Sigmoidectomy ndiko kubviswa kwekuvhiya kwechikamu chekupedzisira chekoloni, iyo sigmoid colon. Inofungidzirwa mune zvimwe zviitiko zve sigmoid diverticulitis, mamiriro akajairika kune vakwegura, kana gomarara regomarara riri pane sigmoid colon.

Sigmoidectomy, kana sigmoid resection, ndiko kuvhiya kubviswa kwe sigmoid colon. Iyi imhando yecolectomy (kubviswa kwechikamu chekoroni). 

Sechiyeuchidzo, colon inoumba nerectum dumbu guru, chikamu chekupedzisira chegumbo rekudya. Iri pakati pedumbu mudiki uye rectum, inoyera ingangoita 1,5 m uye inoumbwa nezvikamu zvakasiyana:

• iyo colon yekurudyi, kana inokwira colon, iri kurudyi rwedumbu;
• iyo yakachinjika colon, inoyambuka chikamu chepamusoro chedumbu uye inobatanidza koroni yekurudyi nekoroni yekuruboshwe;
• koroni yekuruboshwe, kana kuti inodzika colon, inomhanya nekuruboshwe rwedumbu;
• iyo sigmoid colon ndiyo yekupedzisira chikamu chekoroni. Iyo inobatanidza colon yekuruboshwe kune rectum.

Kuvhiya kunoitika pasi peanesthesia, ne laparoscopy (laparoscopy) kana laparotomy zvichienderana nehunyanzvi.

Tinofanira kusiyanisa marudzi maviri emamiriro ezvinhu: kupindira kwekukurumidzira uye kupindira kwakasarudzwa (kwete-kukurumidza), senzira yekudzivirira. Mukusarudza sigmoidectomy, inowanzoitirwa diverticulitis, kuvhiyiwa kunoitika kure neacute episode kubvumira kuzvimba kuderera. Kugadzirira naizvozvo kunobvira. Inosanganisira colonoscopy yekusimbisa kuvepo uye kuona huwandu hwechirwere che diverticular, uye kutonga kunze tumor pathology. Kudya kwakaderera-fiber kunokurudzirwa kwemwedzi miviri mushure mekurwiswa kwe diverticulitis.

Pane nzira mbiri dzekushandisa:

• anastomosis resection: chikamu chechirwere che sigmoid colon chinobviswa uye suture inogadzirwa (colorectal anastomosis) kuisa zvikamu zviviri zvakasara mukukurukurirana uye nokudaro kuvimbisa kuenderera kwekudya;
• Hartmann's resection (kana kuti terminal colostomy kana ileostomy ine rectal stump): chirwere che sigmoid colon segment chinobviswa, asi kuenderera kwekugaya hakudzorereki. The rectum is sutured uye inogara panzvimbo. A colostomy ("artificial anus") inoiswa kwenguva pfupi kuti ive nechokwadi chekubuda kwechituru ("artificial anus"). Iyi nzira inowanzochengeterwa emergency sigmoidectomy, kana paine generalized peritonitis.

Chiratidzo chikuru che sigmoidectomy is sigmoid diverticulitis. Sechiyeuchidzo, diverticula idiki hernias mumadziro ekoloni. Isu tinotaura nezve diverticulosis kana akati wandei diverticula aripo. Anowanzo asymptomatic, asi nekufamba kwenguva anogona kuzadza nezvituru zvinomira, kuoma, uye kutungamirira ku "plugs" uye pakupedzisira kuzvimba. Isu tinobva tataura nezve sigmoid diverticulitis kana kuzvimba uku kunogara mu sigmoid colon. Zvinowanzoitika kune vakwegura. Iyo CT scan (abdominal CT-scan) ndiyo bvunzo yesarudzo yekuongorora diverticulitis.

Sigmoidectomy haina, zvisinei, inoratidzwa mune zvese diverculitis. Mushonga unorwisa mabhakitiriya nenzira yevenous unowanzo kukwana. Kuvhiya kunongotariswa muchiitiko che diverticulum yakaoma ine perforation, njodzi yehutachiona, uye mune zvimwe zviitiko zvekudzokazve, seprophylactic. Sechiyeuchidzo, kupatsanurwa kweHinchey, kwakagadzirwa muna 1978, kunosiyanisa nhanho ina muhurongwa hwekuwedzera kuomarara kwehutachiona:

• danho I: phlegmon kana periodic abscess;
• danho II: pelvic, abdominal kana retroperitoneal abscess (localized peritonitis);
• danho III: generalized purulent peritonitis;
• danho IV: fecal peritonitis (perforated diverticulitis).

Elective sigmoidectomy, kureva kuti elective, inoonekwa mune zvimwe zviitiko zvekudzokorora nyore diverticulitis kana chikamu chimwe chezvakaoma diverticulitis. Zvadaro, inonzi prophylactic.

Emergency sigmoidectomy, inoitwa muzviitiko zvepurulent kana stercoral peritonitis (danho III uye IV).

Chimwe chinoratidza sigmoidectomy kuvapo kwebundu regomarara riri mu sigmoid colon. Inobva yabatanidzwa ne lymph node dissection kubvisa zvose ganglion cheni dzepelvic colon.

Mushure me sigmoidectomy, iyo yese yekoloni inongogara inotora basa reiyo sigmoid colon. Kufamba kunogona kugadziridzwa kwechinguva, asi kudzokera kune zvakajairika kuchaitwa zvishoma nezvishoma.

Muchiitiko chekupindira kwaHartmann, anus yakagadzirwa inoiswa. Kuvhiya kwechipiri kunogona, kana murwere asina njodzi, kutariswa kudzoreredza kuenderera kwekugaya.

Chirwere chekudzivirira sigmoidectomy chakanyanya kukwirira, uye inosvika makumi maviri neshanu muzana yehuwandu hwekunetseka uye inosanganisira chiyero chekushandazve chinotungamira pakuzadzikiswa kweartificial anus dzimwe nguva inotsanangurwa yekuraira kwe25% pagore rimwe reiyo prophylactic colostomy, anoyeuka iyo Haute Autorité. de Santé mune yayo 6 kurudziro. Ichi ndicho chikonzero kupindira kweprophylactic ikozvino kunoitwa nekuchenjerera kukuru.