Sigmoidectomy ndi opaleshoni yochotsa gawo lomaliza la m'matumbo, sigmoid colon. Zimaganiziridwa nthawi zina za sigmoid diverticulitis, zomwe zimachitika mwa okalamba, kapena chotupa cha khansa chomwe chili pa sigmoid colon.

Sigmoidectomy, kapena sigmoid resection, ndi kuchotsa opaleshoni ya sigmoid colon. Uwu ndi mtundu wa colectomy (kuchotsa gawo la m'matumbo). 

Monga chikumbutso, m'matumbo amapanga ndi rectum matumbo akuluakulu, gawo lomaliza la m'mimba. Ili pakati pa matumbo aang'ono ndi rectum, imatalika pafupifupi 1,5 m ndipo ili ndi zigawo zosiyanasiyana:

• m'matumbo kumanja, kapena m'matumbo okwera, omwe ali kumanja kwa pamimba;
• koloni yopingasa, yomwe imadutsa kumtunda kwa mimba ndikugwirizanitsa koloni yolondola kumtunda wakumanzere;
• matumbo akumanzere, kapena m'matumbo otsika, amayenda kumanzere kwa mimba;
• sigmoid colon ndi gawo lomaliza la colon. Zimagwirizanitsa matumbo akumanzere ndi rectum.

Opaleshoni imachitika pansi pa anesthesia wamba, ndi laparoscopy (laparoscopy) kapena laparotomy malinga ndi njirayo.

Tiyenera kusiyanitsa mitundu iwiri ya zinthu: kulowererapo mwadzidzidzi ndi zisankho (zosafunikira), monga njira yodzitetezera. Mu elective sigmoidectomy, yomwe nthawi zambiri imachitidwa chifukwa cha diverticulitis, opaleshoniyo imachitika kutali ndi gawo lopweteka kwambiri kuti kutupa kuchepetse. Kukonzekera ndiko kotheka. Zimaphatikizapo colonoscopy kutsimikizira kupezeka ndi kudziwa kukula kwa matenda a diverticular, ndikuchotsa chotupa chotupa. A otsika CHIKWANGWANI zakudya tikulimbikitsidwa kwa miyezi iwiri pambuyo kuukira diverticulitis.

Pali njira ziwiri zogwiritsira ntchito:

• anastomosis resection: gawo la matenda a sigmoid colon amachotsedwa ndipo suture imapangidwa (colorectal anastomosis) kuyika magawo awiri otsalawo mukulankhulana motero kuonetsetsa kuti kugaya chakudya;
• Hartmann's resection (kapena terminal colostomy kapena ileostomy yokhala ndi chitsa cha rectal): gawo lomwe lili ndi matenda a sigmoid colon limachotsedwa, koma kupitilira kwa kugaya sikubwezeretsedwa. The rectum ndi sutured ndipo amakhala pamalo. Colostomy ("artificial anus") imayikidwa kwakanthawi kuti zitsimikizire kutuluka kwa chopondapo ("artificial anus"). Njira imeneyi nthawi zambiri imasungidwa kwa sigmoidectomy yodzidzimutsa, pakachitika matenda a peritonitis.

Chizindikiro chachikulu cha sigmoidectomy ndi sigmoid diverticulitis. Monga chikumbutso, diverticula ndi zotupa zazing'ono pakhoma la colon. Timalankhula za diverticulosis pamene ma diverticula angapo alipo. Nthawi zambiri amakhala asymptomatic, koma m'kupita kwanthawi amatha kudzaza ndi zinyalala zomwe zimakhazikika, zouma, ndikupangitsa "mapulagi" ndipo pamapeto pake kutupa. Timalankhula za sigmoid diverticulitis pamene kutupa uku kumakhala mu sigmoid colon. Ndizofala kwa okalamba. CT scan (m'mimba CT-scan) ndiye mayeso osankhidwa kuti azindikire diverticulitis.

Sigmoidectomy si, komabe, ikuwonetsedwa mu diverculitis yonse. Kumwa maantibayotiki kudzera munjira ya venous nthawi zambiri kumakhala kokwanira. Kuchita opaleshoni kumangoganiziridwa pokhapokha ngati pali diverticulum yovuta ndi perforation, chiopsezo chake ndi matenda, ndipo nthawi zina kubwereza, monga prophylactic. Monga chikumbutso, gulu la Hinchey, lomwe linapangidwa mu 1978, limasiyanitsa magawo anayi kuti awonjezere kuopsa kwa matendawa:

• Gawo I: phlegmon kapena periodic abscess;
• Gawo II: abscess m'chiuno, m'mimba kapena retroperitoneal (localized peritonitis);
• Gawo lachitatu: purulent peritonitis;
• Gawo IV: fecal peritonitis (perforated diverticulitis).

Kusankha sigmoidectomy, ndiko kuti kusankha, kumaganiziridwa nthawi zina za kubwereza kwa diverticulitis yosavuta kapena gawo limodzi la diverticulitis yovuta. Pambuyo pake, ndi prophylactic.

Emergency sigmoidectomy, yochitidwa ngati purulent kapena stercoral peritonitis (gawo III ndi IV).

Chizindikiro china cha sigmoidectomy ndi kukhalapo kwa chotupa cha khansa chomwe chili m'matumbo a sigmoid. Kenako imalumikizidwa ndi dissection ya lymph node kuchotsa maunyolo onse am'mimba.

Pambuyo pa sigmoidectomy, m'matumbo onsewo mwachibadwa adzagwira ntchito ya sigmoid colon. Ulendowu ukhoza kusinthidwa kwa kanthawi, koma kubwerera kuzinthu zachilendo kudzachitika pang'onopang'ono.

Kukachitika kuti Hartmann alowererepo, anus yochita kupanga imayikidwa. Opaleshoni yachiwiri ingathe, ngati wodwalayo alibe chiopsezo, angaganizidwe kuti akubwezeretsa kugaya chakudya.

Kuwonongeka kwa sigmoidectomy yodzitetezera ndikokwera kwambiri, pafupifupi 25% ya kuchuluka kwa zovuta ndipo kumaphatikizanso kuyambiranso komwe kumatsogolera ku kuzindikira kwa anus opangira nthawi zina otsimikizika a dongosolo la 6% pa chaka chimodzi cha prophylactic colostomy, amakumbukira Haute Autorité. de Santé mu malingaliro ake a 2017. Ichi ndichifukwa chake kulowererapo kwa prophylactic tsopano kumachitidwa mosamala kwambiri.