indlela yokuphila enempilo:
  • Ukuvivinya njalo
  • Ukudla okulinganiselayo okucebile ngezithelo, imifino, namaprotheni angenalutho
  • Ukulala okwanele
     
• Gwema izibangeli ezaziwayo:
  • Gcina idayari yokudla ukuze ubone ukudla okuyinkinga
  • Lawula ukucindezeleka ngempumelelo
     
• Ungabhemi: Ukubhema kuyingozi ikakhulukazi ku-Crohn's Disease
• Cabanga nge-vitamin D supplementation: Ezinye izifundo ziphakamisa ukuxhumana phakathi kokuntuleka kwevithamini D kanye ne-IBD
• Ama-Probiotics: Kungasiza ekugcineni ukuxola, ikakhulukazi ku-ulcerative colitis
• Ukuhlolwa okuvamile: I-Colonoscopies yokuqapha umsebenzi wezifo kanye nesikrini somdlavuza we-colorectal
• Amaqembu okusekela: Ukuxhumana nabanye abane-IBD kunganikeza ukusekelwa ngokomzwelo namacebiso awusizo

Funda kabanzi
 

4. I-Peptic Ulcer Disease
 I-Peptic Ulcer Disease (PUD) yisimo esibonakala ngezilonda ezikhula ngaphakathi kolwelwesi lwesisu kanye nengxenye engenhla yamathumbu amancane. Izimbangela ezivame kakhulu ukutheleleka nge-bacterium Helicobacter pylori (H. pylori) kanye nokusetshenziswa isikhathi eside kwezidakamizwa ezilwa nokuvuvukala (ama-NSAID) njenge-aspirin ne-ibuprofen.

Izilonda ze-Peptic zenzeka lapho ungqimba lwamafinyila oluvikelayo emgudwini wokugaya ukudla luncishisiwe, okuvumela i-asidi yesisu ukuthi ilimaze izicubu ezingaphansi. Izimpawu zingabandakanya ubuhlungu besisu esivuthayo, ukuzwa ukugcwala, ukuqunjelwa, isilungulela, isicanucanu, nokungabekezeleli ukudla okunamafutha. Ezimweni ezimbi kakhulu, izilonda zingaholela ezinkingeni ezinkulu ezifana nokopha noma ukubhobozwa kwesisu noma udonga lwamathumbu.

Ukuphathwa 

• Imithi:
  • I-Proton pump inhibitors (PPIs) ukunciphisa i-asidi esiswini
  • Ama-H2 receptor blockers njengenye indlela yama-PPI
  • Ama-Antacids ukukhululeka ngokushesha kwezimpawu
  • Ama-Cytoprotective agents afana ne-sucralfate ukuvikela ulwelwesi lwesisu namathumbu amancane
     
• Ukuqedwa kwe-H. pylori: Ngokuvamile kuhilela inhlanganisela yama-antibiotic kanye nama-acid suppressants
• Ukuqedwa kwama-NSAID:
  • Uma kungenzeka, yeka noma unciphise ukusetshenziswa kwama-NSAID
  • Uma ama-NSAID edingeka, sebenzisa umthamo osebenza ngempumelelo ophansi kakhulu
     
• Ukulungiswa kwendlela yokuphila:
  • Gwema ukudla okudala ukungakhululeki
  • Yeka ukubhema
  • Nciphisa ukusetshenziswa kotshwala
  • Lawula ukucindezeleka ngokusebenzisa amasu okuphumula noma ukwelulekwa
     
• I-endoscopy yokulandelela: Ukuqinisekisa ukuphulukiswa kwesilonda, ikakhulukazi uma sikhulu noma siyinkimbinkimbi

Prevention 

• Umkhawulo wokusebenzisa ama-NSAID:
  • Uma ukusetshenziswa okuvamile kudingekile, thatha kanye nokudla futhi usebenzise umthamo ophansi kakhulu osebenzayo
  • Cabangela ezinye izidambisi zinhlungu uma kungenzeka
     
• Vikela ku-H. pylori:
  • Zijwayeze ukuhlanzeka, ikakhulukazi ukugeza izandla
  • Gwema ukudla noma amanzi okungenzeka angcolile
     
• Ungabhemi: Ukubhema kungakhuphula i-asidi esiswini futhi kuphazamise ulwelwesi lokuvikela lwesisu
• Nciphisa ukuphuza utshwala: Utshwala obudlulele bungacasula futhi buqede ulwelwesi lwamafinyila esiswini
• Phatha ukucindezela: Nakuba ukucindezeleka kungabangeli izilonda, kungase kubhebhethekise izimpawu
• Yidla ukudla okunempilo: Faka izithelo, imifino, nokusanhlamvu. Gwema ukudla okudala ukungakhululeki
• Hlala u-hydrated: Phuza amanzi amaningi usuku lonke
• Ukuhlolwa okuvamile: Uma unomlando wezilonda, ukuhlolwa njalo kwezokwelapha kungasiza ukubamba futhi welaphe ukuvela kusenesikhathi
• Ama-Probiotics: Ucwaningo luphakamisa ukuthi ama-probiotics angasiza ekuvimbeleni ukutheleleka kwe-H. pylori

Funda kabanzi
 

5. I-Diverticular Disease
Isifo se-Diverticular sibhekisela esimweni lapho izikhwama ezincane, eziqhumayo (i-diverticula) zikhula olwelweni lwesistimu yokugaya ukudla, ngokuvamile engxenyeni engezansi yamathumbu amakhulu (ikholoni). Uma lezi zikhwama zivutha noma zitheleleka, lesi simo sibizwa ngokuthi i-diverticulitis.

Imbangela eqondile yesifo se-diverticular ayiqondwa ngokugcwele, kodwa kukholakala ukuthi ihlobene nokudla okune-fibre ephansi, ukuguga, kanye nezici okungenzeka zofuzo. Lesi simo sivame kakhulu kubantu asebekhulile nasemazweni lapho ukudla kuvame ukuba ne-fiber ephansi.

I-Diverticulosis (ukuba khona kwe-diverticula) ngokuvamile akubangeli izimpawu, kodwa i-diverticulitis ingabangela ubuhlungu obukhulu besisu, imfiva, isicanucanu, nezinguquko emikhubeni yamathumbu.

Ukuphathwa 

• Ukuguqulwa kokudla:
  • Ukudla okune-fiber ephezulu ukuvimbela ukuqunjelwa kanye nokunciphisa ukucindezela kukholoni
  • I-hydration eyanele ukusiza i-fiber isebenze ngempumelelo
     
• Ama-Probiotics: Kungasiza ukugcina ibhalansi enempilo yamagciwane amathumbu
• Ukudla kokuphumula nokudla okuwuketshezi: Ngesikhathi sokuqubuka okukhulu kwe-diverticulitis
• Ukuzivocavoca okuvamile: Ukukhuthaza ukunyakaza kwamathumbu okuvamile kanye nempilo yonke yokugaya
• Ukugwema ukudla okuyizicucu: Abanye abantu bathola ukuthi ukudla okuthile (isib., amantongomane, imbewu, ama-popcorn) kwenza izimpawu zibe zimbi, nakuba ucwaningo lwakamuva lubonisa ukuthi lokhu kungase kungabi yinkinga njengoba kwakucatshangwa.
• Imithi: 

Ukudambisa izinhlungu: IParacetamol ingasiza ekudambiseni ubuhlungu. Kufanele ugweme i-aspirin noma ibuprofen, engaphazamisa isisu sakho. 

Ama-antibiotics: Udokotela angase anikeze ama-antibiotics ukuphatha i-diverticulitis emnene. 

Ama-Antispasmodics: Le mithi ingasiza ngamajaqamba esiswini. 

Ama-laxatives akha ngobuningi: Lawa angasiza ekuqunjweni nasekuhudo. 

Ukuhlinzwa: 

Ukuhlinzwa kungase kunconywe uma kube nezinkinga ezingathi sína, njengokugqabuka, ukuvaleka kwekholoni, noma ukopha kwe-diverticular. 

Prevention 

• Ukudla okune-fiber ephezulu:
  • Khomba amagremu angama-25-30 wefiber nsuku zonke
  • Faka inala yezithelo, imifino, okusanhlamvu okuphelele, nemidumba
     
• Hlala u-hydrated: Phuza okungenani izingilazi zamanzi eziyi-8 nsuku zonke ukuze usize i-fiber isebenze ngempumelelo
• Ukuzivocavoca okuvamile: Khomba okungenani imizuzu engama-30 yomsebenzi omaphakathi izinsuku eziningi zeviki
• Gcina isisindo esinempilo: Ukukhuluphala ngokweqile kuyingozi engozini ye-diverticular disease
• Gwema ukudonsa kanzima ngesikhathi ukhipha amathumbu:
  • Ungazibi isifiso sokuphuma amathumbu
  • Gwema ukuhlala endlini yangasese isikhathi eside
     
• Yeka ukubhema: Ukubhema kuhlotshaniswa nengozi eyengeziwe ye-diverticulitis
• Nciphisa ukusetshenziswa kwenyama ebomvu: Ukudla kakhulu inyama ebomvu kuye kwahlotshaniswa nengozi eyengeziwe
• Cabanga nge-fiber supplements: Uma uzama ukuthola i-fiber eyanele ekudleni kwakho kuphela
• Phatha ukucindezela: Ukucindezeleka okungapheli kungase kwandise ingozi ye-diverticulitis flare-ups
• Ukuhlolwa okuvamile: Ikakhulukazi uma unomlando we-diverticular disease

Funda kabanzi
 

6. Izifo zeCeliac
Isifo se-Celiac yisifo se-autoimmune lapho ukungena kwe-gluten kuholela ekulimaleni emathunjini amancane. I-Gluten iyiphrotheni etholakala ukolweni, ibhali, ne-rye. Lapho abantu abanesifo se-celiac bedla i-gluten, imizimba yabo iphakamisa impendulo yokuzivikela komzimba ehlasela amathumbu amancane, ilimaza i-villi, imidwebo emincane efana neminwe eqondisa amathumbu amancane futhi ikhuthaze ukumuncwa kwezakhi.

Isifo se-Celiac singakhula kunoma iyiphi iminyaka ngemva kokuba abantu beqale ukudla ukudla noma imithi equkethe i-gluten. Uma singelashwa, isifo se-celiac singaholela ezinkingeni zempilo ezingathi sína, ezihlanganisa ukungondleki, ukukhumuzeka kwamathambo, ukungazali, izimo zezinzwa, futhi ezimweni ezingavamile, umdlavuza. 

Izimpawu zingahluka kakhulu futhi zingabandakanya izinkinga zokugaya ukudla (ubuhlungu besisu, ukuqunjelwa, isifo sohudo, ukuqunjelwa), ukukhathala, ukuncipha komzimba, i-anemia, nokunye. Abanye abantu abanesifo se-celiac bangase bangabi nazimpawu nhlobo.

Ukuphathwa 

• Ukudla okuqinile kwe-gluten-free:
  • Susa yonke imithombo ye-gluten, kuhlanganise nemithombo efihliwe ekudleni okugayiwe kanye nemithi
  • Sebenzisana nodokotela wezokudla obhalisiwe ukuze uqinisekise ukudla okulinganiselayo, okunomsoco
     
• Isengezo sokudla okunomsoco:
  • Kungase kudingeke ukulungisa ukushiyeka, ikakhulukazi ezigulini ezisanda kutholwa
  • Izithako ezivamile zihlanganisa i-iron, i-calcium, i-vitamin D, i-zinc, namavithamini B
     
• Ukulandelela okujwayelekile kwezokwelapha: Ukuqapha ukuphulukiswa nokuphatha noma yiziphi izinkinga
• Izikena zokuminyana kwethambo: Ukuhlola i-osteoporosis, evamile esifweni se-celiac
• Imithi: Uma amathumbu akho amancane alimele kakhulu noma unesifo se-celiac esiphikisayo, ama-steroid angase anconywe ukulawula ukuvuvukala. I-steroids ingadambisa izimpawu ezinzima zesifo se-celiac kuyilapho amathumbu ephulukisa.Eminye imithi, njenge-azathioprine noma i-budesonide, ingase isetshenziswe.

Prevention 
Nakuba isifo se-celiac singenakuvinjelwa, njengoba kuyinkinga ye-autoimmune enezakhi zofuzo, kukhona amasu okuvimbela izinkinga nokuphatha isimo ngokuphumelelayo:

• Ukunamathela ngokuqinile ekudleni okungenalo i-gluten: Lona ukuphela kokwelashwa okusebenzayo kwesifo se-celiac
• Ukuhlolwa kwezempilo okujwayelekile: Ukuqapha ukuphulukiswa nokubamba noma yiziphi izinkinga kusenesikhathi
• Fundisa amalungu omndeni: Izihlobo zokuqala kufanele zihlolwe isifo se-celiac
• Qaphela ngokungcoliswa okuphambene: Sebenzisa izitsha zokupheka ezihlukene nezindawo zokulungiselela ukudla okungenalo i-gluten
• Funda amalebula ngokucophelela: I-Gluten ingafihlwa ekudleni okuningi okucutshunguliwe ngisho neminye imithi
• Hlela lapho udla ngaphandle: Shayela izindawo zokudlela kusenesikhathi ukuze nixoxe ngezinketho ezingenayo i-gluten
• Gcina impilo yonke: Ukuvivinya umzimba njalo, ukulawula ukucindezeleka, nokulala ngokwanele kungasekela inhlalakahle yonke

Funda kabanzi

Funda kabanzi

1.I-appendectomy
I-Appendectomy iyinqubo yokuhlinzwa ukuze kukhishwe i-appendix, isikhwama esincane esixhunywe kukholoni. Kungolunye lokuhlinzwa okuphuthumayo okuvamile okwenziwa emhlabeni wonke. Inqubo ingenziwa ngokuhlinzwa okuvulekile kwendabuko noma nge-laparoscopically, kuye ngesimo sesiguli kanye nokuthandwa ngudokotela ohlinzayo.

Kungani sekwenziwe
I-Appendectomy yenziwa ngokuyinhloko ukwelapha i-appendicitis eyingozi, okuwukuvuvukala kwesithasiselo. Uma ingelashwa, i-appendicitis ingaholela ekuqhumeni kwe-appendix, okubangela ukutheleleka okungase kube yingozi empilweni okubizwa ngokuthi i-peritonitis. Ingozi yokuphila konke yokuthuthukisa i-appendicitis ingama-8.6% emadodeni kanye no-6.7% kwabesifazane.

izimpawu:

• Ubuhlungu obungazelelwe obuqala ngakwesokudla kwesisu esingaphansi
• Ubuhlungu obuba bubi nakakhulu uma ukhwehlela, uhamba noma wenza okunye ukunyakaza okubuhlungu
• I-nausea nokuhlanza
• Ukulahlekelwa kwesifiso
• Imfiva yezinga eliphansi engase ibe yimbi njengoba ukugula kuqhubeka
• Ukuqunjelwa noma isifo sohudo
• Ukuqhakaza esiswini

Izinzuzo
Izinzuzo eziyinhloko ze-appendectomy zihlanganisa:

• Ukukhululwa kobuhlungu nokungakhululeki: Ukukhipha isithasiselo esinegciwane kususa umthombo wobuhlungu nokuvuvukala.
• Ukuvinjelwa kwezinkinga: Ukuhlinzwa kuvimbela i-appendix ekuqhumeni futhi kubangele i-peritonitis, okungase kube yingozi empilweni.
• Ukwelashwa okuqondile: Lapho isithasiselo sesisusiwe, i-appendicitis ayikwazi ukuphinde ivele.
• Ukuthola ngokushesha: Iziguli eziningi zingaya ekhaya ngosuku olungu-1 ngemva kwe-laparoscopic noma inqubo evulekile.
• Ingozi ephansi yezinkinga zesikhathi eside: I-Appendectomy iyinqubo ephephile enengozi ephansi yezinkinga zesikhathi eside.
• Izinga lempilo elithuthukisiwe: Iziguli zingabuyela emisebenzini evamile ngokushesha ngemva kokuhlinzwa.

Funda kabanzi

2. I-cholecystectomy (ukususwa kwenyongo)
I-cholecystectomy yindlela yokuhlinzwa yokukhipha inyongo, isitho esincane esingaphansi kwesibindi esigcina inyongo. Lokhu kuhlinza ngokuvamile kwenziwa ukuze kwelashwe inyongo nezinye izimo ezihlobene ne-gallbladder. Inqubo ingenziwa nge-laparoscopically (i-invasive kancane) noma ngokuhlinzwa okuvulekile.

Kungani sekwenziwe
 I-Cholecystectomy ngokuvamile inconywa ezimweni ezilandelayo:

• Amatshe enyongo: Ukwakheka kwe-gallstones kuyinkinga evamile ye-gallbladder engabangela ubuhlungu obukhulu nokuvuvukala.
• I-Cholecystitis: Ukuvuvukala kwe-gallbladder, ngokuvamile ngenxa yamatshe enyongo, kungaholela ezinkingeni ezinzima.
• Ama-polyps e-Gallbladder: Lezi yizimila olwelweni lwangaphakathi lwe-gallbladder. Nakuba eziningi ziyingozi, ama-polyp amakhulu angase adinge ukususwa.
• I-Biliary Dyskinesia: Isimo lapho i-gallbladder ingasebenzi kahle, okuholela ebuhlungu obungapheli kanye nokungaphatheki kahle.

Izinzuzo
 Izinzuzo ze-cholecystectomy, ikakhulukazi i-laparoscopic cholecystectomy, zifaka:

• Ukubuyisela Ngokushesha: Iziguli ngokuvamile ziba nobuhlungu obuncane nokungakhululeki ngemva kokuhlinzwa kwe-laparoscopic futhi ngokuvamile zingabuyela emisebenzini evamile ngokushesha okukhulu.
• Ukuncipha Kwezibazi: Ukusikwa okuncane kubangela isibazi esincane uma kuqhathaniswa nokusikwa okukhulu okudingekayo ekuhlinzeni okuvulekile.
• Ukuhlala Okufushane Esibhedlela: I-cholecystectomy ye-Laparoscopic idinga ukuhlala isikhathi esifushane kakhulu esibhedlela.
• Ukukhululwa ezimpawini: Ukususwa kwe-gallbladder egulayo kuqeda ubuhlungu nokungakhululeki okuhambisana nezimo ze-gallbladder.
• Ukuvinjelwa kwezinkinga: Ukuhlinzwa kuvimbela izinkinga ezingaba khona njengokugqabuka kwe-gallbladder noma ukuvinjwa kwe-bile duct.
• Izinga lempilo elithuthukisiwe: Iziguli zingadla ngokujwayelekile ngaphandle kokwesaba i-dyspepsia ehlobene ne-gallbladder nobuhlungu.

Funda kabanzi

3. I-Colectomy 

I-Colectomy iyinqubo yokuhlinzwa ehilela ukususa yonke ikholoni noma ingxenye yekholoni (amathumbu amakhulu). Ngokuvamile kwenziwa ukwelapha izimo ezinzima zezifo zamathumbu ezivuvukalayo njengesifo sika-Crohn nesifo sokuqaqamba kwamathumbu, kanye nomdlavuza wekoloni.

Kungani sekwenziwe
I-Colectomy inganconywa ezimweni ezilandelayo:

• Izimpawu ezinzima ezingaphenduli emithini
• Umdlavuza weColon
• Ukopha okungenakulawulwa
• Izinkinga ezifana nokuvinjwa kwamathumbu, ukubhobozwa, noma ukopha kakhulu
• Izinguquko eziyingozi kukholoni
• I-megacolon enobuthi, inkimbinkimbi enzima futhi engaba yingozi empilweni yesifo samathumbu esivuvukalayo
   

Izinzuzo

• Ukukhululeka kwezimpawu: Ukususwa kwezingxenye ezinesifo emathunjini kunganciphisa kakhulu noma kuqede izimpawu ezinjengobuhlungu besisu, isifo sohudo, nokopha komgudu.
• Ukwelashwa komdlavuza: Isiza ekulawulweni komdlavuza kapopopo
• Ukuvinjelwa kwezinkinga: Ukuhlinzwa kungavimbela izinkinga ezinkulu njengokubhoboza noma i-megacolon enobuthi.
• Isixazululo sesikhathi eside sokuvuvukala kwamathumbu: Nakuba kungelona ikhambi lesifo sikaCrohn, i-colectomy inganikeza ukukhululeka kwezimpawu zesikhathi eside ezigulini eziningi. Ezimweni ze-ulcerative colitis, ukususa lonke ikholoni kususa ingozi yomdlavuza wekoloni. Ezinye iziguli zingase zikwazi ukwehlisa noma ziqede isidingo sazo semithi evimbela ukuzivikela komzimba.

4. Ukukhishwa kwamathumbu 

Ukukhishwa kwamathumbu kuyinqubo yokuhlinzwa ehlanganisa ukukhipha ingxenye enesifo yamathumbu nokuxhuma kabusha iziphetho ezinempilo. 

Kungani sekwenziwe

Ukukhishwa kwamathumbu amancane: Ikhipha ingxenye yamathumbu amancane, eyaziwa nangokuthi ithumbu elincane. Lokhu kuhlinzwa kwenziwa lapho ithumbu elincane ligula noma livalekile. 

Ukukhishwa kwamathumbu amakhulu: Okwaziwa nangokuthi i-colectomy, lokhu kuhlinzwa kususa wonke noma ingxenye yamathumbu amakhulu, aziwa nangokuthi ikholoni. Uhlobo lwe-colectomy olwenziwe luncike ekutheni iyiphi ingxenye yekholoni ekhishwayo. 
 

Ukukhishwa kwamathumbu kwenziwa ukwelapha izimo ezifana nalezi:

• Isifo sikaCrohn
• Ukuvinjwa kwamathumbu
• Izikhova
• Ukulimala okubuhlungu kukholoni
• Ukopha okungalawuleki emathunjini
• Umdlavuza we-colorectal noma izimo ezithile eziyingozi 
   

Ngesikhathi sokuhlinzwa, udokotela ohlinzayo uzo:

1. Hlola amathumbu ukuze uthole izindawo ezingenampilo
2. Susa ingxenye eyonakele
3. Hlanganisa iziphetho ezimbili ezisikiwe ndawonye ukuze wenze ishubhu eqhubekayo 
    

Ukuhlinzwa kungenziwa nge-laparoscopically noma ngokuhlinzwa okuvulekile. 

Izinzuzo
Izinzuzo zokukhishwa kwamathumbu zihlanganisa:

• Ukukhululeka kwezimpawu: Ukuhlinzwa kunganikeza ukukhululeka okukhulu ebuhlungwini, isifo sohudo, nezinye izimpawu ezihlobene nesifo sikaCrohn.
• Ukuthuthukiswa kokudla okunomsoco: Ukususa izingxenye ezinesifo zamathumbu kungathuthukisa ukumuncwa kwezakhi kanye nesimo sokudla okunempilo okuphelele.
• Ukwehliswa kwemithi: Ezinye iziguli zingakwazi ukunciphisa noma ukuqeda isidingo sazo semishanguzo ye-immunosuppressive ngemva kokuhlinzwa.
• Ukwelashwa kwezinkinga: Ukuhlinzwa kungalapha ngempumelelo izinkinga ezinjengama-fistula, amathumba, namathumba.
• Ukwelashwa komdlavuza: Ukukhishwa kwamathumbu kuyingxenye ebalulekile yokwelashwa komdlavuza we-colorectal.
• Ukuphatha isikhathi eside kwesifo sikaCrohn: Nakuba kungelona ikhambi, ukukhishwa kwamathumbu kunganikeza ukulawula izimpawu zesikhathi eside ezigulini eziningi ezine-Crohn's disease.

5. Ukulungiswa kwe-Hernia

Ukulungiswa kwe-Hernia kuyinqubo evamile yokuhlinzwa eyenziwa ukuze kulungiswe i-hernia, okwenzeka lapho isitho noma izicubu ezinamafutha zikhama endaweni ebuthakathaka emsipha ozungezile noma izicubu ezixhumeneyo ezibizwa ngokuthi i-fascia. Izinhlobo ezivame kakhulu ze-hernia yi-inguinal (i-groin yangaphakathi), i-incision (okubangelwa ukusika), i-femoral (i-groin yangaphandle), i-umbilical (inkinobho yesisu), ne-hiatal (isisu esingaphezulu).

Kungani sekwenziwe

Ukuhlinzwa ukulungisa i-Hernia ngokuvamile kunconywa ngenxa yezizathu ezilandelayo:

• Ukuze unciphise ukungakhululeki: I-Hernias ingabangela ubuhlungu, ikakhulukazi lapho ukhwehlela, ugoba noma uphakamisa izinto ezinzima.
• Ukuze uvimbele izinkinga: I-hernia engelashiwe ingaholela ezinkingeni ezinkulu njengokuvinjwa kwamathumbu noma ukuklinywa.
• Ukuthuthukisa izinga lempilo: I-Hernias ingaphazamisa imisebenzi yansuku zonke futhi ibangele ukukhathazeka kwezimonyo.
• Ukuvimbela ukukhula kwe-hernia: Njengoba i-hernia ivame ukukhula ngokuhamba kwesikhathi, ukulungiswa kusenesikhathi kungavimbela ukuhlinzwa okuyinkimbinkimbi kamuva.

Ama-hernia amaningi angalungiswa nge-laparoscopically, okuholela ekusikeni okuncane nokululama ngokushesha.

Izinzuzo
 Izinzuzo zokuhlinzwa kokulungisa i-hernia zifaka:

• Impumuzo Yobuhlungu: Iziguli eziningi zithola ukuncipha okuphawulekayo noma ukuqedwa kobuhlungu obuhlobene ne-hernia.
• Ukuvinjelwa kwezinkinga: Ukuhlinzwa kunciphisa ubungozi bezinkinga ezingathi sína njengokuvaleka kwamathumbu noma ukuklinywa.
• Umsebenzi othuthukisiwe: Iziguli ngokuvamile zingabuyela emisebenzini evamile ngaphandle kwemingcele ngemva kokululama.
• Ukuthuthukiswa kwezimonyo: Ukulungiswa kwe-Hernia kungathuthukisa ukubukeka kwamaqhubu abangelwa i-hernias.
• Isixazululo sesikhathi eside: Nakuba ukuphindaphinda kungenzeka, ukulungiswa okuningi kwe-hernia kunikeza isisombululo esihlala isikhathi eside.

Funda kabanzi

6. Ukuhlinzwa kokuvinjwa kwamathumbu

Ukuhlinzwa kokuvinjwa kwamathumbu kuyinqubo ebandakanya ukususa ukuvaleka kanye nanoma yiziphi izingxenye zamathumbu ezilimele noma ezifile. Uhlobo lokuhlinzwa luncike kumbangela yokuvinjwa kanye nengxenye yamathumbu ethintekile. 

Nazi ezinye izinhlobo zokuhlinzwa okuvimbela amathumbu:

• Ukulungiswa kokuvinjwa kwamathumbu: Udokotela ohlinzayo wenza ukusikeka esiswini ukuze athole futhi avule ukuvaleka. Izingxenye zamathumbu ezilimele zingase zikhishwe noma zilungiswe.
• Ukubekwa kwe-stent: Ishubhu le-wire mesh lifakwa emathunjini ukuze lihlale livulekile futhi likhulule izimpawu. Lokhu kungaba yisixazululo sesikhashana kuze kube yilapho isiguli sesilungele ukuhlinzwa.
• I-colostomy noma ileostomy: Uma ingxenye yamathumbu idinga ukususwa futhi iziphetho zingakwazi ukuphinde zixhunywe, udokotela ohlinzayo angase akhiphe isiphetho esisodwa ngembobo esiswini. 

Kungani sekwenziwe

Ukuhlinzwa kokuvimbela amathumbu ngokuvamile kwenziwa ezimweni ezilandelayo:

• Ukuvinjwa kwamathumbu okuphelele: Lapho kukhona ukuvaleka okuphelele okuvimbela ukudlula kwanoma yikuphi okuqukethwe emathunjini.
• Ukuvinjelwa okuncane okungaxazululi: Ezinye izithiyo ezingaphelele zingase zilawuleke ngendlela elondolozayo, kodwa ukuhlinzwa kuyadingeka uma kuqhubeka noma kuba kubi kakhulu.
• Ukuvinjwa okuhlanganisiwe: Lesi yisimo esiphuthumayo sezokwelapha lapho ukunikezwa kwegazi engxenyeni yamathumbu kunqanyulwa.
• Izithiyo ezingapheli, eziphindaphindayo: Ezimweni lapho izithiyo ziqhubeka zivela ngenxa yezimo ezikhona ezifana nokunamathela noma amathumba.

Izinzuzo

Izinzuzo zokuhlinzwa kokuvimbela amathumbu zihlanganisa:

• Ukukhululwa kwezimpawu: Ukuhlinzwa kungadambisa ngokushesha ubuhlungu obukhulu nokungakhululeki okuhambisana nokuvinjwa kwamathumbu.
• Ukuvinjelwa kwezinkinga: Ukuhlinzwa okufika ngesikhathi kungavimbela izinkinga ezinkulu njengokubhobozwa, i-sepsis, noma ukufa kwezicubu.
• Ukubuyisela ukusebenza kwamathumbu: Ukuhlinzwa okuphumelelayo kuvumela ukudlula okuvamile kokuqukethwe kwamathumbu.
• Ukuxilongwa nokwelashwa kwezimo ezingaphansi: Ukuhlinzwa kungase kwembule futhi kuvumele ukwelashwa kwezimbangela eziwumsuka ezifana nezimila noma ukunamathela.

8. Fundoplication for reflux disease

I-Fundoplication iyinqubo yokuhlinzwa esetshenziselwa ukwelapha isifo se-reflux ye-gastroesophageal (GERD) kanye ne-hiatal hernia. Uhlobo oluvame kakhulu i-Nissen fundoplication, lapho ingxenye engaphezulu yesisu (i-fundus) isongwe ngomminzo ongezansi ukuze kuqiniswe umgoqo phakathi kommizo nesisu, ukuvimbela i-acid reflux.

Kungani sekwenziwe

I-Fundoplication inganconywa kulezi zimo ezilandelayo:

• Izimpawu ezinzima ze-GERD ezingaphenduli ngokwanele emithini.
• Isifiso sokuyeka ukusetshenziswa kwemithi yesikhathi eside ye-GERD.
• Ukuba khona kwezinkinga ezivela ku-GERD, njenge-esophagitis noma i-Barrett's esophagus.
• I-aspiration pneumonia ephindaphindiwe ngenxa ye-reflux.
• I-hernia enkulu yokuzala ebangela izimpawu.
• Izinkinga ze-Esophageal motility 

Izinzuzo

Izinzuzo ze-fundoplication zifaka:

• Ukwelashwa kwesikhathi eside okusebenzayo: Iziguli eziningi zithola ukuncipha okukhulu noma ukuqedwa kwezimpawu ze-GERD.
• Kwehlisiwe ukuncika emithini: Iziguli eziningi zinganciphisa noma ziyeke ukusebenzisa imithi yokucindezela i-asidi.
• Ukuvinjelwa kwezinkinga: Ukuhlinzwa kungasiza ekuvimbeleni izinkinga zesikhathi eside ze-GERD ezifana ne-esophageal strictures noma i-Barrett's esophagus.
• Izinga lempilo elithuthukisiwe: Iziguli zivame ukubika ukulala okungcono, imikhawulo yokudla embalwa, kanye nokuphila kahle okuphelele.
• Ukwelashwa kwezimo ezihambisanayo: Inqubo ingakwazi ngesikhathi esisodwa ukubhekana ne-hiatal hernia.

9. I-Strictureplasty yezingxenye zamathumbu ezinciphile

I-Strictureplasty iyindlela yokuhlinzwa esetshenziselwa ukwelapha izingxenye ezincane zamathumbu, ngokuvamile ezigulini ezine-Crohn's disease. Ngokungafani nokukhishwa kabusha, okususa ingxenye enesifo yamathumbu, i-strictureplasty ikhulisa indawo encane ngenkathi igcina ubude bamathumbu.

Kungani sekwenziwe

I-Stricctureplasty ngokuvamile yenziwa ezimweni ezilandelayo:

• Ukuba khona kwemigqa emifushane emathunjini amancane.
• Izindawo eziningi zokuncipha emathunjini amancane.
• Ukukhishwa kwamathumbu okubanzi kwangaphambilini, lapho ukulondoloza ubude bamathumbu kubalulekile.
• Izingqinamba ezivamile ngemva kokuhlinzwa kwangaphambilini.
• Ukuze ugweme isifo se-bowel syndrome ezigulini ezisengozini.

Izinzuzo

Izinzuzo ze-strictureplasty zihlanganisa:

• Ukulondolozwa kwamathumbu: Ngokugwema ukukhishwa kabusha, i-strictureplasty isiza ukugcina ubude nomthamo wokumunca wamathumbu.
• Ingozi encishisiwe ye-short bowel syndrome: Lokhu kubaluleke kakhulu ezigulini esezihlinzwe kaningi.
• Ukukhululeka kwezimpawu: Inqubo ingadambisa izimpawu ezivimbelayo ezibangelwa ukucinana kwamathumbu.
• Umsoco othuthukisiwe: Ngokuthuthukisa ukusebenza kwamathumbu, i-strictureplasty ingathuthukisa ukumuncwa kwezakhi.
• Amathuba endlela yokuhlasela kancane: Kwezinye izimo, i-strictureplasty ingenziwa nge-laparoscopically, inikeza izinzuzo zokusikwa okuncane nokululama ngokushesha.

Funda kabanzi

Ukuhlinzwa kwe-Bariatric, okubuye kwaziwe ngokuthi ukuhlinzwa kwesisindo, kubhekisela eqenjini lezinqubo zokuhlinza emathunjini eziklanyelwe ukusiza abantu abanokukhuluphala ngokweqile ukuze bathole ukuncipha okuphawulekayo nokuqhubekayo kwesisindo. Lezi zinqubo zisebenza ngokushintsha uhlelo lokugaya ukudla, kungaba ngokukhawulela inani lokudla isisu esingakubamba, ukunciphisa ukumuncwa kwezakhi, noma inhlanganisela yakho kokubili.

Ukuhlinzwa kwe-Bariatric ngokuvamile kucatshangelwa abantu abangakwazi ukuthola noma ukugcina isisindo esinempilo ngokudla nokuzivocavoca kuphela, futhi abanezimo zempilo ezihlobene nokukhuluphala. Kubalulekile ukuqaphela ukuthi ukuhlinzwa kwe-bariatric akusona isixazululo esisheshayo noma isixazululo esilula, kodwa kunalokho kuyithuluzi okuthi, lapho lihlanganiswa nezinguquko zendlela yokuphila, lingaholela ekuthuthukisweni okuphawulekayo kwezempilo kanye nekhwalithi yokuphila.

I-Gastric Banding

I-Laparoscopic adjustable gastric banding (LAGB) iyinqubo ye-bariatric evimbelayo ehlanganisa ukubeka ibhande le-silicone eliphefumulayo endaweni engenhla yesisu. Lokhu kudala isikhwama esincane, kunciphisa ukudla futhi kukhuthaze ukusutha kwangaphambi kwesikhathi. Ibhendi ingalungiswa ngemuva kokuhlinzwa ngokungeza noma ukususa usawoti echwebeni elingaphansi kwesikhumba. I-LAGB iyabuyiseleka emuva futhi ayishintshi i-anatomy yomgudu wokugaya ukudla. Kodwa-ke, iwile ekuthandeni ngenxa yezinga layo eliphezulu lokuhluleka kanye nezinkinga ezingaba khona zesikhathi eside.

Funda kabanzi mayelana no Gastric Banding 

I-Gastrectomy yeSleeve

I-sleeve gastrectomy iyinqubo ye-bariatric evimbelayo ehilela ukususa cishe u-80% wesisu, ukudala "umkhono" we-tubular eduze kwe-curvature encane. Lokhu kunciphisa umthamo wesisu futhi kunciphisa ukukhiqizwa kwe-ghrelin, okuholela ekwehliseni indlala. Inqubo ngokuvamile yenziwa nge-laparoscopically futhi ithatha cishe imizuzu engama-60-90. Kuphumela ekuncipheni okukhulu kwesisindo kanye nokuthuthukiswa kwezifo ezihambisana nokukhuluphala ngokweqile. I-gastrectomy ye-sleeve ayibandakanyi ukuhlelwa kabusha kwamathumbu, okunciphisa ubungozi bezinkinga ezihlobene ne-malabsorption.

Funda kabanzi ngenhla kwe-Sleeve Gastrectomy

I-Gastric Bypass

I-Roux-en-Y gastric bypass (RYGB) iyinqubo ehlanganisiwe ekhawulayo kanye ne-malabsorptive. Kuhilela ukudala isikhwama esincane sesisu kanye nokuhlela kabusha amathumbu amancane ukuze akhe ukumiswa kuka-Y. Lokhu kunciphisa ukudla futhi kunciphisa ukumuncwa kwezakhi. I-RYGB iholela ekwehleni okukhulu kwesisindo kanye nokwenza ngcono kwezifo ezihlobene nokukhuluphala ngokweqile, ikakhulukazi uhlobo lwesifo sikashukela sohlobo 2. Inqubo ngokuvamile yenziwa nge-laparoscopically futhi ithatha cishe amahora angu-1.5. I-RYGB idinga ukondliwa okunempilo impilo yonke kanye nokulandelelwa ngenxa yengozi yokushoda kwamavithamini namaminerali.

I-Bilio-pancreatic Diversion

I-Biliopancreatic diversion with duodenal switch (BPD/DS) iyinqubo eyinkimbinkimbi ye-malabsorptive ehlanganisa i-sleeve gastrectomy ne-bypass yamathumbu. Kubandakanya ukukhipha cishe amaphesenti angama-80 wesisu kanye nokuhlela kabusha ithumbu elincane ukuze kwehliswe kakhulu ukumuncwa kwezakhi. I-BPD/DS iphumela ekuncipheni okukhulu kwesisindo phakathi kwezinqubo ze-bariatric futhi inezinga eliphezulu kakhulu lokukhululwa kwesifo sikashukela. Kodwa-ke, kunengozi enkulu yokuntula ukudla okunomsoco kanye nezinkinga, ezidinga ukwengezwa impilo yonke kanye nokulandelela okuseduze.

Funda kabanzi mayelana ne-Bilio-pancreatic Disease

Ukuhlinzwa Kwe-Metabolic

Ukuhlinzwa kwe-Metabolic kubhekisela ezinkambisweni ze-bariatric ezihloselwe kakhulu ukwelapha ukuphazamiseka kwe-metabolic, ikakhulukazi uhlobo lwesifo sikashukela sohlobo 2, ezigulini ezikhuluphele. Lezi zinqubo, njenge-RYGB kanye ne-sleeve gastrectomy, zishintsha amahomoni amathumbu kanye ne-metabolism, okuholela ekulawuleni okuthuthukisiwe kwe-glycemic kanye nokuxazululwa kwezingxenye ze-metabolic syndrome. Ukuhlinzwa kwe-Metabolic kuboniswa ezigulini ezine-BMI ≥30 kg/m² (≥27.5 kg/m² kubantu base-Asia) ezinesifo sikashukela sohlobo 2 olungalawulwa kahle noma ezinye izifo ezihlobene nokukhuluphala.

Funda kabanzi mayelana nokuhlinzwa kwe-metabolic

I-Endoscopic Bariatric Surgery

Ukwelashwa kwe-Endoscopic bariatric (EBT) kuyizinqubo ezihlasela kancane ezenziwa kusetshenziswa ama-endoscopes aguquguqukayo. Ahlanganisa amasu afana namabhaluni e-intragastric, i-endoscopic sleeve gastroplasty, kanye nokwelashwa kwe-aspiration. I-EBTs ihlose ukuvala igebe phakathi kokuphathwa kwezokwelapha kanye nokuhlinzwa kwe-bariatric yendabuko, enikeza inketho engathandeki kakhulu yokuncipha kwesisindo. Lezi zinqubo zivame ukuhlehliswa futhi zingase zilungele iziguli ezine-BMI ephansi noma lezo ezingezona ukhetho lokungenelela ngokuhlinzwa.

Funda kabanzi mayelana no EBT

I-Single Incision Laparoscopic Surgery (SILS)

I-Single Incision Laparoscopic Surgery (SILS) iyindlela ethuthukisiwe ehlasela kancane esebenzisa ukusika okukodwa, ngokuvamile enkabeni, ukwenza izinqubo ze-bariatric. Le ndlela inikeza imiphumela yezimonyo ethuthukisiwe kanye nobuhlungu obungase bube buncane ngemva kokuhlinzwa uma kuqhathaniswa ne-laparoscopy evamile yamachweba amaningi. I-SILS ingasetshenziswa ezinkambisweni ezihlukahlukene ze-bariatric, okuhlanganisa i-sleeve gastrectomy kanye ne-gastric bypass. Kodwa-ke, kudinga imishini ekhethekile namakhono athuthukile we-laparoscopic.

Funda kabanzi mayelana no SILS

Ukuhlinza nge-Robotic

Ukuhlinzwa kwe-robotic bariatric kusebenzisa uhlelo lwamarobhothi olusizwa ngekhompiyutha ukwenza izinqubo zokunciphisa umzimba. Udokotela ohlinzayo ulawula izingalo zerobhothi kusuka kukhonsoli, enikeza ukubonakala okuthuthukisiwe kwe-3D kanye nokukhohlisa kwethuluzi okunembile. Le ndlela ingasetshenziswa ezinkambisweni ezihlukahlukene ze-bariatric, kuhlanganise ne-sleeve gastrectomy kanye ne-gastric bypass. Ukuhlinzwa kwerobhothi kungase kunikeze izinzuzo ezinjengokunwebeka okuthuthukisiwe ezindaweni eziqinile kanye namazinga ezinkinga okungenzeka anciphise. Nokho, kudinga ukuqeqeshwa okukhethekile kanye nemishini.

Funda kabanzi mayelana ne-Robotic Surgery 

Funda kabanzi

Ukuqonda Umdlavuza Wama-Gastrointestinal
Umdlavuza weGastrointestinal (GI) yiqembu lezifo ezithinta uhlelo lokugaya ukudla. Lezi zomdlavuza zingakhula ezingxenyeni ezihlukahlukene zepheshana le-GI, okuhlanganisa i-esophagus, isisu, isibindi, amanyikwe, amathumbu amancane, ikholoni, kanye ne-rectum. E-Apollo Institute of Gastroenterology, sisebenza ngokukhethekile ekuxilongeni, ekwelapheni nasekulawuleni lezi zimo eziyinkimbinkimbi.

Izinhlobo Zomdlavuza Wamathumbu
Ezinye zezinhlobo ezivame kakhulu zomdlavuza we-GI zifaka:

• Umdlavuza We-Esophageal - Funda kabanzi
• Umdlavuza Wesisu (Wesisu) - Funda kabanzi
• Umdlavuza weColorectal - Funda kabanzi
• Umdlavuza wePancreatic - Funda kabanzi
• Umdlavuza Wesibindi - Funda kabanzi
• Umdlavuza Wamathumbu Amancane - Funda kabanzi 

Ukwelashwa komdlavuza we-Gastrointestinal (GI) kuncike ohlotsheni nendawo yomdlavuza, kanye nemigomo yesiguli. Izinketho zokwelapha zihlanganisa: 

• Ukuhlinzwa: Ukususwa ngokuphelele kwesimila kanye nezicubu ezizungezile. Uhlobo lokuhlinzwa luncike endaweni yomdlavuza.

• Ukwelashwa ngamakhemikhali: Izidakamizwa ezicekela phansi amangqamuzana omdlavuza ngokuwavimba ekukhuleni nasekuhlukaniseni. 

  Funda kabanzi

• Ukwelashwa kwamafutha: Isetshenziselwa ukuncipha izimila noma ukubulala amangqamuzana omdlavuza asele ngemva kokuhlinzwa. 

  Funda kabanzi

• Ukwelapha okuhlosiwe: Izidakamizwa eziqondisa izakhi zofuzo ezithile, amaprotheni, noma izindawo zezicubu ezinomthelela ekukhuleni komdlavuza. 

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• immunotherapy: Izidakamizwa ezicindezela noma ezishukumisa amasosha omzimba ukuze zisize ukulwa nomdlavuza. 

  Funda kabanzi

• Ukwelashwa kwe-Neoadjuvant: Ukwelashwa okunikezwa ngaphambi kokuhlinzwa ukuze kuncishiswe isimila noma kwenziwe ukuhlinzwa kuphephe futhi kusebenze kangcono.

• Ukwelashwa kwe-Adjuvant: Ukwelashwa okunikezwa ngemva kokuhlinzwa ukuze kwehliswe ingozi yokubuya komdlavuza.

• I-Anastomosis: Inqubo yokuxhuma izingxenye ezinempilo zomphimbo noma isisu ukuze ubuyisele ukusebenza.

• Ukufakelwa kwesibindi: Inketho yezinye iziguli ezinomdlavuza wesibindi. 

  Funda kabanzi

Ezimweni ezithuthuke kakhulu, odokotela bangase bagxile ekusizeni izimpawu kunokuba belaphe lesi sifo. 

Funda kabanzi

Ezinye izindlela zokwelapha zokuhlinzwa zomdlavuza weGastrointestinal 

1. I-Gastrectomy (ukususwa kwesisu)
 I-Gastrectomy ihilela ukususa konke noma ingxenye yesisu. Ngaphansi kwe-anesthesia ejwayelekile, udokotela ohlinzayo ufinyelela esiswini noma ngokusikwa kwesisu esikhulu (ukuhlinzwa okuvulekile) noma izimbotshana ezimbalwa (indlela ye-laparoscopic). Ku-gastrectomy ephelele, isisu sonke siyasuswa kanye nama-lymph nodes aseduze. Ku-gastrectomy eyingxenye, kuphela ingxenye yesisu ekhishwayo. Umgudu wokugaya ube usukwakhiwa kabusha ngokuxhuma umminzo ngqo emathunjini amancane (nge-gastrectomy isiyonke) noma kuxhunywe kabusha isisu esisele emathunjini amancane (ngengxenye ye-gastrectomy).

Kwenziwani?
I-Gastrectomy yenziwa:

• Yelapha umdlavuza wesisu
• Susa izilonda eziyingozi
• Vimbela umdlavuza kubantu abasengozini enkulu yofuzo
• Yehlisa izimpawu ezimeni ezithuthukile

Izinzuzo

• Kungaba ukwelapha ezigabeni ezithile zomdlavuza wesisu
• Ivimbela ukukhula komdlavuza kubantu abasengozini enkulu
• Inikeza ukukhululeka ezimpawu ezimeni ezithuthukile
• Ivumela isiteji esinembile kanye nokwelashwa kokulandelela okulungiselelwe

Funda kabanzi

2. I-Colectomy ye-Colon Cancer
I-Colectomy ihilela ukususa konke noma ingxenye yekholoni. Udokotela ohlinzayo wenza izimbobo esiswini, ngokuhlinza okuvulekile noma nge-laparoscopically. Ingxenye yekholoni equkethe umdlavuza iyasuswa, kanye nomkhawulo wezicubu ezinempilo kanye nama-lymph nodes aseduze. Iziphetho ezinempilo zekholoni zibe sezixhunywa kabusha (i-anastomosis). Kwezinye izimo, kungase kudingeke i-colostomy yesikhashana noma ehlala njalo, lapho ukuphela kwekholoni kulethwa ngembobo odongeni lwesisu.

Kwenziwani?
I-Colectomy yenziwa:

• Susa umdlavuza wekoloni
• Vimbela ukusabalala komdlavuza
• Yehlisa izimpawu ezimeni ezithuthukile
• Thola izicubu ukuze uxilongwe kahle kanye nesiteji
   

Izinzuzo

• Kungaba ekwelapheni umdlavuza wamakholoni osesigabeni sakuqala
• Inikeza ulwazi olunembile lwesiteji
• Ingase ivimbele izinkinga ezifana nokuvinjwa kwamathumbu
• Ithuthukisa izinga lempilo ngokudambisa izimpawu
• Ivumela ukwelashwa kwe-adjuvant okuhambisanayo okusekelwe emiphumeleni ye-pathology

3. Ukuhlinzwa Kwe-Pancreatic: Inqubo ka-Whipple 
Ukuhlinzwa kwe-pancreatic kuyehluka kuye ngendawo kanye nezinga lomdlavuza. Inqubo evame kakhulu inqubo ye-Whipple (pancreaticoduodenectomy), ehlanganisa ukukhipha ikhanda le-pancreas, ingxenye yamathumbu amancane, i-gallbladder, futhi ngezinye izikhathi ingxenye yesisu. Ezinye izinqubo zihlanganisa i-distal pancreatectomy (ukukhipha umzimba nomsila we-pancreas) kanye ne-pancreatectomy ephelele (ukukhipha wonke amanyikwe). Udokotela ohlinzayo ube eselungisa kabusha umgudu wokugaya ukudla ukuze abuyisele ukusebenza kwawo.

Kwenziwani?
Ukuhlinzwa kwe-pancreatic kwenziwa ngale ndlela elandelayo: +

• Susa umdlavuza we-pancreatic
• Yelapha izilonda ezinomdlavuza
• Yehlisa izimpawu ezimeni ezithuthukile
• Thola izicubu ukuze uxilongwe kahle kanye nesiteji

Izinzuzo

• Kungaba ekwelapheni umdlavuza we-pancreatic osekuqaleni
• Kunganweba kakhulu ukusinda ezimweni ezithuthuke kakhulu
• Inikeza ukukhululeka ezimpawu ezifana ne-jaundice nobuhlungu
• Ivumela isiteji esinembile kanye nokwelashwa kokulandelela okulungiselelwe
• Ithuthukisa izinga lempilo ezimweni eziningi

Funda kabanzi

4. Ukukhishwa Kwesibindi
Ukususwa kwesibindi kuhilela ukususa ngokuhlinzwa ingxenye yesibindi equkethe umdlavuza. Udokotela ohlinzayo wenza imbobo esiswini ukuze afinyelele esibindini. Ngokusebenzisa isiqondiso sesithombe esithuthukisiwe, isimila sitholakala futhi sikhishwe ngokucophelela kanye nomphetho wezicubu zesibindi ezinempilo. Inani lesibindi esisusiwe lincike kusayizi kanye nendawo yesimila. Kwezinye izimo, ukuhlinzwa kungenziwa nge-laparoscopically. Ngemuva kokususwa, isibindi esisele siyahlolwa ukuthi azikho izimpawu zokusabalala komdlavuza.

Kwenziwani?
Ukukhishwa komdlavuza wesibindi kwenziwa ku:

• Susa umdlavuza wesibindi oyinhloko (i-hepatocellular carcinoma)
• Susa izimila ze-metastatic ezisabalele esibindini kwezinye izitho
• Nikeza ukukhululeka ezimpawu ezimeni ezithuthukile
• Thola izicubu ukuze uxilongwe kahle kanye nesiteji
   

Izinzuzo

• Kungaba ekwelapheni umdlavuza wesibindi usaqala
• Inganweba ukusinda ezimweni ezithuthuke kakhulu
• Ithuthukisa izinga lempilo ngokukhulula izimpawu
• Ivumela isiteji esinembile kanye nokwelashwa kokulandelela okulungiselelwe
• Inikeza ithuba lokuthi isibindi sivuselele izicubu ezinempilo

Funda kabanzi

Ukufakelwa kwesibindi 

Ukufakelwa kwesibindi kuyinqubo yokuhlinzwa eyinkimbinkimbi ehlanganisa ukubuyisela isibindi esigulayo noma esilimele ngesinempilo esivela kumnikeli. Lokhu kusebenza okusindisa impilo ngokuvamile kunconywa ezigulini ezinesifo sesibindi sokuphela noma ukwehluleka kwesibindi okukhulu lapho ezinye izinketho zokwelapha seziphelile.

Kwenziwa kanjani?
Ukuhlinzwa kokufakelwa kabusha kuhilela ukukhipha isibindi sesiguli esigulayo futhi esikhundleni saso kufakwe isibindi sonke noma ingxenye yesibindi esinempilo kumnikeli. Kunezinhlobo ezintathu eziyinhloko zokufakelwa kwesibindi:
 

1. Ukufakelwa kwe-Orthotopic: Uhlobo oluvame kakhulu, lapho kusetshenziswa khona isibindi sonke esivela kumuntu oshonile onikelayo.

2. Ukufakelwa komnikeli ophilayo: Ingxenye yesibindi somnikeli ophilayo iyafakwa.

3. Ukunikela okuhlukanisiwe: Isibindi somnikeli oshonile sihlukaniswa phakathi komuntu omdala nomntwana otholayo.

Phakathi nokuhlinzwa, udokotela ohlinzayo usika isiguli esiswini, akhiphe isibindi esigulayo, futhi axhumanise ngokucophelela isibindi esinikelayo nemithambo yegazi yesiguli kanye nemigudu yenyongo.

 

Izizathu Zokufakelwa Kwesibindi

Ukufakelwa kwesibindi kuyatuswa lapho isibindi somuntu singasasebenzi ngokwanele ukuze sisekele ukuphila. Izizathu ezijwayelekile zihlanganisa:

• I-cirrhosis ebangelwa i-hepatitis C engapheli noma ukusebenzisa kabi utshwala isikhathi eside
• Umdlavuza wesibindi oyinhloko
• I-Cholangitis
• Ukwehluleka kwesibindi okukhulu ngenxa yokutheleleka noma izinkinga zemithi

Izinzuzo

Ukufakelwa kwesibindi kunikeza izinzuzo eziningi ezigulini ezinesifo sesibindi sokuphela:

• Izinga lempilo elithuthukisiwe: Iziguli zingabuyela emisebenzini evamile yansuku zonke futhi ziphile ukuphila okuphumelelayo.
• Ukwenyuka kweminyaka yokuphila: Inqubo isindisa impilo ezigulini eziningi.
• Ukusebenza kwesibindi okuthuthukisiwe: Isibindi esisha sibuyisela izinqubo ezijwayelekile ze-metabolic.
• I-Energy boost: Abamukeli abaningi babika amazinga angeziwe wamandla kanye nekhono elithuthukisiwe lokubhekana nemisebenzi yansuku zonke.
• Ukukhiqiza okungeziwe: Iziguli ngokuvamile zingabuyela emsebenzini futhi zihlanganyele emisebenzini ehlukahlukene.
• Ukuzala okuthuthukisiwe: Kulabo asebekhulile, ukuzala kungase kubuyiselwe.

Izinhlobo Zabanikeli
Ukufakelwa kwesibindi kungenziwa kusetshenziswa izitho zezinhlobo ezimbili zabanikelayo:

1. Abanikeli abashonile: Iningi lesibindi esinikelwe livela kubantu abahlele ukunikela ngezitho zomzimba noma imindeni yabo enikeze imvume ngemva kokufa kobuchopho.

2. Abanikeli abaphilayo: Ngokuvamile izihlobo noma abangane bomuntu othola i-inshuwalense bahlolwa kabanzi ngokwezokwelapha nangokwengqondo ngaphambi kokunikela ngengxenye yesibindi sakhe.

Ukunakekelwa Kwangemva Kokufakelwa 

Ngemva kokufakelwa, iziguli kufanele ziphuze imishanguzo ye-immunosuppressive impilo yazo yonke ukuze zigweme ukwenqatshwa kwesibindi esisha. Ukulandelela njalo nokuqapha kubalulekile ukuze uqinisekise impumelelo yokufakelwa futhi ulawule noma yiziphi izinkinga ezingaba khona.

Funda kabanzi