Sigmoidectomy shine cirewar sashin ƙarshe na hanji, sigmoid colon. Ana la'akari da shi a wasu lokuta na sigmoid diverticulitis, yanayi na kowa a cikin tsofaffi, ko ciwon daji wanda ke kan sigmoid colon.

Sigmoidectomy, ko sigmoid resection, shine cirewar tiyata na sigmoid colon. Wannan nau'i ne na colectomy (cire wani yanki na hanji). 

A matsayin tunatarwa, hanji yana samuwa tare da dubura babban hanji, sashi na ƙarshe na tsarin narkewa. Ya kasance tsakanin ƙananan hanji da dubura, yana auna kusan 1,5 m kuma ya ƙunshi sassa daban-daban:

• hanjin dama, ko hawan hawan, wanda ke gefen dama na ciki;
• maƙarƙashiya mai jujjuyawa, wanda ke ƙetare ɓangaren sama na ciki kuma ya haɗa hanjin dama zuwa hanjin hagu;
• hanjin hagu, ko saukowa, yana gudana tare da gefen hagu na ciki;
• sigmoid colon shine kashi na ƙarshe na hanjin. Yana haɗa hanjin hagu zuwa dubura.

Ana yin aikin a ƙarƙashin maganin sa barci na gabaɗaya, ta hanyar laparoscopy (laparoscopy) ko laparotomy dangane da fasaha.

Dole ne mu bambanta nau'ikan yanayi guda biyu: shiga tsakani na gaggawa da shiga tsakani (marasa gaggawa), a matsayin ma'aunin rigakafi. A cikin zaɓaɓɓen sigmoidectomy, yawanci ana yin shi don diverticulitis, aikin yana faruwa ne daga mummunan yanayin don ba da damar kumburin ya ragu. Don haka shiri yana yiwuwa. Ya haɗa da colonoscopy don tabbatar da kasancewar da kuma ƙayyade yawan cututtukan da ke da wuyar gaske, da kuma kawar da cututtukan ƙwayar cuta. Ana ba da shawarar rage cin abinci mai ƙarancin fiber na tsawon watanni biyu bayan harin diverticulitis.

Akwai dabaru guda biyu na aiki:

• Anastomosis resection: an cire sashin sigmoid colon mai cuta kuma an yi suture (colorectal anastomosis) don sanya sassan biyu da suka rage a cikin sadarwa kuma don haka tabbatar da ci gaba da narkewa;
• Hartmann's resection (ko m colostomy ko ileostomy tare da kututturen kututture): an cire sashin sigmoid colon mara lafiya, amma ba a dawo da ci gaban narkewar abinci ba. An dinke duburar kuma ya tsaya a wurin. Ana sanya colostomy (“anus wucin gadi”) na ɗan lokaci don tabbatar da fitar da stool (“anus ɗin wucin gadi”). An keɓe wannan fasaha gabaɗaya don sigmoidectomies na gaggawa, a cikin yanayin peritonitis na gaba ɗaya.

Babban alamar sigmoidectomy shine sigmoid diverticulitis. A matsayin tunatarwa, diverticula sune ƙananan hernias a bangon hanji. Muna magana akan diverticulosis lokacin da diverticula da yawa suke. Yawancin lokaci suna asymptomatic, amma bayan lokaci zai iya cika da stools wanda zai bushe, bushe, kuma ya haifar da "plugs" kuma a ƙarshe kumburi. Muna magana akan sigmoid diverticulitis lokacin da wannan kumburi yana zaune a cikin sigmoid colon. Yana da yawa a cikin tsofaffi. CT scan (CT-scan na ciki) shine jarrabawar zabi don bincikar diverticulitis.

Sigmoidectomy, duk da haka, ba a nuna shi a duk diverculitis ba. Maganin rigakafi ta hanyar venous gabaɗaya ya wadatar. Ana yin la'akari da tiyata kawai a cikin yanayin rikice-rikice masu rikitarwa tare da perforation, hadarin wanda shine kamuwa da cuta, kuma a wasu lokuta na sake dawowa, a matsayin prophylactic. A matsayin tunatarwa, rarrabuwar Hinchey, wanda aka haɓaka a cikin 1978, ya bambanta matakai 4 don ƙara tsananin kamuwa da cuta:

• mataki na I: phlegmon ko kumburin lokaci-lokaci;
• mataki na II: kumburin pelvic, na ciki ko retroperitoneal (peritonitis na gida);
• mataki na III: purulent peritonitis;
• mataki IV: fecal peritonitis (perforated diverticulitis).

Zaɓaɓɓen sigmoidectomy, wato zaɓaɓɓu, ana la'akari da shi a wasu lokuta na sake dawowa na diverticulitis mai sauƙi ko na guda ɗaya na diverticulitis mai rikitarwa. Sa'an nan shi ne prophylactic.

Sigmoidectomy na gaggawa, wanda aka yi a lokuta na purulent ko stercoral peritonitis (mataki III da IV).

Sauran alamun sigmoidectomy shine kasancewar ciwon daji mai ciwon daji wanda ke cikin sigmoid colon. Sannan ana haɗa shi da ɓarkewar kumburin lymph don cire duk sarƙoƙin ganglion na hanjin ƙashin ƙugu.

Bayan sigmoidectomy, sauran hanjin za su dauki nauyin aikin sigmoid colon. Ana iya canza hanyar wucewa na ɗan lokaci, amma za a sake komawa ga al'ada a hankali.

A yayin da Hartmann ya shiga tsakani, ana sanya duburar wucin gadi. Yin aiki na biyu na iya, idan majiyyaci bai gabatar da haɗari ba, za a yi la'akari da shi don dawo da ci gaba na narkewa.

Cutar cututtuka na sigmoidectomy na rigakafin yana da girma sosai, tare da kusan kashi 25% na ƙimar rikitarwa kuma ya haɗa da ƙimar sake aiki wanda ke kaiwa ga ganowar duburar wucin gadi wani lokaci ma'anar tsari na 6% a cikin shekara guda na ƙwayar cuta ta prophylactic, in ji Haute Autorité. de Santé a cikin shawarwarin 2017. Wannan shine dalilin da ya sa yanzu ake yin sa baki tare da taka tsantsan.