Sibuze udokotela ohlinzayo odumile wase-Austria uHarald Rosen mayelana nokuthi ukuhlinzwa kwe-bariatric kuyipanacea yini ekwelashweni kwesifo sikashukela sohlobo 2 ezigulini ezikhuluphele, noma ngabe ukuhlinzwa kwe-gastric bypass kunezinzuzo ngaphezulu kwe-gastroplasty yemikhono, kungaba yiphi ingozi “kuma-kilojoule”.
Umshumeli wethu namuhla nguHarald Rosen, onguchwepheshe kwezokuhlinza jikelele kanye ne-coloproctology, uprofesa woMnyango Wezobuchwepheshe e-Sigmund Freud University of Vienna (Austria), umongameli we-European Society of Surgeons kusukela ngo-2004. Ngenxa ye-odokotela ohlinzayo odumile, kwenziwa imisebenzi eminingi ye-bariatric. Sibuze uMnu. Rosen ukuthi abelane ngolwazi nesipiliyoni sakhe futhi asitshele ukuthi iziguli ezinesifo esikhulu ngokweqile kanye nohlobo 2 lwesifo sikashukela zingalindela ini ngemuva kokungenelela okufanele kokuhlinzwa.
I-Diabeteshelp.i-org: UMnu Rosen, ukuzelapho ubudlelwano phakathi ukufeza i-bariatricx ukusebenzath futhi ukwelapha ushukela ezigulini?
UDkt. Harald Rosen: Sekuyiminyaka eminingi manje, ukuhlinzwa kwe-bariatric kusetshenziselwa ukwelapha isisindo esibi ngokweqile. Ukuzijwayeza kukhombisa ukuthi ngale ndlela, ukwehla kwesisindo ezigulini kuhambisana nokujwayelekile kwama-lipids, ngaphambilini abebephakanyisiwe ngenxa yesifo sikashukela. Ngokusho okusha okutholwe cishe eminyakeni engu-7 edlule, ukuhlinzwa kwe-bariatric kusebenza kakhulu ekwelapheni uhlobo lwesifo sikashukela sohlobo 2.
Amazinga kashukela egazini ajwayelekile ngokushesha nje ngemuva kokuhlinzwa, izinyanga ezimbalwa ngaphambi kokuba isiguli sinokwehla okukhulu kwesisindo somzimba.
I-Diabeteshelp.i-org: Ngabe kukhona izibalo ezisemthethweni ezibonisa ukusetshenziswa ngempumelelo kwe-bariatria ekwelapheni isifo sikashukela?
UDkt. H.R. Uma ucacisa "isifo sikashukela", "ukuhlinzwa kwe-bariatric" / "i-bariatric", kanye "nokuhlinzwa kwe-metabolic" njengemikhakha yokusesha enjini yokusesha yedatha ye-PubMed, uzothola ukushicilelwa okuningi okuvela ezikhungweni ezahlukahlukene, imiphumela yocwaningo eqinisekisa imininingwane yokubonwa.
I-Diabeteshelp.i-org: Ngabe ucabanga ukuthi uyini umphumela wokusebenza ngempumelelo ekwelashweni kwesifo sikashukela?
UDkt. H.R. Lokhu kungenxa yezici ezimbili, ngizohlala phezu kwazo ngemininingwane eminingi. Okokuqala, ukuncishiswa okuphelele kilojoule yansuku zonke edliwayo, okutholakala ngokunciphisa umthamo wesisu noma ngesikhathi sokuhlinzwa kwe-gastric bypass, noma ngesikhathi sokukhipha esiswini kwesisu.
Okwesibili, ukuvimbela ukukhishwa kwama-hormone e-endocrine asebenzayo. Okuphumelela kakhulu kulokhu ukusebenza kwe-shunt, ngenxa yalokho ukudla kudlula i-duodenum.
I-Diabeteshelp.i-org: Ngabe ucabanga ukuthi i-bariatria iyi-panacea yangempela yeziguli ezinesifo sikashukela? Noma, ukubeka umbuzo ngendlela ehlukile, ingabe iphesenti lokuhluleka okungaphezulu liphezulu?
UDkt. H.R. Endabeni yokuhlinzwa kwe-bariatric, i-15-20% yeziguli ihlala inethuba lokuthi ukwelashwa ngeke kulethe imiphumela efunwayo. Ikakhulu, ukuhlinzwa kwe-gastric bypass kungenzeka kungasebenzi. Isizathu salokhu kungaba ukuthi sidle kakhulu usuku lonke, ngenxa yalokho amakholori aqhubeka engena emzimbeni wesiguli, noma ukucaciswa kobuchwepheshe bokuhlinzwa. Isibonelo, kwesinye isikhathi odokotela abahlinzayo bashiya isisu esikhulu kakhulu (“isikhwama”) noma sifushane kakhulu isigaba sethimba elicishiwe, okuholela ekutheni i-malabsorption (ukungangeni kahle kwezakhi zomzimba).
I-Diabeteshelp.i-org: Njengoba wazi, ngeikhona izinhlobo ezimbili ukuhlinzwa kwe-bariatric. Kungenzeka yini ukusho ukuthi ezinye zazo zisebenza kangcono kushukela?
UDkt. H.R. Ukuhlinzwa kabili kwe-bariatric kubhekwa njengokujwayelekile - ukuhlinzwa kwe-gastric bypass kanye ne-gastroplasty yemikhono, noma ukuqiniswa kabusha kwesisu. Ukuhlinzwa kweBypass kubandakanya, okokuqala, ukunciphisa inani lesisu ngokwakha uhlobo lwesisu esiswini, okubizwa ngokuthi "isisu esincane," bese okwesibili, kuvala cishe amamitha amabili wesisu esincane, lapho kudonswa khona izakhamzimba. Ngokungafani nokuqhaqhazela, ukuhlukaniswa kabusha kwesisu esiswini kuphelele ekunciphiseni ivolumu yayo ngokunikeza ukwakheka kweshubhu, noma umkhono. Kuze kube manje, zombili lezi zinhlelo zivame ukwenziwa ngokungahambisani kahle, ngoba ngo-laparoscopy.
Njengoba ngike ngasho, cishe kuma-15-20% wamacala, ukubuya kwesisindo ngokweqile, ngamanye amazwi, ukwelashwa akusebenzi. Uma isiguli siqala ukuthola isisindo futhi, ngokwemvelo, kunethuba lokuphindeka kwezimpawu zesifo sikashukela.
Ngaphezu kwalokho, ukuzijwayeza kukhombisa ukuthi ngemuva kwe-gastroplasty yemikhono, le nkinga ingaqedwa ngokuxhuma isisu. Uma ukwanda kwesisindo okuphindaphindekayo kwenzeka ngemuva kokuqunjelwa, amathuba okuphumelela awaphakeme kangako.
I-Diabeteshelp.i-org: Ngabe ushukela uzobuya uma isiguli singasanamatheli ekudleni futhi sidla konke ngokulandelana, kufaka namaswidi?
UDkt. H.R. Kumkhuba wethu, bekuneziguli eziningana ezinesisindo esiqale ukukhula futhi ngemuva kokwehla okuphumelelayo ngenxa ye-gastroplasty yemikhono. By the way, le ndlela enkulu esetshenziswa emnyangweni wethu. Njengoba ngike ngaphawula, le nkinga iqedwa ngempumelelo ngokuthuthumela.
Inkinga enkulu ephakama kakhulu nge-gastroplasty ye-tubular ukuthi iziguli eziningi zizama “ukukhipha” imikhawulo esevolini yesisu ngokudla lokho okubizwa ngokuthi ama-kilojoule owuketshezi, okungukuthi, iziphuzo ezinekhalori ephezulu, okuholela, naphezu kwethamo elincane lesisu (ngaphansi kwama-200 ml) , isisindo asisuki noma siqala ukukhula ngemuva kokwehla ngempumelelo.
Ngakho-ke, uma, lapho kuxoxiswana ngokudla ngesikhathi sokubonisana kokusebenza okubonakalayo, udokotela uyaqonda ukuthi isiguli sithambekele ekudleni amaswidi ngamanani amakhulu, kunconyelwa ukubheka inketho yokuhlinzwa kokuhlinzwa kwesibeletho kuqala.
Iqiniso liwukuthi ngemuva kokuhlinzwa ngasesiswini okudlula esiswini, ukusebenzisa ushukela ngokweqile kungavusa le mizwa okuthiwa yi-dumping syndrome.
Ngale nkinga, izimpawu ezizimele zokuzimela, njengokujuluka ngokweqile nesiyezi, ziqala ukuvela imizuzu eyi-15 ngemuva kokudla ushukela. Lokhu kuyithinta kabi inhlala-kahle isiguli. Ngakho-ke, lezi zimpawu zingabonakala njengohlobo lokuphindisela ukusetshenziswa koshukela.
Abanye emva kokuqala kwalesi sifo abasazivumeli ukuthi basebenzise ushukela omningi. Ngasikhathi sinye, kuneziguli ezingakuboni kunesidingo sokushintsha imikhuba yazo, zibona ukulahleka kwesifo njengethonya lokwelashwa.
