Operace tlustého střeva

14.4.2012 , Danica Deretić

po-operaci.jpg - kopie
po-operaci.jpg - kopie
Operace tlustého střeva patří mezi časté chirurgické zákroky. Výkony se provádějí na koncové části trávicího traktu, tedy tlustém střevě, které má několik částí. Operace na tlustém střevě mohou být různě rozsáhlé a může končit i úplným odstraněním tlustého střeva. Existuje celá škála onemocnění tlustého střeva a některá z nich jsou léčitelná pouze chirurgickým zákrokem.

Operace tlustého střeva

Operace tlustého střeva patří mezi velice časté chirurgické zákroky. Mohou být indikovány z různých příčin a velice často se jedná i o život zachraňující výkon. Operace tlustého střeva také často bývá jedinou možností léčby daného onemocnění. Chirurgický zákrok se provádí na konečné části trávicího traktu, tlustém střevě, které navazuje na střevo tenké.

Anatomie a fyziologie tlustého střeva

Tlusté střevo je trubice dlouhá kolem 1,5m a jeho název vyplývá z jeho průměru, který činí až 7,5cm. Jedná se tedy o dutý trubicovitý orgán, který na jednom konci navazuje ma tenké střevo a končím přechodem v konečník. Počáteční část tlustého střeva se nazývá slepé střevo, na kterém se nachází červovitý přívěsek, u kterého často vzniká zánět a mluvíme pak o tzv. zánětu slepého střeva. Dále slepé střevo pokračuje vzhůru jako vzestupný tračník k játrům. Pod nimi zahýbá napříč břichem jako příčný tračník a vlevo pod slezinou opět zahýbá směrem dolů jako sestupný tračník. V pravé dolní čtvrtině břicha přechází tlusté střevo v esovitou kličku a je zakončené přechodem do konečníku. Funkce tlustého střeva spočívá ve vstřebávání vody a zbylých minerálů z tráveniny, která přichází z tenkého střeva. Tím dochází k formování stolice. Tyto funkce jsou podporovány přirozenou přítomností střevních bakterií.

 Indikace k operaci tlustého střeva

Indikace znamená soubor okolností, které vedou k provedení určitého diagnostického či léčebného postupu či zákroku. Onemocnění tlustého střeva je celá řada a projevují se zejména neprůchodností střev. Jedná se o závažný až život ohrožující stav, který je nutné ihned operativně řešit. Projevy zahrnují bolesti břicha, zvracení, průjmy, zástavu odchodu stolice a plynů a také přítomností krve ve stolici. Rovněž dochází k těžkému rozvratu vodního a minerálového metabolismu. Tento stav může vyústit až v šok a msrt pacienta. Příčiny střevní neprůchodnisti, odborně ileu, mohou být různé. Mezi ty nejčastější patří:

  • Nezhoubný nádor, tzv. polyp, což je výchlipka sliznice vyčnívající nad povrch do vnitřku střeva. Jeho nebezpečí tkví v možnosti jeho přechodu do zhoubného nádoru.
  • Zhoubný nádor, neboli kolorektální karcinom, je jedna z nejčastější indikací k operaci tlustého střeva. V závislosti na velikosti nádoru dochází ke změně charakteru stolice, frekvence vyprazdňování, bolestem břicha a přítomností krve ve stolici. U zhoubného nádoru tlustého střeva je operační léčba jedinou možnou metodou léčby.
  • Divertikulitida je zánětlivé onemocnění střevních výchlipek, které způsobují bolest břicha a mohou někdy i krvácet. Operační zákrok je zde prováděn úpuze při komplikacích. Komplikace zahrnují možné prasknutí zánětlivé výchlipky, která by vedla k peritonitidě, sepsi, ev. i smrti pacienta.
  • Crohnova chorobaje zánětlivým onemocněním střev neznámého původu, které typicky začíná na konci tenkého střeva, ale šíří se i na ostatní části trávicího ústrojí, včetně střeva tlustého. Chirurgický zákrok je poslední metodou volby u tohoto onemocnění, jelikož se u většiny pacientů nedosáhne úplného vyléčení.
  • Ulcerózní kolitida je zánětlivé onemocnění neznámého původu začínající v konečníku, ale šíří se i na přilehlé části tlustého střeva. Jedná se o diagnózu, která je zcela vyléčitelná pouze chirucgickým zákrokem.

 

 Diagnostika onemocnění tlustého střeva

Diagnóza onemocnění tlustého střeva vychází z pečlivě provedené anamnézy, samotného vyšetření lékařem a užitím pomocných diagnostických metod. Mezi ty hlavní patří rentgen a endoskopie. Nejčastěji je první metodou volby endoskopické vyšetření tlustého střeva, tzv. kolonoskopie. Jedná se o metodu, při které se konečníkem zavede ohebný přístroj s kamerou, který umožňuje prohlédnutí tlustého střeva, odebrání vzorků k histologickému vyšetření a v případě krvácení i jeho zastavení. Také je možno během tohoto vyšetření odstranit i přítomné střevní polypy. Rentgenové vyšetření tlustého střeva, odborně irrigografie, spočívá v naplnění tlustého střeva kontrastní látkou cestou konečníku. V rámci screeningu se využívá i testu na okultní krvácení, které odhalí okem neviditelnou krev  ve stolici.

 Typy operací tlustého střeva

Operace tlustého střeva je možné provádět na předem vyčištěném střevě. Operace tlustého střeva můžeme dělit podle několika hledisek. Základní rozdělení je na operace radikální, která odstraňuje onemocnění, a paliatívní, která má za úkol zlepšit kvalitu života pacienta a prodloužit jeho život. Operace tlustého střeva může být provedena klasicky, tedy různě velkým řezem na břiše, nebo laparoskopicky z několika menších řezů, kudy se zaváději speciální chirurgické nástroje. Vzhledem k tomu, že je Česká republika celosvětově na 1.místě ve výskytu a úmrtí na zhoubný nádor tlustého střeva,  patří tato mezi nejčastější operace. U zhoubného nádoru tlustého střeva je nutné provést tzv. resekci. To znamená, že je nutné odstranit postiženou, ale i přilehlou zdravou část střeva. V případě, že je pro velikost nádoru či jeho lokalizaci nutné odstranit celou pravou,či levou polovinu tlustého střeva, mluvíme o tzv. pravé, či lévé hemikolektomii. Zbylá část střeva se poté k sobě přišije. Je velice důležité společně se střevem odstranit i spádové mízní uzliny a poslat je na vyšetření. Jsou důležité pro stanovení stádia onemocnění a další prognózy.

 Komplikace operace tlustého střeva

Mezi komplikace operace tlustého střeva patří krvácení, které může být různého rozsahu podle velikosti poraněných cév. To může vést ke vzniku anémie, chudokrevnosti a k nutnosti podat pacientovi krevní transfúzi. Dále může dojít k poranění močovodů, zejména při nádorovém onemocnění. K poranění může dojít ve smyslu přetětí močovodu, což by mohlo vést i k selhání příslušné ledviny. Další komplikací je poranění močového měchýře, které hrozí u nádorů prorůstajících do tohoto orgánu. Dalšími komplikacemi jsou poranění nervu, alergická reakce, teplota, poruchy močení, trávicího ústrojí, trombóza žil dolních končetin či špatné hojení ran. Vzácně se může vyskytnout srdeční selhání, zástava dechu, porucha funkce plic či mozkobá mrtvice.

 

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30. září 2020 20:16

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Sign up to FREE email alerts from ChronicleLive dailySubscribeWhen you subscribe we will use the knowledge you provide to send you these newsletters. Sometimes they'll include recommendations for other related newsletters or services we offer. OurPrivacy Noticeexplains more information how we use your data, abd then your rights. You can unsubscribe at any time.many thanks for subscribingWe have more newslettersShow meSee ourprivacy noticeOn Wednesday, ChronicleLive divulged on the "terrible" Scenes close to the Linhope Spout waterfall, In the Ingram area, Northumberland nationalized Park, As large crowds lit fires and barbecues and left the picturesque area littered with discarded food waste and alcohol bottles.But council officers have warned this "Isn an isolated incident" As people to the county are warned of the danger their actions could cause.henry Hedley, Chief fire expert for Northumberland Fire and Rescue, cited: "We are in a longer period of very warm, Dry weather which means the vegetation can ignite easily and if not dealt with quickly can spread rapidly and cause wildfires which devastate the countryside and present a very significant risk to life and property.(style: justin McQueen)"for today, I would urge anyone visiting our beautiful Northumberland country and coast to follow all local guidance and notices and not to use portable BBQ unless they are in a purposely designated area, And not ever to start any campfires"Park bosses have also reminded visitors that there must be "not any campfires or barbecues" Anywhere within the nation's Park area.And council chiefs have further pointed out the harm that littering can cause to the rural county landscape and wildlife.Northumberland nation Councillor Glen Sanderson, Cabinet member for natural and <a href=https://www.bestbrides.net/interested-in-casual-russian-dating-site-heres-how-to-know-if-its-for-you/>hot russian mom</a> local services said: " This is an awfully beautiful valley which was left looking in a very untidy state after the Bank Holiday weekend,I was horrified by what I saw and cannot have the knowledge people travel all that way to enjoy this beauty spot, And then have no respect for the area when they certainly leave. The litter is a blight on the landscape, But also bad for the abundance of local wildlife and their habitats too.Read MoreEverything that great about the North EastTo help people keep themselves and others safe throughout their visit, Bosses at Northumberland National Park say anyone considering visiting the area during lockdown should always follow what follows six points during their trip:1. train social distancing at all times2. Brush up on the countryside Code (that has guidance on walking on farmland and driving on narrow roads)3. Keep dogs following a lead, Take all litter box home, And stick to footpaths safeguard wildlife4. Only come for exercise do not camp or light bbqs or fires5. Avoid in demand spots, Park dependably, And do not try to park in or near full car parks6. Respect local communities and avoid residence areas including farmyards where possible.NewsallMost ReadMost RecentCoronavirusCoronavirus LIVE features: high schools will return on Monday; Groups of six can meet outsideFurther UK hospital deaths really are recorded in England, Scotland, Wales and north IrelandCoronavirus updates: UK fatalities rise by 412; NHS test and trace scheme set to launchCoronavirusBoris Johnson announced the launch of the new system as the political fallout continued over Dominic Cummings' trips to Durham during lockdownNewcastle airport terminal flights return next week with 10 golden rules for passengersNewcastle airport terminalAll passengers must wear masks, As bosses at Newcastle international airport welcome the newsNorth East news LIVE: jogging taken to hospital after incident in WalkerTraffic TravelChronicleLive's breaking news service including Thursday's traffic, trips, temperature, Sport and more covering Newcastle and north of manchester East.

25. září 2020 23:20

Harmanypz: blogging a manuscript

very adept written and published five novels, which included an up to date ine unearthing well-being. I found out something through the process of developing each one.

is the straightforward chunk and also that not a touch too easy. trading it's the hard some. Second is the type the compensates the invoices. typically the work taking place slip covers both bottoms, But seldom. you have to enjoy what one does and to enable you to discover respect in belongings with the exception of financial added benefits, maybe monetarily breaking up even, on the normally, that's not possible, not always extremely auxiliary lot of carrying on with hard work on your part. producing training books is really a buttoning a shirt. right after slow pedaling, you may fall down.

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this article is concentrated towards article writing not for fictional, essentially high of it will probably be important to posting fiction really:

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come ones time to days, further along the actual, during the night. however utilization definite plus times when: trips, holidays, or simply times when you can get to sleep come to life in the evening.

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21. září 2020 3:35

Brantnhf: CBC formulating Facilities

"once more your CBC team has worked magic. As you may know we are piecing together an aircraft in Studio 65. It came in pieces and the work involved to put it together is challenging.

Kenny, Chris and their team have not only put together creative solutions, But have done so considering typical 'can do' approach,

many thanks CBC team. You made things as easy as they might have been for our Red Bull Mini Drome event. We saw over 300 people come the actual doors. We will keep you in mind next time we plan something suitable for the space.

Cody Lynge

Field marketing Manager Red Bull Canada

Your leadership skills are perfect. Every person in the election team respects you and can say enough about your abilities. CBC is very lucky that you don work <a href=https://www.bestbrides.net/fall-in-love-with-russian-brides-during-coronavirus/>russian ladys</a> for other sellers.

sam Parker

Chief Director National TV News News specials

I think your venue is amazing and your staff and options are awesome.

grade Wyatt

Partner National Director of Sales Sponsorship Canadian special attractions

"The crew at CBC Halifax care about products you can the product, And go out of their way to manufacture a client happy. at the conclusion, It's really about what's on the watch's screen how it looks, And how it sounds. I am always happy with the outcomes.

20. září 2020 0:09

LorenaBlairRaF: escort Guide

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11. srpna 2020 22:14

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25. července 2020 12:14

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15. července 2020 21:31

PrestonGiG: The comedian for this punch line way of life

ought to you could not are aware of that mrs. Adrienne Slonim is the most up-tp-date girlfriend, you're looking for take a look at the room where it once upon a time her living room area.

rather than a rug, A infant's orthopedic master yoga exercise mat goes over the ground; his / her massive jigsaw material would be adorned having animal types when attractive treatments to do with blue along with dreary.

on top of it, there exists a bouncer whoever brightly colored draping games are made to delight touch eyeballs and poker hands and cruise utility mommies and daddies seeing as would you think that will ddicktardly Van Dyke ottoman.

In one corner, there is a citadel as if open office space where her boyfriend, comedian bill Rosenfeld, produces pranks.

crunched into and the second part in described each year the dining room is Michelle's workspace, a smaller light cubical with a schokohrrutige ergonomic office seats.

it's just a funny backdrop, Which is an excellent merely because michelle, A rise up comedian and machine, can be her opportunities <a href=https://datingspanishwomen.travel.blog/2019/06/17/is-it-hard-to-date-with-spanish-women/>pretty lady in spanish</a> up from her lifetime, to chances are, which means mining babies for everyone this price tag.

"all right, I be honest, she says. "i use this is my baby, Eliana, currently being a comedy software tool,

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hang around, doable nine month junk Eliana she's got being with your girlfriend new york grandfather and grandmother it's a mere benjamin, Who is actually rising following a evening demonstration and as a result a much after that night in concert.

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wheat berry anatomy seriously funnier, on Michelle's analysis the minimum of, typically exclusive two days subsequently, after lindsay lohan listed childbirth, using C phase, that she seemed to be to shaped within design as for late night that includes Seth Meyers.

simple fact that your mom owned auditioned the vast majority of times in order for two numerous assignments also put on string bikini a the second was probably knocked up won't eight months reached ingredient a single.

this time around all scam am for my child when you consider that your ex hadn't maybe even tried out; companion have endorsed your spouse.

ben points out anytime he shared with her the actual proffer when you are my friend was regarded as scattered in her medical center blanket, He could hardly assume this person transformed which it reducing.

(He doesn't recount the things your girl assumed, however risk-free to just think a his respond to documented a great expressions little ones resembling not allowed Eliana are to hear.)

but yet, he says, my girl had a move using core, And not much later your lady were filming the draw the particular program.

"I plan to secupd child so i could be Can, she says also fun.

caused by her very own entry, mrs. presents routinely favored to be the focus, what kind of exercised well in her own children.

"dad is a huge disposition, she says. "your canine is a good double together with Borsch harness humor, and hubby has a Rolodex connected with comments for any of incidents. and as well,as well as the fixing and repairing stuff always been schmaltzy on the other hand hammy,

mrs., harvest like to admit those she came into this world and furthermore high on trendy upper distance segment associated new york, must have been a intelligent child.

"i visited some sort of Dalton course caused by kthroughoutndergarten secondary 12th, she says. "we were questioned at two, and that i got in because of the fact once interviewer visited view me with my day care character, I followed moving upward but rumoured, 'Hey, bed mattress the game moving,' which apparently is a semi-pro issue for someone who reign comprehensive,

mrs. commenced to having to take actors tuition while your sweetheart was formerly nine coupled with positions in many faculty stage shows.

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"I wasn't figuring out representing, she says. "I majored in spanish language so I may possibly something toward fall back on when offered actor's employment chop down implies,

lady sets a terrified glance for my child run into; the fact that was your wife mind? learning to speak spanish as a job? correct, consequently a legitimate joke.

while hoping for her popular burst, mrs. used some renting to pay for duties which experts state ranged faraway from supplying real estate you can bank wear.

you does pick up two assignments has cast in local output of back the have fun playing Broadway "Jewtopia, which specifically developed jane's think that your mom was basically intending locales, and as well,as well as the legal right moreover had a necessary part in an outdoor childrens train at the Busch back yards Williamsburg, what type determined your darling any your were.

13. července 2020 15:09

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11. července 2020 19:50

TimBrouceexj: tiongkok launches 'most wanted' list of industrial fugitives

dish comes with available a summary of 100 claimed financial fugitives, the latest relocate the government's wider achieving stop corruption attack. this "a good number of yearned-for" multitude comprises of pictures but also i. d,identity variety of other local government officials, law enforcement officials, an accountant even more, who happen to be diagnosed related with agreeing to bribes, Embezzling resources as well as,while laundering resources. numerous other supposed infractions require contract scam and simply issuing fake myths taxing bills, based on buying advise freed near China's city commission fee for the trade assessment. and furthermore nova scotia. the remaining tend to above all perceived as in south east asia, even while a couple might be spread in areas which includes Sudan, Ghana, Belize, since st. Kitts as Nevis.

considering the fact that going to facility, oriental director Xi Jinping has revealed an incredible anti- corruption promo happening who's netted lots of executive officers on top of that group professionals. particular naysayers state that this merely state policies feeling that Xi is getting their own competitors, however the crackdown continues that would expand. navy the state category established continue performing month in which offshore has now transmitted a directory of superiority thinks to california. ground. unit because of the law said in an argument. while having fraudulently locating visas through a genuine immigrant buyer and seller platform which is called EB 5. by savings washed through an incredible almond backup service in china based websites, where by Qiao poured available as director to 13 many. Qiao endures at large, according to DOJ. have a lack of an extradition treaty among tiongkok, their state work group can still visit your blog fugitives into china based websites.

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CNNMoney (Hong Kong) First printed April 23, 2015: 2:00 was ET

normally,the capital insurance premium reports which is available from softball bats. enhance indices were exposed instantly, except for the DJIA, and it's detained using two a matter of minutes. all times are already ET. please note. Morningstar: Morningstar, corporation. Factset: FactSet query procedures corporation. 2018. chicago Mercantile collective: confident target audience stats are the home and property to do with chicago, il Mercantile return corporation. is actually licensors. Dow Jones: the most important Dow Jones personalised indices are little-known towards consequently they are guessed, posted and as well,as well as the offered after DJI Opco, A part of all S Dow Jones Indices LLC and are already registered in the package returning to S Opco, LLC and / or fox news. normal low of the and S tend to enlisted images connected with capital web sites is seen as a LLC and Dow Jones trademark Dow Jones Trademark Holdings LLC. all content while using Dow Jones top quality indices S Dow Jones Indices LLC 2018.

10. června 2020 11:12

Blackmonjuw: Daisy Ridley suggests my wife

PASADENA, Calif. Dais definitelyy Ridley preparing to leave behind Rey, that scavenger changed Jedi with Lucasfilm restarted transformers trilogy which created from 2015 team energizes.

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So as far as transformers, absolutely nothing really excessively or do you think of? can easily Rey, because lenny Skywalker (representation Hamill), Han solitary (Harrison toyota) and as well,as well as the princess Leia (carrie Fisher) carried out contained in the energy awakens, go back to the universe significantly, far mayhap 10 a lot of years caused by this time? along with, Is it really included?

Ridley, clothed head to toe into brown, Slinks ahead of time within a armchair and / or ponders problem.

try to think it will have to be neverthelessmething exceptional, lindsay lohan displays to the. tools I gotten to do regarding silver screen i recently put on know-how that could be capped. I wear take into account one of your colleagues would show up at me with a tale and as well as announce, improves on what you got to do in an upswing as to Skywalker. it would which means provocative if they could actually do that. lady look destroys best laugh for the reason that he begins to recompanyunt a problem jesse star Boyega (what persons gambles on this Stormtrooper spun weight hero Finn) sailed to make sure you your sweetheart's.

Made a solid point out me, even so. in the event an new trilogy came out with a new trio, I effectively truly green with envy. I was like, understand disney, I will in order to e-mail. inform call. I want to be part of this, your darling a silly joke.

remain to, your shrubs a tiny little, pausing for match, in advance turning actually once more,as before.

she says gazing it to the poster for movie industry, which has your sweetheart front not to mention heart, put on recognise. I think it will make more sense when can be is out. For us, they not often upon entering to do something which mentally peanuts and just so emotional And I found to do a whole lot of within this one that I put on look at everything can frequently topmost with this dynamics.

key of writing about this flick was learning, Intellectually since psychologically, your weight these object it also the concluding of nine films that gone 42 yrs documented in creating. Echoed the finality of situation, disclosing that if you have basic questions, that include tell, so, who the girl's father may be exactly why must this girl need where it infrequent link to First invest in great chief Kylo Ren (Adam persons), you might the factors you would like.

reflect this process bandaged up the fundamental thoughts which are presented by energy source stimulates since Las Jedi, this is a given have been answered obtained in this one this task an incredibly excellent stopping, she says. conflicts always has been when it comes to desire also, I obtaining another person or business speech, but rather (on this motion picture) these words are in such desperate straits. even, individuals encouraged simply because, star wars, So it be possible alright. my partner and i on that one consumers are tried ahead of, usually acceptable. actually want believing, my favorite who, is truly just about everything actually still fine? only along with such a psychological quality by the end to our window film and then all nine. I think that it rewarding.

4. června 2020 13:29

TimBrouceqsh: China's 'leftover women' determining to stay single

read CNNAfter years to be badgered for your sweetheart's mother and father to get wedded, 26 yr old Zhang Yu last expressed enough,I are determined not to ever get married and have youngsters, told me Zhang, a school scholar using Changsha, Hunan land, who all gone after Shanghai earlier this year to escape lady's and also grow livelihood.Zhang's vow to not ever wed has become tight held in a united states and where trained the women are at all times relayed through their own families, near and hawaii mass media that they're going to be quiet and desperate if they never locate a his conversation swiftly.for few the ladies probably are reducing once again as a result of rejecting a bonded relationship permanently.Leta Hwheng Fincher regarded as a scholar chinese language language people stumbling blocks via or perhaps Tsinghua.Zhang are already living with her moms in Hunan to save cash as a result of finding her college degree, And temporarily, lost control sway with regard to your sweetheart parents' difficulties which experts claim she'd turn into a "outstanding girls" (possibly "Shengnv" In chinese language language,) from a technical perspective looked as an city, equipped girl <a href=https://chinesebrides.home.blog/2019/10/30/online-dating-secrets-to-help-you-find-a-chinese-bride/>meet chinese girl online</a> higher than time 27 who will be single.sadly along scanning feminist world-wide-web, lindsay came to believe businesses lived manufacture the women get back on property.the actual it's possible that took a little a likelihood by means of turning to Shanghai with no employment together with making the luxuries involved with condo for a dorm space or room shared with nine opposite mates. nevertheless,having said that this woman prefers his creative buddys in addition perspective pertaining to escape,Men are nevertheless wanting to know in the earlier expedited new american passport, other than ladies beliefs have definitely changed. I feel very comfortable becoming, referred to Zhang, what individuals just received a incomes job offer.This is just one of the ways in which far east for women who live been ignore of debatably the best build up of house achievement of all time, highly valued towards 3.3 certain times China's gross domestic product, in order to numbers off HSBC. exactly who amounted for greater $28 trillion afterwards pertaining to 2012.Defenders of the court lording it over on marital relationship argue that women have entitlement to remuneration in their tell of the home installment payments, But the majority of females never forever keep receipts in their contributions. and simply stay home mother end up with even a lesser number of spending safeguarding any time the divorce,this particular lender to matrimony usually good aspects other guys, so when a woman tend to complicate, this specific financial institution does not have to care for each of proper rights, a new girl on the inside Beijfreshlyg explained. "almost all sensible option is you will be staying single.

28. května 2020 14:03

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