Ukuhlinza kwe-Gastric Sleeve

Enye yezindlela ezithandwa kakhulu zokubhekana nokukhuluphala ukuhlinzwa kwe-bariatric. Ingenye edume kakhulu ukuhlinzwa kwe-bariatric lapho ubukhulu besisu sakho buncishiswa noma bususwe okuholela ekuncipheni kwesisindo ngokushesha. Umgomo wokuhlinzwa komkhono wesisu uwukwenza uzizwe ugcwele ngaphandle kokudla okuningi futhi ulahlekelwe isisindo ngenkathi kushintsha umzimba wakho. Ukuhlinza okungenakuhlasela kancane okwehlisa isifiso sokudla futhi kukhawulele inani lokudla ongakudla. Kulesi sihloko, sizoxoxa ngokuthi kuyini ngempela ukuhlinzwa komkhono wesisu nokuthi kusebenza kanjani.

Kuyini ukuhlinzwa kwemikhono yesisu?

Ukuhlinzwa komkhono wesisu kungenye yezinto ezidume kakhulu izinqubo zokulahlekelwa isisindo emhlabeni okuholela ekulahlekelweni kwesisindo okuphawulekayo nokusheshayo. Eyaziwa nangokuthi i-laparoscopic sleeve gastrectomy, ihilela ukukhishwa kwesisu sakho esingaba ngu-80%. Indawo esele yesisu yisikhwama se-tubular esifana nebhanana. Kuyinketho yokuhlinzwa yokulahlekelwa isisindo ephelele yomuntu ongabonanga imiphumela yokuguqulwa kokudla nokuzivocavoca noma imithi yokwehlisa isisindo. Ifanele futhi kumakhandidethi angafanele ukuthola okunye ukuhlinzwa kwesisindo ngenxa yobungozi obuhambisana nezimo zezempilo ezifana ne-anemia noma i-BMI ephezulu. Ngokuhlinzwa komkhono wesisu, ungalindela ukwehla cishe ngo-1 kg ngesonto kuze kube yilapho umzimba wakho ufinyelela ebangeni lesisindo esinempilo. Kodwa-ke, ukuze lokhu kwenzeke, kufanele ulandele izincomo eziqondene nesiguli ngemuva kokuhlinzwa ozinikezwe udokotela ongcono kakhulu we-gastroenterologist e-Hyderabad njengokushintsha indlela yokuphila (okungukuthi, ukudla nokulala ngesikhathi, ukuvivinya umzimba nsuku zonke imizuzu engama-60, njll.)

Yiziphi izinzuzo zokuhlinza imikhono yesisu?

Nakhu ukuthi kungani kufanele ukhethe ukuhlinzwa komkhono wesisu esibhedlela se-gastroenterology e-Hyderabad ngaphezu kwezinye izinqubo zokwehlisa isisindo:

• Ushintsho kuphela olwenziwe kule nqubo ubukhulu besisu okuqinisekisa ukuthi imisebenzi yokugaya iyagcinwa.
• Izimbobo nezinzwa zesisu zihlala zingashintshiwe futhi ziqinile.
• Ukuhlinzwa komkhono wesisu kwenziwa kusetshenziswa i-laparoscope okusho ukuthi ayihlaseli, futhi kunikeza izibazi ezincane nokululama ngokushesha.
• Njengoba le nqubo ingenawo umthelela ohlelweni lokugaya ukudla, uzolulama ngokushesha kunezinye izinqubo (imvamisa phakathi kwamahora angama-48 kuye kwangama-72).
• Isebenza ngokulinganayo ekuzuzeni kwesisindo okungcono kune-lap-band noma okulingana nokuhlinzwa kwe-gastric bypass, ikakhulukazi ezigulini ezigula kakhulu ze-BMI.
• Ukuhlala esibhedlela ngemuva kwenqubo kufushane (cishe izinsuku ezi-2).

Ingabe kukhona ukuhlolwa okudingekayo ngaphambi kokuhlinzwa komkhono wesisu?

Yebo, ukuze kwenziwe ukuhlinzwa kuphephe futhi kubikezelwe, ukuhlolwa kwegazi kuyenziwa ezigulini ezihlanganisa ukuhlola iqembu legazi, isilinganiso segazi eligcwele, amazinga e-cholesterol, nokuhlolwa kwama-hormone anjengokuthi - ghrelin; i-leptin; I-DHEA; iprolactin; i-testosterone; i-estradiol; njll., izinga lesisekelo samavithamini namaminerali, ukuhlolwa kokuhlolwa kwesifo sikashukela, nokuhlolwa kwezinso, indlala yegilo, nesibindi. Kungase kudingeke ukuthi uthole i-X-ray yesifuba kanye ne-ECG kanye ne-2D echo ngaphambi kokuhlinzwa.

Kwenziwa kanjani ukuhlinzwa komkhono wesisu?

Ezimweni eziningi, ukuhlinzwa komkhono wesisu kwenziwa njengenqubo encane ehilela ukusebenzisa i-laparoscope, ishubhu elilula nelincane elinekhamera, nezinye izinsimbi ezixhunywe kuso. Le laparoscope ifakwa ngaphakathi kwesisu sakho ngokusikwa okuncane. Ngaphambi kokuba inqubo iqale, uzonikezwa i-anesthesia jikelele, umuthi okufaka ebuthongweni obujulile. Uzodinga i-ventilator ukuze uphefumule ngesikhathi senqubo. Phakathi nenqubo, udokotela ohlinzayo uzohlukanisa isisu sakho sibe izingxenye ezimbili. Cishe u-80% wengxenye engaphandle egobile yesisu sakho izosikwa isuswe. Ku-20% asele, imiphetho izohlanganiswa ndawonye kusetshenziswa izinsimbi ezikhethekile, okwenza isisu esimise okukabhanana esingama-25% kuphela osayizi wangempela. Yonke inqubo izothatha cishe ihora. Ngemva kokuqedwa, uzodluliselwa egumbini lokutakula lapho kuzodingeka uhlale elinye ihora. Njengoba udokotela ohlinzayo enza amanxeba amancane esiswini, azophulukisa ngokushesha. Kungenxa yemvelo encane yenqubo ezokuvumela ukuthi ululame ngokushesha kunalokho obungaba nakho ngemva kwenqubo lapho kusetshenziswa khona ukusika okukhulu ukuvula isisu sakho. Ngaphandle uma kunenkinga, uzokwazi ukuya ekhaya ezinsukwini ezi-2 kuya kwezi-3 ngemuva kwenqubo.

Ingabe bukhona ubuhlungu ngemva kokuhlinzwa komkhono wesisu?

Ubuhlungu ngemva kwale nqubo buyancipha kakhulu, ikakhulukazi ngoba yenziwa kusetshenziswa i-laparoscope. Nokho, ezinye iziguli zibika izimpawu ezilandelayo ngokushesha ngemva kokuhlinzwa:

• Ubuhlungu ehlombe lakho lesobunxele
• Ukuqina kwesisu
• Umuzwa wokuthunga endaweni yakho engenhla yesisu

Kodwa-ke, lezi zinzwa zenzeka ngezikhathi ezithile amahora ambalwa futhi zixazulule cishe usuku noma ezimbili. Futhi, lokhu kuphatheka kabi ngeke kukukhawulele nganoma iyiphi indlela futhi uzokwazi ukuhlala futhi uhambe kahle ngemva kwamahora angu-6 ukuqeda ukuhlinzwa.

Ngabe kusebenza kangakanani ukuhlinzwa komkhono wesisu?

Kunezindlela ezimbili lapho ukuhlinzwa komkhono wesisu kungakusiza ulahlekelwe isisindo:

1. Njengoba isisu sakho sizoba sincane kakhulu kunangaphambili, uzozizwa ugcwele futhi udle kancane. Lokhu kusho ukuthi uzobe udla ama-calories ambalwa.
2. Inqubo ihilela ukususa ingxenye yesisu enesibopho sokukhiqiza i-ghrelin - ihomoni ehambisana nendlala. Ngaleyo ndlela kunciphisa isifiso sokudla futhi kukwenze uzizwe usuthi ngenani elincane lokudla, amahora amade.

Kuyaqapheleka ukuthi i-10-15% yesisindo eseqile ilahlekile phakathi nezinsuku ezingama-30 ngemuva kokuhlinzwa. Kulindeleke ukuthi ulahlekelwe cishe amaphesenti angama-50 esisindo sakho eseqile ezinyangeni eziyi-12 nje ngemuva kokuhlinzwa komkhono wesisu futhi abanye bangalahlekelwa ngisho nangama-60 kuye kwangama-70 esisindo sabo. Kodwa-ke, kubalulekile ukukhumbula ukuthi uzokwazi ukubona imiphumela kuphela uma unamathela ohlelweni lokuvivinya umzimba kanye nokudla olunconywe udokotela wakho. Uma usebenzisa lezi zinguquko zendlela yokuphila, ukuncipha kwakho kwesisindo kuzoba isikhathi eside. Ngokunciphisa lesi sisindo eseqile, uzokwazi ukuthuthukisa ngokuphawulekayo izinga lempilo yakho okwenza kube lula ukwenza imisebenzi yansuku zonke. Futhi, ukuncipha kwesisindo kuzokwehlisa ingozi yezimo zempilo ezihlobene nokukhuluphala ngokweqile ezifana ne-obstructive sleep apnea, uhlobo lwesifo sikashukela sohlobo 2, umfutho wegazi ophakeme (umfutho wegazi ophakeme), i-hyperlipidemia (i-cholesterol ephezulu), ukungazali, nezinhlungu zamalunga.

Ubani ofanele ukuhlinzwa kwemikhono yesisu?

Noma yiluphi uhlobo lokuhlinzwa kwe-bariatric okuhlanganisa ukuhlinzwa komkhono wesisu kunconywa kuphela kubantu abangakwazanga ukubona imiphumela ngemva kokwenza imizamo eqinile yokuthuthukisa imikhuba yabo yokudla nokudla nokusebenzisa imithi yokunciphisa umzimba. Nangemuva kwalokho, kunemibandela ethile okufanele uhlangabezane nayo ukuze ufanelekele le nqubo. Lezi zindlela zinqunywa ngesisekelo sokuthi uhlushwa yini isimo sezempilo esihlobene nokukhuluphala ngokweqile noma cha kanye ne-BMI yakho (Body Mass Index). Nazi izimo ezifanelekile zokuhlinzwa komkhono wesisu:

• Ukukhuluphala ngokweqile (Morbid) (Amaphuzu we-BMI angaphezu kwama-37.5)
• Ukukhuluphala (Amaphuzu we-BMI phakathi kuka-32.5 no-37.5) okungenani ngesimo esisodwa esihlobene nokukhuluphala.

Kwezinye izimo, ukuhlinzwa komkhono wesisu kungenziwa uma ukhuluphele kodwa ungakhuluphali futhi unesimo sempilo esibalulekile esihambisana nesisindo sakho.

Ingabe zikhona izingozi kanye nezinkinga ezihlobene nokuhlinzwa imikhono esiswini?

Ngokuvamile, ukuhlinzwa komkhono wesisu kuyindlela ephephile uma kuqhathaniswa. Noma kukhona ubungozi obuthile kanye nezinkinga ezihambisana nakho njengokunye ukuhlinza, amathimba odokotela abanolwazi lokuhlinza aqinisekisa ukuthi lokhu kuyagwenywa. Nazi izinkinga ezimbalwa ezingase zenzeke ngemva kokuhlinzwa, okungase kudinge ukwelashwa okwengeziwe ukuze kulungiswe okufanayo:

• Ukopha - Lokhu kwenzeka lapho ukopha ngaphakathi emzimbeni noma esilondeni sokuhlinzwa kuba nzima okuholela ekushaqekeni.
• Ukushaya kwenhliziyo okungajwayelekile - Inqubo ingandisa ingozi yokushaya kwenhliziyo okungajwayelekile njenge-atrial fibrillation.
• I-Pulmonary embolism - Lokhu kungenzeka lapho ingxenye yehlule legazi iphuka futhi ifinyelela emaphashini.
• I-Deep vein thrombosis (DVT) - Inqubo kanye nokululama kungandisa ingozi yokwakheka kwehlule legazi emthanjeni. Umthambo ovame ukuthinteka usemlenzeni.
• Inyumoniya - Ubuhlungu benqubo bungakuphoqa ukuthi uphefumule kancane okuholela ekuthelelekeni kwamaphaphu njengenyumoniya.
• Ukushoda kwamavithamini - Ingxenye yesisu eyakhishwa inengxenye ekumunceni amavithamini adingwa umzimba. Uma ungazithathi izithasiselo zamavithamini, ungase ube nokushoda.
• Isilungulela (GERD) - Ukulungisa kabusha isisu ngokuhlinzwa komkhono wesisu kungabangela noma kubangele isilungulela sakho sibe sibi kakhulu. Kodwa-ke, lokhu kungelashwa kusetshenziswa imithi etholakala ngaphandle kwekhawunta.

Uma ufuna ukwehlisa isisindo ngemva kokuhlinzwa komkhono wesisu futhi uwugcine, kuzomele ushintshe ukuzivocavoca kwakho kanye nemikhuba yokudla. Uma udla ukudla okungenampilo, udla kakhulu, noma uzivocavoca kancane, uzophinde ukhuluphale. Okunye ukukhathazeka okuvamile okuhlotshaniswa nokuhlinzwa komkhono wesisu yisikhumba eseqile esishiywe ngemuva kokuncipha kwesisindo. Lokhu kuvame kakhulu uma ulahlekelwa isisindo esiningi ngokweqile ngokushesha. Kungabhekwa njengomphumela ohlangothini wenqubo. Uma isikhumba eseqile sikuhlupha, singasuswa ngokuhlinzwa. Kodwa-ke, kufanele ukhumbule ukuthi kuzothatha cishe izinyanga eziyi-18 ukuze umzimba uzinze ngemuva kwenqubo. Kungcono ukulinda lokhu isikhathi eside ngaphambi kokucabangela inqubo yokukhishwa kwesikhumba. Kuze kube yileso sikhathi, ungazama amasu athile okuqinisa isikhumba njengokuvivinya umzimba nsuku zonke, ukwanda kwamanzi kanye nokudla okunamaphrotheni amaningi. Into eyodwa okufanele uyicabangele ngaphambi kokuhlinzwa komkhono wesisu ukuthi akuhlehliseki. Uma ungajabule ngemiphumela, ngeke ukwazi ukushintsha isisu sakho sibe ngendlela esasiyiyo phambilini.

Yiziphi izinguquko zokudla ngemva kokuhlinzwa komkhono wesisu?

Ngaphambi kokuba uhlinzwe ngomkhono wesisu, udokotela wakho ohlinzayo uzokwazisa ngendlela yokuphila kanye nezinguquko zokudla okuzodingeka uzilandele kuhlanganise nokudla okuwuketshezi ngaphambi kokuhlinzwa njengengxenye yokulungiselela ukuhlinzwa. Ngalezi zinguquko, ngeke nje ukwazi ukufeza ukulahlekelwa kwesisindo sakho sangaphambi kokusebenza kodwa futhi ukukugcina ngemva kokuhlinzwa. Udokotela wakho uzokwenza inqubo ethile yomkhono wesisu kuye ngezinga lokukhuluphala kwakho. Nazi iziqondiso ezijwayelekile zokudla okufanele uzilandele:

• Emasontweni amabili ngaphambi kwenqubo kuzodingeka ulandele ukudla okuwuketshezi okucebile ngamaprotheni nama-carbohydrate aphansi.
• Phakathi nesonto lakho lokuqala ngemva kokuhlinzwa, uzovunyelwa kuphela ukususa uketshezi. Uzokwazi ukwengeza uketshezi olujiyile, njengokunyakazisa phakathi nesonto lesi-2 ngemuva kokuhlinzwa. Uzokwazi ukudla ukudla okuhlanzekile ngemva kwesonto lesi-3.

Cishe inyanga eyodwa ngemva kwenqubo, uzokwazi ukudla ukudla kwakho okuvamile nokunempilo. Nokho, isifiso sakho sokudla sizoba sincane kunalokho esasiyikho ngaphambi kokuhlinzwa. Ngeke uzizwe ulambile njengakuqala futhi usuthe ngokushesha. Ngenxa yokudla kwakho okuncane nokudla okulinganiselwe, ungase uthole okunye ukusilela kokudla okunempilo ohambeni olude. Kungakho kubalulekile ukuthatha ama-multivitamin noma ezinye izithasiselo ezidingekayo ukuze wenze lokhu.

Isiphetho

Ukuhlinzwa komkhono wesisu kungenye yokuhlinzwa okudume kakhulu kwe-bariatric okusebenza ngokunciphisa ubukhulu besisu sakho ukuze udle kancane. Njengoba ubukhulu besisu buncishisiwe, uzothola ukulamba okuncane. Ukuze ufanelekele le nqubo, kufanele uhlangabezane nemibandela ethile. Okokuqala, uzodinga ukuqinisekisa ukuthi zonke ezinye izindlela zokunciphisa isisindo zehlulekile kuhlanganise nokuzivocavoca, ukudla, kanye nemithi yokunciphisa umzimba. Esinye isimo esifanelekayo ukuthi ngabe uhlushwa yinoma yisiphi isimo esihlobene nokukhuluphala nokuthi iphakeme kangakanani i-BMI yakho. Uma inqubo isiqediwe, kuzodingeka ulandele indlela yokuzivocavoca enempilo nokudla okunempilo njalo. Lokhu kuzoqinisekisa ukuthi uyakwazi ukulahlekelwa ngaphezu kuka-50% wesisindo eseqile ezinyangeni eziyi-12. Ngakho-ke, uma ukholelwa ukuthi uyahambisana nemibandela yokuhlinzwa kwe-bariatric, kuyalulekwa ukuthi uthintane nochwepheshe we-bariatric onolwazi kusenesikhathi, ukuze okufanayo.