Gukoresha ivuriro rya arc-ishusho yo gukata stapler

Gushyira mu bikorwaarc gukata

Kanseri y'urwungano ngogozi ni iyo kwerekana ikibyimba cyo hasi gitandukanijwe na anal ya 7cm munsi cyangwa kiri muri rectum rectum ya 1/3 paragarafu.Ubushakashatsi bw’ubuvuzi bwemeje ko kanseri y'inkondo y'umura yinjira mu rukuta rwa kure ari nto kandi munsi ya 3% ikaba irenze 2cm.Kubwibyo rero, kwandura kanseri y’ururenda rwa kure hamwe n’igice cyo mu nda kirenze 2cm birahagije, bityo bikagura ibimenyetso byerekana ko kanseri y’imbere yanduye kandi ikanatanga umusingi w’amahame yo kubaga anus-kanseri yo kubaga kanseri yo mu mara.Muri icyo gihe, umubare munini w’ubuvuzi hamwe n’ubushakashatsi bwakozwe na pelvic hasi bwerekanye ko mugihe cyose umuyoboro wa anal, sphincter anal na levator anus ubitswe neza, anus irashobora kubikwa kugirango ikomeze imikorere isanzwe.Ubushakashatsi bwa Pathologiya kugirango bwunvikane byimbitse kubyerekeranye na kanseri yibara ya biologiya imyitwarire yihariye ya chirurgie chirurgie irinda ikoranabuhanga rya anal ikunda kuba abahanga kandi stapling zitandukanye zigaragara cyane cyane ikoreshwa rya staping ebyiri no kunoza uburyo bwo kubaga benshi kandi babaga kuri ultra-low anastomose idashoboka tekiniki imbogamizi zo kumenyera abarwayi ba kanseri y'inkondo y'umura igenda yiyongera.

Hamwe nogukoresha cyane tekinoroji ya stapler ebyiri, usanga ko kubarwayi bamwe na bamwe bafite umubyimba muto kandi ufite umubyibuho ukabije, igikoresho cyambere cyo gufunga umurongo gifite inenge nyinshi, bigatuma abarwayi bamwe batakaza amahirwe yo kubungabunga anal.Arc gukata anastomat kubera inama yihariye igoramye yogushushanya bihuye numubiri wumuntu wuburyo bwa pelvic byoroshye kurambura kugera kumwanya wa pelvic byimbitse byacagaguye no kudoda syncronisation yarangije bikomeza kugabanya umwanda kugirango wirinde igikoresho cyo gufunga umurongo kigomba gukorwa. mu mwanya muto cyane w'ingorane hamwe n'ibisubizo bivamo urukiramende rushobora gukomeretsa bishobora;Gukata stapler ya arc yoroshya intambwe yo gukora ya kure ya rectum ya kure kandi igabanya igihe cyo gukora, bigatuma anastomose ebyiri byoroha kandi birashoboka.Byatangajwe ko indwara ya fistula ya anastomotique nyuma yo kubagwa ikunze kuba hagati ya 2,5-5.0% kubuhanga bubiri bwa anastomotike ikoresheje umurongo.Muri iri tsinda, indwara ya fistula ya anastomotique nyuma yo kubagwa yari 4.3% ku barwayi 46 barwaye kanseri yo mu mura yabazwe no kubaga anus hamwe na stapler yo gukata arc idafite amaraso ya anastomotique cyangwa stenosis, byerekana ko ishyirwa mu bikorwa ry’imigozi igira uruhare mu kurangiza neza. ya ultra-low rectal kanseri yimbere imbere itiriwe yongera ibibazo bya anastomotic.Nyamara, amakuru menshi arakenewe kugirango yemeze ibyiza byayo mukugabanya kwandura fistula ya anastomotique ugereranije numurongo wa stapler.

Kimwe na stapler y'umurongo, ingorane zo kurinda kanseri y'inkondo y'umura ikingira ikoresheje arc gukata cyane cyane harimo kumeneka kwa anastomotic, kuva amaraso ya anastomotique, stenosis ya anastomotique, kwandura neza, fistula ya rectovaginal, gufata inkari nyuma yo kubagwa no gukora nabi imibonano mpuzabitsina.Nta maraso ya anastomotique, stenosis ya anastomotique na fistula ya rectovaginal, ariko inshuro 2 za fistula ya anastomotique.Ufatanije nubuvanganzo kugirango tuvuge muri make uburambe bwiyi porogaramu arc guca anastomat impamvu nyamukuru ya fistula ya anastomotique ni ahantu h'imiterere ya anastomotike yimbitse, ikora igoye, imiyoboro minini y’amaraso idahwitse cyangwa impagarara, imiyoboro idahwitse na nyuma yibikorwa ntabwo ari umwanda wubusa nibintu byaho hamwe na rusange bakennye muri rusange imiterere, umubyibuho ukabije, cavit pelvic ni ntoya, kuvura anticancer mbere yo gutangira, ibintu bya sisitemu nka diabete mellitus.

Kugirango wirinde ko habaho fistula ya anastomotique, hagomba kwitonderwa ibintu bikurikira mugihe ukoresheje ibikoresho byo gutema arc no kudoda kugirango ubungabunge buke bwa kanseri yinkondo y'umura.