I-Cystectomy iwukuhlinzwa ukuze kukhishwe esinyeni ngaphansi kwe-anesthesia ejwayelekile. Kuhilela ukusungulwa kwesistimu ye-bypass ukukhipha umchamo. Lokhu kungenelela kwenzelwa ukwelapha imidlavuza ethile, noma ezigulini ezithile eziphethwe isifo sezinzwa noma ezithola ukwelashwa okunzima okushintsha ukusebenza kwesinye. Ngemuva kwe-cystectomy, imisebenzi yomchamo, ubulili kanye nokuzala kuyaphazamiseka.

I-Cystectomy ukuhlinzwa ukuze kukhishwe esinyeni. Ukuhlinzwa kungenziwa nge-laparotomy (ukusika ngezansi kwenkaba) noma ngokuhlinzwa kwe-laparoscopic ngosizo lwerobhothi noma ngaphandle kwalo. Ngokuvamile kuhilela ukukhishwa kwe-prostate emadodeni, kanye nesibeletho kwabesifazane.

Kuzo zonke izimo, kuhilela ukusungulwa kwesistimu ye-bypass ukuze ithathe indawo yesinye futhi ikhiphe umchamo okhiqizwa izinso.

Izinhlobo ezintathu zokutholwa zingenzeka:

• I-ileal neo-bladder, ecatshangelwa ukuthi uma i-urethra (ishubhu elivumela umchamo uphume) ingagcinwa: udokotela ohlinzayo wakha esinyeni sokwenziwa ngesiqephu samathumbu asilolongela sibe idamu . Ibe isixhuma leli phakethe ne-ureter (amashubhu athwala umchamo ezinso) kanye nomgudu womchamo. Le neo-bladder ivumela ukuphuma komchamo ngezindlela zemvelo;
• I-cutaneous continent bypass: udokotela ohlinzayo wakha esinyeni sokwenziwa kusuka ocezwini lwamathumbu alulolonga ngendlela ye-reservoir. Ube esexhuma lesi sikhwama epayipini elixhunywe ku-orifice ezingeni lesikhumba elivumela isiguli ukuba senze ukuthulula okuvamile okwenziwa ngesandla;
• I-uretero-ileal bypass ngokusho kukaBricker: udokotela ohlinzayo ususa ingxenye yamathumbu exhuma ezinso nge-ureters futhi exhuma esikhumbeni eduze nenkaba. Ukuphela kwengxenye kwakha ukuvuleka okubonakalayo esiswini okusebenza njengesisekelo sephakethe langaphandle elihlanganiswe nomzimba lapho umchamo ugeleza njalo. Isiguli kufanele sikhiphe futhi sishintshe lesi sikhwama njalo.

Ukulungiselela i-cystectomy

Lokhu kungenelela kudinga ukulungiswa, ikakhulukazi ezigulini ezibuthakathaka kakhulu (umlando wenhliziyo, ama-anticoagulants, isifo sikashukela, njll.) Phakathi nezinsuku eziyi-10 ezandulele ukuhlinzwa, isiguli kufanele silandele iseluleko esivamile esinikezwa ithimba labahlinzayo: ukuphumula , ukudla okulula, ukuyeka ukubhema. , abukho utshwala ...

Amathumbu kungenzeka asetshenziswe ngesikhathi senqubo yokubekwa kwesistimu yokudlula. Ngakho-ke kufanele kulungiswe ngokudla okungenansalela ukuze kuqale ezinsukwini ezimbalwa ngaphambi kokuhlinzwa.

Usuku ngaphambi kokungenelela

Isiguli singena esibhedlela ngosuku olwandulela ukuhlinzwa. Kumelwe adle uketshezi oluvumela amathumbu ukuba aphele.

Izigaba ezahlukene ze-cystectomy

• Udokotela obulala izinzwa ubeka i-epidural catheter ngaphansi kwe-anesthesia yendawo ukuze alawule ubuhlungu ngemva kokuhlinzwa. Ube esesilalisa ngokuphelele isiguli;
• Udokotela ohlinzayo ususa isinye (futhi ngokuvamile i-prostate nesibeletho) nge-laparoscopic noma ukuhlinzwa kwe-laparoscopic;
• Ube esebeka i-bypass yomchamo ukuze kuqedwe umchamo.

Uma kwenzeka i-cystectomy yomdlavuza, ukukhishwa kwesinye kuhlotshaniswa nalokhu:

• Kwabesilisa, i-lymph node dissection (ukuhlinzwa ukuze kukhishwe wonke ama-lymph nodes endaweni lapho kungenzeka ukuthi umdlavuza usakazeke khona) nokususwa kwe-prostate;
• Kwabesifazane, i-lymph node dissection kanye nokususwa kodonga lwangaphambili lwesitho sangasese sowesifazane nesibeletho.

• I-Cystectomy yindlela yokwelapha ejwayelekile yomdlavuza othinte umsipha wesinye, uhlobo olubi kakhulu lomdlavuza wesinye;
• I-Cystectomy ingase imiselwe umdlavuza wesinye ongazange ufinyelele emsipha uma kwenzeka umdlavuza uphindaphinda naphezu kokukhishwa kwe-tumor (ukususwa kwesimila esithweni) kanye nokwelashwa kwezidakamizwa okunqunywe njengomugqa wokuqala;
• Okokugcina, ukukhishwa kwesinye kungacatshangelwa ezigulini ezithile eziphethwe isifo sezinzwa noma ezithola ukwelashwa okunzima (i-radiotherapy) okushintsha ukusebenza kwesinye.

Izinsuku ezilandela ukusebenza

• Isiguli sifakwe ekunakekelweni okujulile ukuze ithimba lezokwelapha likwazi ukulawula ubuhlungu (i-epidural catheter), umsebenzi womchamo (ukuhlolwa kwegazi), ukusebenza kahle kwemikhondo kanye nokuqala kabusha kokuhamba;
• Umchamo ukhishwa ngama-catheter, futhi indawo eqhutshwayo ikhishwa ngamapayipi angaphandle kunoma yiluphi uhlangothi lokusikwa kwesisu;
• Ithimba liqinisekisa ukuthi isiguli siphinde sithole ukuzimela ngokushesha ngangokunokwenzeka;
• Isikhathi sokulaliswa esibhedlela okungenani yizinsuku eziyi-10.

Izingozi nezinkinga

Izinkinga zingavela ezinsukwini ezilandela ukusebenza:

• Ukopha;
• I-phlebitis kanye ne-pulmonary embolism;
• Amagciwane (umchamo, ulwelwesi, isibazi noma jikelele);
• Izinkinga ze-Urinary (ukunwebeka kwesinye samathumbu, ukunciphisa izinga le-suture phakathi kwamathumbu kanye nemigudu yomchamo, njll.);
• Izinkinga zokugaya ukudla (ukuvinjwa kwamathumbu, isilonda esiswini, njll.)

Okuqhamuka uma udla imishanguzo

I-Cystectomy ukungenelela okune-sequelae emisebenzini yomchamo nezocansi:

• Ubulili nokuzala kuphazamisekile;
• Kwabesilisa, ukususwa kwe-prostate kuholela ekulahlekelweni kwezinqubo ezithile zokuqhafaza;
• I-continence (ikhono lokulawula ukuphuma komchamo) ishintshiwe kakhulu;
• Ebusuku, iziguli kufanele zivuke zikhiphe esinyeni futhi zigweme ukuvuza.