تعريف
A small bowel resection is the removal of part of the small intestine. The small intestine includes the duodenum, jejunum, and ileum. The surgery can be done through an open incision or using smaller incisions.
أسباب هذا الإجراء
This procedure may be done to treat the following conditions:
- Bleeding, infection, or ulcers in the small intestines
- Cancer
- Precancerous polyps
- مرض كرون
- انسداد معوي
- إصابة
المضاعفات المحتملة
Complications are rare, but no procedure is completely free of risk. If you are planning to have a resection, your doctor will review a list of possible complications, which may include:
- نزيف شديد
- العدوى
- Blockage of the intestine caused by scar tissue
- Hernia formation at the incision site
تشمل العوامل التي قد تزيد من خطر حدوث مضاعفات ما يلي:
- التدخين
- جراحة سابقة في البطن
- سوء التغذية
- Chronic illness
- تعاطي المخدرات
ما يمكن توقعه
قبل الإجراء
قد يقوم طبيبك بما يلي:
- اختبار بدني
- اختبارات الدم والبول
- X-rays of the chest and abdomen
- الأشعة المقطعية للبطن
المؤدية إلى الإجراء الخاص بك:
- التحدث مع طبيبك عن الأدوية الخاصة بك. قد يطلب منك التوقف عن تناول بعض الأدوية تصل إلى أسبوع واحد قبل العملية مثل:
- الأسبرين أو غيره من العقاقير المضادة للالتهابات
- مميعات الدم
- Take medicines as recommended by your doctor. This may include antibiotics.
- Your intestines should be cleaned out for the surgery. During the week before surgery, eat high-fiber foods and drink plenty of water. This will encourage bowel movements. Other cleansing methods may also be recommended, including enemas, laxatives, and a clear-liquid diet. You may be asked to drink a large container of solution that helps with the complete emptying of your intestines.
- Begin fasting as directed by your doctor.
التخدير
General anesthesia will be given. You will be asleep.
الوصف الداخلي
The procedure may be done with one of two methods:
- Traditional open incision—An incision will be made into the abdomen in the area of the diseased intestine.
- Laparoscopic technique—A few small incisions will be made in the abdomen. Carbon dioxide gas will be pumped into the abdomen through an incision. A laparoscope, which is a thin tube with a small camera on the end, will be inserted through the incisions. Special tools will also be inserted through these incisions. The laparoscope sends a view of the interior of the abdomen to a video monitor.
In either type of surgery, the small intestine will be clamped above and below the diseased section. This section will be cut free and removed.
If there is enough healthy intestine left, the free ends of the intestine may be joined together. Otherwise, a permanent or temporary ileostomy is created. An ileostomy is an opening called a stoma in the abdomen. The end of the small intestine closest to the stomach is attached to the opening. This allows intestinal contents to drain into a sealed pouch on the outside of the body. If a temporary ileostomy is created, another operation will be necessary several months later to reverse it.
The abdomen incisions will be closed with stitches.
كم من الوقت سيستغرق ؟
About 1-4 hours
كم هو مؤلم ؟
Anesthesia prevents pain during the procedure. Talk to your doctor about medicine to help manage the pain in recovery.
متوسط الإقامة في المستشفى
The usual length of stay is 5-7 days. Your doctor may choose to keep you longer if complications arise.
رعاية ما بعد العملية
في المستشفى
A catheter will be placed in your bladder before surgery. You will also have a nasogastric tube. This is a small tube that goes in through your nose and down into your stomach. The tube may be used to drain fluids from your stomach or to help deliver food to your stomach. The catheter and tube will remain until you are able to eat and go to the bathroom normally.
في البيت
عند عودتك إلى المنزل، قم بما يلي للمساعدة في ضمان التعافي بسلاسة:
- Your doctor will tell you when you can resume your normal activities.
- Check with you doctor about doing any heavy lifting or tiring activities.
- Do not drive unless your doctor has given you permission to do so.
- اسأل طبيبك حول, عندما هي آمنة للاستحمام, السباحة, أو نقع في الماء.
- Exercise your legs while in bed to prevent blood clots.
- If you go home with an ileostomy, you will receive instructions on how to change the bag and maintain personal hygiene.
- تأكد من اتباع تعليمات طبيبك.
استدعاء الطبيب
بعد مغادرة المستشفى، اتصل بطبيبك في حالة حدوث أي مما يلي:
- علامات الإصابة, بما في ذلك حمى وقشعريرة
- Any redness, swelling, bleeding, or drainage from the incision site
- Your bandage becomes soaked with blood
- Stitches or staples come apart
- الغثيان و / أو القيء الذي لا يمكنك السيطرة عليه بالأدوية التي أعطيت لك بعد الجراحة ، أو التي تستمر لأكثر من يومين بعد الخروج من المستشفى
- Persistent abdominal pain or bloating
- Constipation or diarrhea
- Rectal bleeding or tarry-colored stools
- ألم لا يمكنك السيطرة عليه بالأدوية التي أعطيت لك
- السعال، ضيق التنفس، أو ألم في الصدر
- ألم أو حرقة أو إلحاح أو كثرة التبول أو استمرار ظهور الدم في البول
- New symptoms
في حالة الطوارئ ، اتصل على المساعدة الطبية على الفور.