Cystectomy ndiko kuvhiya kubvisa dundira pasi peanesthesia yakawanda. Zvinosanganisira kugadzwa kwenzira yekubvongodza yekubvisa weti. Kupindira uku kunoitirwa kurapwa kwemamwe magomarara, kana mune vamwe varwere vane chirwere chetsinga kana kurapwa zvinorema izvo zvinoshandura kushanda kwedundira. Mushure mekuita cystectomy, urinary mabasa, zvepabonde uye kubereka zvinokanganiswa.

Cystectomy ndiko kuvhiyiwa kubvisa dundira. Kuvhiya kunogona kuitwa ne laparotomy (kuchekwa pazasi peguvhu) kana ne laparoscopic oparesheni kana pasina robhoti rubatsiro. Kazhinji inosanganisira kubviswa kweprostate muvarume, uye chibereko muvakadzi.

Muzviitiko zvese, zvinosanganisira kugadzwa kweiyo bypass system yekutsiva dundira uye kubvisa weti inogadzirwa neitsvo.

Mhando nhatu dzekubvisa dzinogoneka:

• Iyo ileal neo-bladder, inotariswa kana urethra (chubhu inobvumira weti kuti ibudiswe) inogona kuchengetwa: chiremba anovhiya anovaka dundira kubva pachidimbu cheura chaanoumba kuita dhamu. Inobva yabatanidza homwe iyi kune ureters (machubhu anotakura weti kubva kuitsvo) uye urethra. Iyi neo-bladder inobvumira kubviswa kweweti nenzira dzechisikigo;
• The cutaneous continent bypass: chiremba anovhiya anovaka dundira kubva pachidimbu cheura chaanoumba muchimiro chedhamu. Anobva abatanidza bhegi iri nechubhu yakabatana negonhi padanho reganda iro rinobvumira murwere kuti aite zvenguva dzose kubuda kwemaoko;
• Iyo uretero-ileal bypass maererano naBricker: chiremba anovhiya anobvisa chikamu cheura icho chinobatana neitsvo kuburikidza neureters uye icho chinobatana neganda pedyo neguvhu. Kupera kwechikamu kunoumba kuvhurika kunoonekwa padumbu kunoshanda sechitsigiro chehomwe yekunze yakagadziriswa kurwisa muviri umo weti inogara ichiyerera. Murwere anofanira kubvisa uye kuchinja bhegi iri nguva dzose.

Kugadzirira cystectomy

Kupindira uku kunoda kugadzirira, kunyanya kune varwere vakawanda vasina simba (nhoroondo yemwoyo, anticoagulants, chirwere cheshuga, nezvimwewo) Mumazuva gumi asati avhiyiwa, murwere anofanira kutevera mazano anowanzopiwa neboka rekuvhiya: kuzorora , zvokudya zvishoma, kurega kusvuta. , hapana doro ...

Ura hunogona kushandiswa panguva yekuiswa kwebypass system. Saka zvinofanirwa kugadzirirwa nekudya-kusina chikafu kutanga mazuva mashoma kuvhiyiwa kusati kwaitwa.

Zuva risati rapindira

Murwere anopinda muchipatara zuva risati raitwa oparesheni. Anofanira kunwa mvura inoita kuti ura hubude.

Matanho akasiyana ecystectomy

• Anesthesiologist anoisa epidural catheter pasi peanesthesia yemunharaunda kudzora marwadzo mushure mekuvhiyiwa. Ipapo anoita kuti murwere arare zvakakwana;
• Chiremba anovhiya anobvisa dundira (uye kazhinji prostate uye chibereko) ne laparotomy kana laparoscopic operation;
• Anobva agadzira nzira yekunzvenga weti yekubvisa weti.

Muchiitiko che cystectomy yegomarara, kubviswa kwedundira kunobatanidzwa ne:

• Muvarume, lymph node dissection (kuvhiya kubvisa lymph nodes yose kubva munzvimbo iyo kenza inogona kupararira) uye kubviswa kweprostate;
• Muvakadzi, lymph node dissection uye kubviswa kwe anterior wall yemukadzi uye chibereko.

• Cystectomy ndiyo kurapa kwakajairwa kwegomarara rakakanganisa tsandanyama yedundira, iyo yakaipisisa mhando yegomarara redundi;
• Cystectomy inogona kurongerwa kenza yedundira iyo isati yasvika mhasuru pakaitika kenza kudzoka zvisinei nebundu resections (kubviswa kwebundu kubva munhengo) uye kurapwa kwezvinodhaka kunotsanangurwa semutsara wekutanga;
• Pakupedzisira, kubviswa kwedundira kunogona kutariswa mune vamwe varwere vane chirwere chetsinga kana kurapwa kunorema (radiotherapy) iyo inoshandura kushanda kwedundira.

Mazuva akatevera kuvhiyiwa

• Murwere anoiswa muhutano hwakanyanya kuitira kuti boka rezvokurapa rigone kudzora marwadzo (epidural catheter), urinary function (kuongororwa kweropa), kushanda kwakakodzera kwevatungamiri uye kutangazve kwekufambisa;
• Weti inodururwa nekatheta, uye nzvimbo inoshandiswa inodonhedzwa nekunze kwemvura kune rumwe rutivi rwedumbu redumbu;
• Chikwata chinova nechokwadi chekuti murwere anowanazve kuzvitonga nekukurumidza sezvinobvira;
• Nguva yekuiswa muchipatara ingangoita mazuva gumi.

Ngozi uye zvinetso

Matambudziko anogona kuoneka mumazuva anotevera kuvhiyiwa:

• Kubuda ropa;
• Phlebitis uye pulmonary embolism;
• Zvirwere (weti, lining, vanga kana generalized);
• Urinary complications (kuwedzera kwedumbu remukati, kuderera pamwero we suture pakati peura uye urinary ducts, nezvimwewo);
• Zvinetso zvekugaya (kuvharwa kwematumbo, ronda remudumbu, nezvimwewo)

Zvikanganiso

Cystectomy kupindira kune sequelae pane weti uye zvepabonde mabasa:

• Zvepabonde uye kubereka zvinokanganiswa;
• Muvarume, kubviswa kweprostate kunotungamirira mukurasikirwa kweimwe nzira dzekugadzirisa;
• Continence (kukwanisa kudzora kubuda kweweti) inogadziriswa zvakanyanya;
• Husiku, varwere vanofanira kumuka kuti vabudise dundira uye kudzivirira kubuda.