ʻO Sigmoidectomy ka wehe ʻana i ka ʻāpana hope o ke kolonā, ʻo ka sigmoid colon. Manaʻo ʻia ia i kekahi mau hihia o ka sigmoid diverticulitis, kahi maʻi maʻamau i ka poʻe ʻelemakule, a i ʻole ka maʻi maʻi maʻi maʻi ma ka ʻōpū sigmoid.

ʻO ka Sigmoidectomy, a i ʻole ka ʻoki ʻana o ka sigmoid, ʻo ia ka wehe ʻana o ke kolo sigmoid. He ʻano colectomy kēia (ka wehe ʻana i kahi ʻāpana o ke kolonā). 

I mea e hoʻomanaʻo ai, hoʻokumu ʻia ke kolone me ka rectum ka ʻōpū nui, ka ʻāpana hope o ka ʻāpana digestive. Aia ma waena o ka ʻōpū liʻiliʻi a me ka rectum, e ana ʻo ia ma kahi o 1,5 m a ua hana ʻia i nā ʻāpana like ʻole:

• ʻo ke kolonā ʻākau, a i ʻole ka piko piʻi, aia ma ka ʻaoʻao ʻākau o ka ʻōpū;
• ʻo ke kolonā transverse, kahi e hele ai ma ka ʻaoʻao o luna o ka ʻōpū a hoʻopili i ke kolonā ʻākau i ke kolone hema;
• ʻo ke kolonā hema, a i ʻole ke kolo iho, e holo ana ma ka ʻaoʻao hema o ka ʻōpū;
• ʻO ke kolonā sigmoid ka ʻāpana hope loa o ke kolonā. Hoʻopili ia i ke kolonā hema i ka rectum.

Hana ʻia ka hana ma lalo o ka anesthesia maʻamau, ma ka laparoscopy (laparoscopy) a i ʻole laparotomy ma muli o ke ʻano hana.

Pono mākou e hoʻokaʻawale i ʻelua ʻano o ke kūlana: ka hoʻopiʻi pilikia a me ka hana elective (non-urgent), ma ke ʻano he mea pale. Ma ka sigmoidectomy elective, e hana mau ʻia no ka diverticulitis, lawe ʻia ka hana mai ka hopena acute e ʻae i ka hoʻohaʻahaʻa ʻana. No laila hiki ke hoʻomākaukau. Loaʻa iā ia kahi colonoscopy e hōʻoia i ka hiki ʻana mai a hoʻoholo i ka nui o ka maʻi diverticular, a kāpae i ka pathology tumor. Manaʻo ʻia kahi ʻai haʻahaʻa haʻahaʻa no ʻelua mahina ma hope o ka hoʻouka ʻana o ka diverticulitis.

Aia nā ʻenehana hana ʻelua:

• anastomosis resection: wehe ʻia ka ʻāpana o ka colon sigmoid maʻi a hana ʻia kahi suture (colorectal anastomosis) e hoʻokomo i nā ʻāpana ʻelua i ke kamaʻilio a pēlā e hōʻoia ai i ka hoʻomau ʻana o ka digestive;
• ʻO ka ʻoki ʻana o Hartmann (a i ʻole colostomy hope a i ʻole ileostomy me ka ʻōpala rectal): wehe ʻia ka ʻāpana sigmoid colon maʻi, akā ʻaʻole i hoʻihoʻi ʻia ka hoʻomau ʻana o ka digestive. Hoʻopili ʻia ka rectum a paʻa i kahi. Hoʻonoho ʻia kahi colostomy ("artificial anus") no ka manawa pōkole e hōʻoia i ka hoʻokuʻu ʻana o ka stool ("artificial anus"). Mālama ʻia kēia ʻano hana no nā sigmoidectomies pilikia, i ka wā o ka peritonitis ākea.

ʻO ka hōʻailona nui no ka sigmoidectomy he sigmoid diverticulitis. E like me ka hoʻomanaʻo ʻana, he mau hernia liʻiliʻi nā diverticula i ka paia o ke kolonā. Ke kamaʻilio nei mākou no ka diverticulosis ke loaʻa kekahi mau diverticula. ʻO ka maʻamau asymptomatic lākou, akā hiki i ka manawa ke hoʻopiha i nā stools e stagnate, maloʻo, a alakaʻi i nā "plugs" a ma hope o ka mumū. A laila e kamaʻilio mākou no ka sigmoid diverticulitis i ka wā e noho ai kēia mumū i loko o ka colon sigmoid. He mea maʻamau i ka poʻe ʻelemakule. ʻO ka CT scan (abdominal CT-scan) ka hōʻike koho no ka hoʻomaʻamaʻa ʻana i ka diverticulitis.

ʻAʻole hōʻike ʻia ʻo Sigmoidectomy i nā diverculitis āpau. ʻO ka lāʻau antibiotic ma ke ala venous ua lawa. Noʻonoʻo wale ʻia ka ʻoki ʻana i ka wā o kahi diverticulum paʻakikī me ka perforation, ʻo ia ka pilikia o ka maʻi, a ma kekahi mau hihia o ka hoʻi hou ʻana, ma ke ʻano he prophylactic. I mea e hoʻomanaʻo ai, ʻo ka Hinchey classification, i hoʻomohala ʻia i ka makahiki 1978, e hoʻokaʻawale i nā pae 4 i mea e hoʻonui ai i ka paʻakikī o ka maʻi:

• pae I: phlegmon a i ʻole abscess periodic;
• pae II: pelvic, abdominal or retroperitoneal abscess (localized peritonitis);
• pae III: peritonitis purulent maʻamau;
• pae IV: fecal peritonitis (perforated diverticulitis).

ʻO ka sigmoidectomy elective, ʻo ia hoʻi elective, noʻonoʻo ʻia i kekahi mau hihia o ka hoʻi hou ʻana o ka diverticulitis maʻalahi a i ʻole kahi hanana hoʻokahi o ka diverticulitis paʻakikī. A laila he prophylactic.

ʻO ka sigmoidectomy pilikia, hana ʻia i nā hihia o ka purulent a i ʻole stercoral peritonitis (pae III a me IV).

ʻO ka hōʻailona ʻē aʻe no ka sigmoidectomy ʻo ia ka loaʻa ʻana o kahi maʻi maʻi maʻi maʻi i loaʻa i ka colon sigmoid. Hoʻopili ʻia ia me ka wehe ʻana i ka puʻu lymph no ka wehe ʻana i nā kaulahao ganglion a pau o ke kolonā pelvic.

Ma hope o ka sigmoidectomy, e lawe maoli ke koena o ke kolonā i ka hana o ka colon sigmoid. Hiki ke hoʻololi ʻia ka transit no kekahi manawa, akā e hana mālie ʻia ka hoʻi ʻana i ka mea maʻamau.

I ka hopena o ke komo ʻana o Hartmann, kau ʻia kahi anus artificial. Hiki ke hana ʻelua, inā ʻaʻohe pilikia o ka mea maʻi, e noʻonoʻo ʻia e hoʻihoʻi i ka hoʻomau digestive.

He kiʻekiʻe loa ka maʻi maʻi o ka sigmoidectomy preventive, me ka 25% o ka nui o ka hoʻopiʻi ʻana a loaʻa kahi helu hana hou e alakaʻi ana i ka ʻike ʻana o kahi anus artificial i kekahi manawa o ke kauoha o 6% i hoʻokahi makahiki o ka colostomy prophylactic, hoʻomanaʻo ka Haute Autorité de Santé i kāna mau ʻōlelo aʻoaʻo 2017. ʻO ia ke kumu i hoʻomaʻamaʻa ʻia ai ka hana prophylactic me ka akahele nui.