Tin Tuc Tu Bac Si Giai Phau Su Giai Phau Ve Laparoscopic Anti-Reflux

SU GIAI PHAU CHO BENH “O CHUA”

Neu qui vi dau kho ve benh “o chua”, bac si giai phau cua qui vi co the gioi thieu ve su giai phau cua Laparoscopic Anti-Reflux de chua tri trung benh nay.

Benh nay con duoc goi la benh Gastroesophageal reflux disease (GERD). Bai viet sau day cat nghia cho qui vi hieu ro ve nhung dieu sau day:

  • Benh Gastroesophageal reflux disease (GERD) la benh gi?
  • Su chua tri va giai phau cho benh GERD.
  • Su giai phau thi thuc hien nhu the nao.
  • Ket qua xay ra sau khi giai phau.
  • Nhung su doi mong gi neu qui vi chon lua, de co su giai phau ve Laparoscopic Anti-reflux.

Benh Gastroesophageal reflux disease (GERD) la benh gi?

Mac du la benh “ O chua” thi thuong dinh nghia trong nhieu van de cua su tieu hoa. Trong danh tu y khoa, no chinh la mot chung benh cua Laparoscopic Anti-reflux. Trong tinh trang nay, chat acid trong bung di tro lai tu trong bung den cuon hong. Benh “ o chua”tiec ra mot chat dang, va dau o giua nhung manh gan hay o duoi co. Cai cam giac co the toa ra xuyen qua co hong va co. Nhieu ngou o nuoc My co cam giac dau don it nhat mot lan trong vong mot thang. Nhung trieu trung khac cung co the xay ra la non mua, nuot kho khi an va ho khinh nien hay tho kho khe.

Cai gi la nguyen nhan cua benh GERD?

Khi qui vi an, thuc an di tu mieng toi bung xueng qua mot cai ong goi la cuong hong. O cuoi cua cuong hong la mot vong tron goi la Lower Esophageal sphincter (LES). LES hoat dong nhu la mot xu bap, chay mot chieu cho thuc an chay xuyen qua bung. Binh thuong cai xu bap nay no dong ngay sau khi nuot thuc an de ngan can chat sinh trong bung di nguoc tro lai, ma co chat acid di vao cuong hong. Benh GERD xay ra khi LES khong lam viec dung muc va de cho chat acid chay tro nguot, va lam sot cuong hong.

Cai gi thi dong gop cho benh GERD?.

Mo so nguoi sanh voi mot LES yeu tu nhien. Voi nhung nguoi khac, thuc an beo, cay, mot so thuoc uong, quan ao chat, hut thuot la, uong ruou, tap the dung manh bao, hay thay doi vi tri cua than hinh ( cuoi xuong, hay nam xuong) co the la nguyen nhan cua LEX de co ran,nguyen nhan cu Reflux. Hiatal Hernia (mot danh tu cho GERD) co the xuat hien trong nhieu benh nhan, ma dau kho boi benh GERD, nhung khong co the la nguyen nhan cua trung benh “o chua”.

Benh GERD thi duoc chua tri nhu the nao?

GERD thi thuong duoc tri trong 3 phan duoi day:

  • Phuong canh song hang ngay phai thay doi: Trong nhieu truong hop, thay doi su khien an, va uong thuoc antacid o quay ban, co the giam bot chung benh. Giam can, ngung uong thuoc, uong ruou, va su thay doi phuong phap an uong, su nghi nguoi cung co the giup.
  • Phuong phap tri lieu bang thuoc: Neu chung benh van con sau khi thay doi canh song, thi phep tri lieu bang thuoc phai duoc dung. Thuoc Antacids cho acid o bung va thuoc o quay ban con the giam xuong so luong acid o trong bung san xuat ra. Ca hai co the giam thieu duoc chung benh. Thuoc bien toa cua bac si cung co the chua khoi con dau cua cuong hong va giam bot chung benh. Dung phuong phap nay nen hoi y kien cua bac si giai phau cua qui vi.
  • Phuong phap giai phau: Nhung benh nhan ma khong co ket qua tot, sau khi thay doi canh song, hay sau khi dung thuoc, hay nhung nguoi cu tiep tuc uong thuoc de dieu khien chung benh cua ho. Nhung nguoi nay phai song, voi tinh trang cua ho hay phai trai qua cuoc giai phau. Phuong phap giai phau rat co hieu qua trong van de chua tri benh GERD. Co nhieu phuong phap de thu, nhu la phuong phap Intralluminal Endoscopic procedures, day la su thay doi giua laparoscopic va phuong phap giai phau mo tung ra. Qui vi can hoi y kien voi bac si mo hay bac si gia dinh khi qui vi de xem minh co the la mot thanh vien trong bat cu phuong phap chua tri tren.

Cai loi gi trong viec dung phuong phap Laparoscopic?

  • Cai loi cua phuong phap laparoscopic thi thuong cung cap nhung dieu sau day:
  • Giam thieu con dau, sau khi giai phau.
  • Thoi gian o benh vien ngan hon.
  • Tro lai lam viec mau hon.
  • Gia tang viec tham my sau khi giai phau.

Qui vi co phai la mot thanh vien cho phuong phap chua tri Laparoscopic?

Mac du phuong phap mo cua Laparoscopic Anti-Reflux co nhieu loi ich, no cung co the khong thich hop voi vai nguoi benh nhan. Qui vi phai di lay y kien cua bac si mo chuyen mon trong nghanh Laparoscopic Anti-Reflux, hay la bac si gia dinh, hay la nhung vi Gastroenterologist de tim ra cai phuong phap nao thi thich hop voi qui vi.

Cai gi can phai co truoc khi cuon giai phau Laparoscopic Anti-Reflux thuc hien :

  • Sau khi bac si mo trinh bay su ruoi do va su loi ich cua cuon giai phau, qui vi phai viet xuong su dong y cho cuon giai phau duoc thuc hien.
  • Chuan bi truoc khi mo, la khiem xoat mau, tinh trang thuoc men, chup phim x-ray cho nguc va lam EKG tuy thuoc vao tuoi tac va tinh trang suc khoe cua qui vi.
  • Bac si mo co the doi hoi qui vi phai de trong cai ruot gia va lam sach ruot cua qui vi truoc khi giai phau. Qui vi co the chi uong nuoc loc trong 1 hay vai ngay truoc khi mo.
  • Loi khuyen cua bac si la qui vi nen tam rua, o buoi toi truoc do, hay buoi sang truoc khi mo.
  • Qui vi khong duoc an uong bat cu cai gi sau nua dem, truoc khi giai phau , ngoai tru thuot uong cua bac si mo cho phep qui vi uong voi nuoc, o buoi sang truoc khi mo.
  • Nhung thu thuoc nhu Aspirin, lam mau loan ra, thuoc chong sung len (arthritis medications), thuoc bo co vitamin E, can phai ngung tam thoi, cho vai ngay hay cho 1 tuan truoc khi giai phau.
  • Nhung thuoc de kien an hay St. John’s Wort khong duoc dung truoc 2 tuan truoc khi mo.
  • Ngung hut thuoc va xep dat bat cu su tro giup, ma qui vi can co o nha.

Cai gi can phai co trong ngay giai phau:

  • Thuong la qui vi phai den benh vien buoi sang cua cuoc giai phau.
  • Nhan vien y ta se de mot cay kim vao manh mau cua qui vi va dung de cho thuoc trong luc giai phau.
  • Binh thuong cho thuoc truoc khi mo rat la can thiet.
  • Qui vi co the bi me hay ngu trong luc mo trong vai tieng dong ho.
  • Sau khi mo qui vi se duoc dua ra phong hoi phuc,cho toi khi thuc day.
  • Hau het nhung benh nhan co the o trong benh vien buoi toi sau khi mo va co the o them vai ngay.

Cuoc giai phau Laparoscopic Anti-Reflux thuc hien nhu the nao?.

  • Laparoscopic anti-reflux giai phau con duoc coi la (Laparoscopic Nissen Fundoplication) bao gom cai suc day cua xu bap giua cuong hong va bung. No cot giua phan tren cua bung va chung quanh phan duoi cua cuong hong- Cot chung quanh mot cai hot dog.
  • Trong phuong phap mo nay, bac si dung mot do cat rat nho (1/4 toi ½ inch) de di vao cai bung xuyen qua mot cai ong hep. Cai Laparoscope se noi voi mot may hinh quay video nho, dat xuyen qua cho cat, de cho nguoi bac si co the thay tat ca bo phan cua benh nhan, bang man anh tryuen hinh.
  • Hoan toan cuoc mo thi thuc hien ben trong sau khi cai bung no ra, vi duoc thoi hoi vao.

Cai gi xay ra neu cuoc mo khong co the thuc hien duoc hay hoan thanh boi phuong Phap Laparoscopic ?

Mot so benh nhan dung phuong phap laparoscopic khong duoc de dang, boi vi khong co the thay hay cam cu nhung te bao duoc. Co nhieu yeu to co the doi lai su mo bang phuong phap mo lon ra (open), nhu chat beo trong co the, co nhung cai theo cu trong nhung vu giai phau truoc do hay bi chay mau nhieu trong luc giai phau. Quyet dinh lam bang phuong phap mo lon ra, la cai de nghi cua bac si mo xay ra truoc khi hay trong luc dang giai phau, khi ma bac si mo cam thay su an toan de thay doi puong phap laparoscopic thanh phuong phap mo lon ra , van de nay thi khong co phuc tap, nhung la mot de nghi trong luc giai phau. Quyet dinh de thay doi phuong phap laparoscopic thanh phuong mo lon ra, no con tuy thuoc vao su an toan cua benh nhan.

Nhung cai gi xay ra sau khi giai phau?

  • Benh nhan phai hoat dong, nhe nhang sau khi giai phau.
  • Con dau sau khi giai phau thi thuong nhe, khong dau nhieu, mac du co mot so benh nhan van dung thuoc dau theo toa bac si.
  • Thuoc chong dau Anti-Reflux thi thuong khong dung sau khi giai phau.
  • Mot so bac si mo thay doi, phuong phap kieng an cua benh nhan sao khi giai phau, truoc tien la an nhung chat long, sau do dan dan an nhung thuc an cung. Qui vi co the hoi bac si ve phuong van de kieng an, ngay sau khi giai phau.
  • Qui vi co the tro lai hoat dong binh thuong trong mot thoi gian ngan. Nhung hoat dong nhu tam rua, lai xe, di bo len cau thang, nhan do len, lam viec hay lam sex.
  • Lam cuoc hen voi bac si trong vong 2 tuan sau khi giai phau.

Co anh huong phu trong cuoc giai phau hay khong?

  • Nhieu cuoc tim hieu cho rang da so nhung benh nhan theo phuong chua tri nay thi het benh hay la co su tien trien manh trong benh GERD cua ho.
  • Anh huong phu lau dai trong cuoc giai phau nay thi khong duoc thong thuong.
  • Mot vai benh nhan cam thay nuot thuc an kho, sau khi giai phau. Van de nay se het trong vong 1 toi 3 thang sau khi mo.
  • Doi khi benh nhan can phuong phap cang hay keo cuong hong ra (endoscopic dilation) hay phai giai phau lai.
  • Khai nang phun ra hay oi mua, co the bi gioi han voi phuong phap nay, mot so benh nhan thong bao la cai bung bi sung, len hay phung ra.
  • Rat hiem benh nhan thong bao la khong co mot su tien trien nao trong benh cua ho.

Nhung van de phuc tam gi co the xay ra.

Mac du su giai phau thi an toan, nhung van da phuc tap cung co the xay ra. No co the xay ra o bat cu cuoc giai phau nao.

Su phuc tap duoc ke liet o duoi day nhung khong gioi han:

  • Su chong tro lai cua thuoc me.
  • Mau chay nhieu.
  • Thiet hai cho cuong hong, qua mat, bung, va nhung bo phan trong co the
  • Nhung cai phuc tap binh thoung khac cung co the xay ra.

Bac si giai phau co the noi chuyen voi qui vi. Co ta hay ong ta cung co the giup qui vi quyet dinh, neu su nguy hiem cua Laparoscopic anti-Reflux giai phau, thi it hon la khong co su giai phau.

Khi nao thi goi bac si cua qui vi.

  • Chac chan la phai goi bac si neu qui vi co nhung trieu chung sau day:
  • Con sot tren 101 degrees F (39 degrees C).
  • Mau chay.
  • Bung sung len.
  • Con dau khong cham dut, ngay ca khi uong thuoc.
  • Bi chong mat va non mua.
  • Lanh buot, lanh cong.
  • Ho khinh nien va tho ngan.
  • Nuoc bi rut di o nhung cho cat.
  • Bi do o chung quanh cho cat va no lang rong ra.
  • Qui vi khong co the an, hay uong nhung chat long.

Brought to you by:

SOCIETY OF AMERICAN GASTROINTESTINAL ENDOSCOPIC SURGEONS (SAGES)
11300 West Olympic Blvd., Suite 600
Los Angeles, CA 90064
Tel:
(310) 437-0544
Fax:
(310) 437-0585
E-Mail:
publications@sages.org
This brochure is intended to provide a general overview of a surgery. It is not intended to serve as a substitute for professional medical care or a discussion between you and your surgeon about the need for a surgery. Specific recommendations may vary among health care professionals. If you have a question about your need for a surgery, your alternatives, billing or insurance coverage, or your surgeons training and experience, do not hesitate to ask your surgeon or his/her office staff about it. If you have questions about the operation or subsequent follow up, discuss them with your surgeon before or after the operation.