Noi oʻoki ʻoki arc stapler
ʻO ka maʻi maʻi ʻaʻai haʻahaʻa e kuhikuhi i ka ʻōpū haʻahaʻa ma ka ʻaoʻao o ka anal 7cm ma lalo a i ʻole aia ma ka ʻāʻī o ka rectum o 1/3 paukū.Ua hōʻoia ʻia nā noiʻi pathological i ka palena o ka hiki ʻana o ka maʻi maʻi rectal i ka paia ākea a ʻoi aku ka liʻiliʻi o 3% ma mua o 2cm.No laila, ua lawa ka wehe ʻana o ka maʻi ʻaʻai ʻāʻī me ka ʻāpana ʻōpū i ʻoi aku ma mua o 2cm, no laila e hoʻonui i nā hōʻailona no ka resection haʻahaʻa mua o ka maʻi maʻi rectal a me ka hāʻawi ʻana i ke kumu theoretical no ka ʻoki ʻana i ka anus-preserve no ka maʻi kanesa rectal haʻahaʻa.I ka manawa like, ua hōʻike ka nui o nā hana hoʻomaʻamaʻa a me nā haʻawina hoʻokolohua pelvic floor e like me ka lōʻihi o ka mālama pono ʻana o ka anal canal, anal sphincter a me levator anus, hiki ke mālama ʻia ka anus e mālama i ka hana defecation maʻamau.ʻO ka noiʻi ʻana i ka pathology i ka ʻike hohonu loa o ka colorectal cancer biology behavior specialization of colorectal surgeon protect anal ʻenehana i ʻoi aku ka mākaukau a ʻike ʻia nā stapling like ʻole o ka hoʻohana ʻana i nā stapling pālua a me ka hoʻomaikaʻi ʻana i mea e hoʻonui ai i nā kauka lapaʻau i ka ultra-low anastomosis hiki ʻole ke ʻenehana. nā pilikia e hoʻololi ai i ka piʻi ʻana o ka poʻe maʻi maʻi maʻi maʻi rectal o anus.
Me ka hoʻohana nui ʻana o ka ʻenehana stapler pālua, ʻike ʻia no kekahi mau maʻi me ka pelvis haiki a me ka momona, ʻo ka mea pani laina laina mua he nui nā hemahema, kahi e lilo ai kekahi mau mea maʻi i ka manawa o ka mālama anal.ʻO ka ʻokiʻoki ʻana i ka anastomat ma muli o kona ʻāʻī kūʻokoʻa kūʻokoʻa e hoʻolālā e like me ke kino o ke kanaka o ke ʻano pelvic maʻalahi e kikoo a hiki i ke kūlana o ka papahele pelvic hohonu i ʻoki ʻia a humuhumu i ka synchronization i hoʻopau ʻia e hōʻemi hou i ka pollution e pale i ka mea pani laina pono e lawe ʻia. i loko o kahi haiki loa o nā pilikia a hiki i ka hopena o ka ʻoki ʻoki ʻana i ka ʻeha;Hoʻomaʻamaʻa ka stapler ʻoki arc i nā ʻanuʻu hana o ka wehe ʻana i ka rectum distal a hoʻopōkole i ka manawa hana, e ʻoi aku ka maʻalahi o ka anastomosis pālua.Ua hōʻike ʻia ʻo ka loaʻa ʻana o ka fistula anastomotic postoperative ma waena o 2.5-5.0% no nā ʻenehana anastomotic pālua me ka hoʻohana ʻana i nā stapler linear.I loko o kēia hui, ʻo ka nui o ka postoperative anastomotic fistula he 4.3% ma 46 mau maʻi me ka haʻahaʻa haʻahaʻa rectal maʻi maʻi i hana i ka mālama mālama anus me ka ʻoki ʻoki arc me ka ʻole o ke koko anastomotic a i ʻole stenosis. o ka ultra-low rectal cancer anterior resection me ka hoʻonui ʻole i ka nui o nā pilikia anastomotic.Eia naʻe, ʻoi aku ka nui o nā ʻikepili e hōʻoia i kona pono i ka hōʻemi ʻana i ka nui o ka anastomotic fistula i hoʻohālikelike ʻia me ka linear stapler.
E like me ka linear stapler, ʻo ka hoʻopiʻi o ka mālama ʻana i ka anus rectal haʻahaʻa me ka hoʻohana ʻana i ka stapler ʻoki arc ka nui o ka leakage anastomotic, anastomotic bleeding, anastomotic stenosis, positive incision margin, rectovaginal fistula, postoperative urinary retention and sexual dysfunction.ʻAʻohe koko anastomotic, anastomotic stenosis a me rectovaginal fistula, akā 2 mau hihia o anastomotic fistula.Hoʻohui ʻia me nā palapala e hōʻuluʻulu i nā ʻike o kēia noi arc ʻoki anastomat kumu kumu nui no ka anastomotic fistula kahi anastomotic kahi hohonu, paʻakikī ka hana, ka nui o ke koko ʻilihune kūloko a i ʻole ka ʻeha, intraoperative a postoperative drainage ʻaʻole ka pollution manuahi a me nā kumu kūloko a me ka lehulehu ʻilihune. ʻO ke kūlana, obesity, pelvic cavity he haiki liʻiliʻi, preoperative anticancer therapy, systemic factors like diabetes mellitus.
I mea e pale ai i ka hiki ʻana mai o ka anastomotic fistula, pono e uku ʻia i nā ʻano aʻe i ka wā e hoʻohana ai i ka ʻoki arc a me ka suturing device no ka mālama anal haʻahaʻa o ka maʻi maʻi rectal.
Nā kiko e pono ai ka nānā ʻana i ka mea ʻoki ʻoki arc
(1) hoʻohana akamai i nā mea anastomotic i ka hana maikaʻi.(2) Ua hoʻokaʻawale maikaʻi ʻia ka colon proximal ma ke ʻano o ka hoʻomaʻamaʻa radical me ka ʻole o ka ʻeha anastomotic.Ke hoʻohuoi ʻia ka haʻalulu, pono e hoʻokaʻawale loa ʻia ke kolonā proximal a i ʻole e hoʻokuʻu ʻia ka colonic splenic flexure.(3) Hoʻolako koko maikaʻi no ka anastomosis.ʻAʻole nui ka nui o ka mesangium ma ka ʻaoʻao a me ka mamao e wehe i ka momona o ka paia o ka ʻōpū.(4) Ke koho ʻana i kahi kahua anastomotic: pono e hoʻoneʻe ʻia ke kahua anastomotic ma ka ʻaoʻao haʻahaʻa o ka ʻaoʻao hope ma ka waena waena o ka ʻaoʻao pani o ka rectum, a ʻo ka paia o ka ʻōpū e loaʻa kekahi hapa o ka palena pani o ka rectum.No ka mea, ʻoi aku ka nui o ka loaʻa ʻana o ka ʻāʻī hope ma mua o ka hāʻawi ʻana i ke koko ventral.I ka manawa like, inā ua hoʻokumu ʻia ke kaula alahaka ma waena o ka ʻoki ʻoki ʻana o ka pahu stapler a me ka lihi pani o ka rectum, ua maʻalahi ke kumu i ka paia o ka ʻōpū o ke alahaka ischemia necrosis a me ka fistula.(5) Ma hope koke iho o ka pau ʻana o ka anastomosis, e nānā inā ua paʻa nā apo excision luna a me lalo.Inā loaʻa kahi kīnā, hiki ke hoʻoikaika ʻia ka pūnaewele pili.I ka manawa like, ua hana ʻia ka nānā ʻana i ka manamana lima ma hope o ka anastomosis e nānā inā aia nā kui anastomotic i kahi pōʻai maʻamau.
I ka hopena, e like me ka hoʻomaikaʻi ʻana i ka ʻenehana stapler pālua, hiki ke hoʻokomo ʻia ka stapler ʻoki arc kū hoʻokahi i loko o ka lua pelvic haʻahaʻa.ʻO kāna noi ʻana i ka resection mua o ka maʻi kanesa rectal haʻahaʻa he palekana a maikaʻi hoʻi, ʻoi aku hoʻi no nā poʻe maʻi me kahi wahi maʻi haʻahaʻa a me ka hana paʻakikī.
Ka manawa hoʻouna: Jan-14-2022