Ua nīnau mākou i ka mea lapaʻau Austrian kaulana ʻo Harald Rosen e pili ana inā he hana ʻoiatric panacea i ka mālama ʻana i ka maʻi type 2 i nā mea momona momona, inā he hana pōkole paha ka hopena o ka gastriclasty ma luna o ka gastroplasty tubular, a me nā mea pōʻino e waiho ka "likalora wai".
ʻO kā mākou interlocutor i kēia lā ʻo Harald Rosen, loea kūikawā i ka hōʻola nui ʻana a me ka coloproctology, ka lunaʻōlelo o ke Keʻena ʻOihana Surgical Oncology ma ke Kulanui o Sigmund Freud o Vienna (Austria), ka pelekikena o ka European Society of Surgeons mai 2004. Ma ka moʻomeheu o kēia kauka kaulana, nui nā mau ʻoihana i hana. Ua noi mākou iā Mr. Rosen e kaʻana mai i kāna ʻoihana aʻo e haʻi iā mākou he aha ka hopena o nā mea maʻi me nā mea momona kiʻekiʻe a me ke ʻano maʻi diabetes ʻano hiki ke kūpaʻa ma hope o kahi kūpono kūpono o ka lāʻau.
Na maʻi Diabethelp.org: M. Rosen, iaia ka pilina ma waena ka lawe ʻana bariatricx ka hanath a hoʻōla maʻi ma ka maʻi maʻi?
Kauka Harald Rosen: No kekahi mau makahiki he mau makahiki, ʻoiai ʻoiatric ua hoʻohana ʻia me ka mālama nui i ka momona nui. Hōʻike ka hana hana me kēia ala, ke kaupaona ʻana ka nui o ka maʻi i nā mea maʻi me ka hana maʻamau o nā lipids, i hoʻokiʻekiʻe ʻia ma mua o ka maʻi maʻi. Wahi a nā ʻike hou i hana ʻia ma kahi o 7 mau makahiki i hala aku nei, ʻoiai ʻoiai ʻoi ka miki ʻoiatric i ka hoʻomaʻamaʻa ʻana o nā ʻano maʻi mellitus type 2.
Hōʻalo ka nui o ka glucose koko ma hope o ke kaʻina hana, he mau mahina ma mua o ka mea maʻi i loaʻa ka nui o ke kāʻei kino ma ke kino.
Na maʻi Diabethelp.org: Aia kekahi helu koʻikoʻi e hōʻike ana i ka hoʻohana pono ʻana ʻo bariatria no ka mālama ʻana i ka maʻi maʻi?
Kauka H.R .:. Inā ʻoe e wehewehe "diabetes mellitus", "bariatric surgery" / "bariatrics", a me "metabolic surgery" no nā ʻimi ʻimi i ka PubMed database search engine, e ʻike ʻoe i nā nūpepa nui mai nā papa like ʻole, nā hopena noiʻi i hōʻoia i ka ʻikepili ʻike.
Na maʻi Diabethelp.org: He aha kou manaʻo no ka hopena o ka hopena ma ka mālama ʻana i ka maʻi diabetes?
Kauka H.R .:. Ma muli o kēia mau kumu ʻelua, e noho wau ma luna o lākou. ʻO ka mea mua, ua hōʻemi ʻia ka nui o ka hōʻemi o nā lā i kēlā me kēia lā, i loaʻa e ka hoʻemi ʻana i ka nui o ka pūhaka, ma ka manawa o ka hōʻeha ʻana i ka gastric bypass, a i ka wā hoʻi o ka tubular resection o ka ʻōpū.
ʻO ka lua, pale i ke hoʻokuʻu ʻana o nā hormones ikaika endocrine. ʻO ka hana e ʻoi loa e pili ana i kēia hana he hana shunt, ma muli o ka ʻai i ke aʻa ʻia o ka duodenum.
Na maʻi Diabethelp.org: Manaʻo ʻoe he pā panacea ʻo ka lilo ʻana i ka maʻi i ka maʻi maʻi maʻi? A i ʻole, e waiho i ka nīnau i ʻokoʻa, ʻo ka ʻāpana o ke kūleʻa hiki paha i kiʻekiʻe?
Kauka H.R .:. I ka hihia o ka bariatric hana, ʻo 15-20% o nā mea maʻi e loaʻa iā ia ka manawa e loaʻa ai ka hoʻomaʻamaʻa ʻana i nā hopena i makemake ʻia. Ma keʻano pilikino, hiki ʻole ke kāohi pono. ʻO ke kumu e hiki ai ke kau i ka wā holoʻokoʻa ma ke ao, ma muli o ke ʻano o nā kaloli e hoʻomau i ka kino o ka mea maʻi, a i ʻole he ʻano kikoʻī ʻenehana o ka hana. No ka laʻana, aia kekahi manawa i waiho ka nui o ka ʻōpū hou ("pouch") a i ʻole ka pōkole i kahi ʻāpana o ka ʻōpala liʻiliʻi, a hiki i ka malabsorption (i lawa ʻole ka nui o ka mauʻu).
Na maʻi Diabethelp.org: Me 'oe e ike, mekū i ka mau ʻano ʻelua bariatric hana. ^ E Ha yM. Ua hiki anei ke ʻōlelo i kekahi o lākou e oi aku ka maikaʻi i ka maʻi diabetes?
Kauka H.R .:. Hoʻomaopopo ʻia nā ʻelua mau kaho ʻoiatric no ka maʻamau - ka gastpass bypass gastric a ʻoi me ka lima o ka gastroplasty, a me ka ʻūhā lūlū o ka ʻōpū. Hoʻokomo ʻia ka hoʻomaʻamaʻi Bypass, ma mua, e hōʻemi ana i ka nui o ka ʻōpū ma ke hoʻokumu ʻana i kekahi ʻeke gastric, ka mea i kapa ʻia ʻo "ʻōpū liʻiliʻi," a me ka lua, e huli i ka ʻelua ʻāpana o ka ʻōpū liʻiliʻi, kahi e hoʻopono ai nā mea kanu. ʻAʻole like me ka shunting, ke kāʻei ʻana o ka ʻōpū o ka ʻōpū e hoʻokaʻawale wale ʻia ana i kona nui me ka hāʻawi ʻana i ke ʻano o kahi neʻe, a he kaila iki paha. I kēia lā, ʻae ʻia kēia mau hana ʻelua me ka minimal invasiveness, no ka mea e ka laparoscopy.
E like me kaʻu i ʻōlelo ai, ma ka 15-20% o nā hihia, ʻoi aku ka nui o ka momona kaumaha, i nā hua ʻōlelo ʻē, ʻaʻole like ka maikaʻi o ka mālama ʻana. Inā hoʻomaka ka mea maʻi e kau hou hou i ka paona, kūlohelohe, aia kahi manawa a hoʻomaha i nā hōʻailona maʻi maʻi.
Eia kekahi, hōʻike ka hoʻomaʻamaʻa inā ma hope o ke kīpē o ka gastroplasty hiki ke hoʻopau ʻia i kēia pilikia e ka shunting i ka ʻōpū. Inā loaʻa ka loaʻa ʻana o ka paona koʻikoʻi ma hope o ka shunting, ʻaʻole i kiʻekiʻe nā kūlana o ka pōmaikaʻi.
Na maʻi Diabethelp.org: E hoʻi hou ka maʻi maʻi inā ʻaʻole e hoʻopili ka mea maʻi i ka papaʻai a ʻai i nā mea a pau ma ka lālani, me ke ʻano o nā sweets?
Kauka H.R .:. Ma kā mākou hana hana, he nui nā poʻe maʻi nona ka kaumaha e hoʻomaka hou e ulu hou ma hope o ka hoʻolohi ʻana i kūleʻa ma muli o ka hapanui o ke ana gastroplasty. Ma ke ala, ʻo kēia ke ʻano nui i hoʻohana ʻia ma kā mākou ʻoihana. E like me ka mea i ʻike ai, i hoʻopau ʻia kēia pilikia e ka shunting.
ʻO ka pilikia nui e kū mai nui me ka gastroplasty tubular ʻo nā mea pinepine e hoʻāʻo i ka poʻe maʻi e "outwit" i nā mea paʻa o ka nui o ka ʻōpū ma ka hoʻopau ʻana i nā ʻāpana ʻoka wai, ʻo ia ka nui o nā calorie kūloko, ka mea i hoʻopiʻi ʻia me ka liʻiliʻi liʻiliʻi o ka ʻōpū (ma lalo o 200 ml) , ʻaʻole i haʻalele ka kaumaha, a hoʻomaka e ulu ma hope o ka hoʻohemo maikaʻi ʻana.
No laila, inā ke kamaʻilio nei ka mea ʻai i ka wā o ka kūkā mua, ua ʻike ke kauka e manaʻo nui ana ka mea maʻi e ʻai i nā mea momona i nā mea he nui, ua manaʻo ʻia e noʻonoʻo pono i ke koho o ka gastpass bypass gastric mua.
ʻO ka ʻoiaʻiʻo ma hope o ke kaʻina hana bypass gastric, ʻo ka ʻai nui o ka holi e hiki ai ke hoʻonāukiuki i ka maʻi ʻokoʻa.
Me kēia hoʻopiʻi ʻana, nā hōʻailona autonomic koʻikoʻi, e like me ka hoʻoulu ʻana a me ka hilo ʻana, hoʻomaka e ʻike 15 mau minuke ma hope o ke kō ʻana o ke kō. Hoʻopilikia maikaʻi loa kēia i ka maikaʻi o ka mea maʻi. No laila, hiki i kēia mau hōʻailona ke ʻike ʻia i kahi ʻano o ka hoʻopaʻi no ka pau ʻana o ke kō.
ʻO kekahi ma hope o ka hoʻomaka ʻana o kēia maʻi, ʻaʻole lākou e ʻae iā lākou iho e ʻai i ka nui o ke kō. Ma ka manawa like, aia kekahi mau maʻi i manaʻo ʻole ʻole e pono ke hoʻololi i kā lākou mau hana, ka ʻike ʻana i ka hoʻolei ʻana i ka maʻi maʻi ma kahi ʻaoʻao o ka mālama.
