{"id":1440951,"date":"2024-07-22T00:00:00","date_gmt":"2024-07-21T21:00:00","guid":{"rendered":"https:\/\/analyse.optim.biz\/?p=1440951"},"modified":"2024-07-22T00:00:00","modified_gmt":"2024-07-21T21:00:00","slug":"caz-complex-de-incontinenta-anala-tratat-cu-succes-la-arcadia","status":"publish","type":"post","link":"https:\/\/analyse.optim.biz\/?p=1440951","title":{"rendered":"Caz complex de incontinen\u021b\u0103 anal\u0103, tratat cu succes la Arcadia"},"content":{"rendered":"<div class=\"entry-content\">\n<div id=\"attachment_315854\" class=\"wp-caption alignright\"><img decoding=\"async\" aria-describedby=\"caption-attachment-315854\" loading=\"lazy\" class=\"size-medium wp-image-315854\" src=\"https:\/\/analyse.optim.biz\/wp-content\/uploads\/2026\/01\/chichirau-dragos-300x197-2.png\" alt=\"Dr. Drago\u0219 Chichir\u0103u, medic specialist Chirurgie general\u0103, Arcadia\" width=\"300\" height=\"197\" title=\"chichirau-dragos-300x197-2\"><\/p>\n<p id=\"caption-attachment-315854\" class=\"wp-caption-text\"><a href=\"https:\/\/www.arcadiamedical.ro\/echipa-medicala\/chichirau-dragos-iulian\">Dr. Drago\u0219 Chichir\u0103u<\/a>, medic specialist Chirurgie general\u0103, <a href=\"http:\/\/www.arcadiamedical.ro\">Arcadia<\/a><\/p>\n<\/div>\n<p>O pacient\u0103 \u00een v\u00e2rst\u0103 de 40 de ani din Boto\u0219ani a ales Spitalul Multidisciplinar Arcadia pentru \u00eenc\u0103 o opinie medical\u0103. Pacienta avusese <strong>dou\u0103 na\u0219teri realizate cu epiziotomie<\/strong>, iar \u00een urma celei de-a doua a r\u0103mas cu <strong>incontinen\u021b\u0103 anal\u0103<\/strong> (incapacitate de a controla eliminarea de gaze \u0219i fecale), o problem\u0103 medical\u0103 cu implica\u021bii puternice asupra calit\u0103\u021bii vie\u021bii.<\/p>\n<p><strong>\u00cen prim\u0103 instan\u021b\u0103, incontinen\u021ba a fost par\u021bial\u0103<\/strong>, adic\u0103 se manifesta doar \u00een anumite situa\u021bii. \u00cen anii urm\u0103tori, incontinen\u021ba s-a accentuat, intervenind \u0219i modificarea \u021besuturilor cauzat\u0103 de \u00eemb\u0103tr\u00e2nirea lor. <strong>Incontinen\u021ba anal\u0103 a devenit complet\u0103<\/strong> at\u00e2t pentru gaze, c\u00e2t \u0219i pentru materii fecale \u0219i <strong>a ap\u0103rut o fistul\u0103 ano-vaginal\u0103, adic\u0103 o comunicare \u00eentre canalul anal \u0219i vagin, prin care o parte dintre materiile fecale \u0219i gaze ajungeau \u00een vagin.<\/strong><\/p>\n<p>De\u0219i pacienta mai fusese la consulta\u021bii de Chirurgie f\u0103r\u0103 a ob\u021bine solu\u021bii, a hot\u0103r\u00e2t s\u0103 apeleze \u0219i la Serviciul de Chirurgie general\u0103 din cadrul Spitalului Multidisciplinar Arcadia.<\/p>\n<p>\u00a0<\/p>\n<p><strong>Epiziotomia presupune incizia perineului<\/strong> (\u021besutul care se afl\u0103 \u00eentre vagin \u0219i anus) cu scopul de a m\u0103ri orificul vaginal \u00een timpul na\u0219terii naturale. \u00cen cazul pacientei, <strong>epiziotomia a fost f\u0103cut\u0103 \u00een partea posterioar\u0103, foarte profund, \u0219i a sec\u021bionat mu\u0219chiul canalului anal<\/strong>. Mu\u0219chiul care asigur\u0103 continen\u021ba, sfincterul anal, este un mu\u0219chi circular. Fiind sec\u021bionat, capetele sale s-au \u00eendep\u0103rtat pu\u021bin la \u00eenceput, \u00een anii care au urmat s-au \u00eendep\u0103rtat din ce \u00een ce mai mult, iar mu\u0219chiul a ajuns s\u0103 nu mai asigure deloc continen\u021ba. A ap\u0103rut \u0219i fistula ano-vaginal\u0103.<\/p>\n<p>\u00a0<\/p>\n<p>S-a intervenit chirurgical, sub <strong>anestezie general\u0103<\/strong>, prin <strong>abord anterior transvers<\/strong>, adic\u0103 prin zona dintre vagin \u0219i canalul anal. A fost colorat orificiul fistulos vaginal pentru a se identifica cu precizie leg\u0103tura. <strong>Dup\u0103 ce s-a extirpat \u00een totalitate comunicarea dintre canalul anal \u0219i vagin, a urmat partea mai dificil\u0103, refacerea musculaturii.<\/strong> Unul dintre capetele sfincterului era pozi\u021bionat la ora 14:00, iar cel\u0103lalt la ora 10:00 (ca \u0219i cum ne-am uita la ceas), deci aproximativ o treime din circumferin\u021ba sfincterului era lipsit\u0103 de continuitate muscular\u0103. <strong>Capetele au fost aduse \u00eempreun\u0103 \u0219i au fost realizate dou\u0103 r\u00e2nduri de suturi.<\/strong> \u00centruc\u00e2t calitatea \u021besuturilor era precar\u0103 deoarece pacienta era obez\u0103, <strong>au fost sutura\u021bi \u0219i mu\u0219chii ridic\u0103tori anali pentru asigurarea unui plan rezistent<\/strong>.<\/p>\n<p>\u00a0<\/p>\n<p>Interven\u021bia chirurgical\u0103 a fost una dificil\u0103, de fine\u021be \u0219i a durat 2 ore \u0219i 30 de minute. Pacienta a fost spitalizat\u0103 4 zile.<\/p>\n<p><strong>Evolu\u021bia postoperatorie a fost foarte bun\u0103.<\/strong> Pacienta a fost deosebit de cooperant\u0103 \u0219i a respectat recomand\u0103rile cu privire la <strong>regimul alimentar necesar a fi urmat pentru a avea un scaun de consisten\u021b\u0103 intermediar\u0103 \u00een fiecare zi<\/strong>. \u00cen contextul constip\u0103rii, un scaun mare \u0219i dur poate provoca ruperea mu\u0219chiului atunci c\u00e2nd trece prin zona operat\u0103. Totodat\u0103, pacienta a f\u0103cut <strong>exerci\u021bii de reeducare sfinterian\u0103<\/strong> \u00eentruc\u00e2t mu\u0219chii ref\u0103cu\u021bi trebuie s\u0103 lucreze pentru a se ob\u021bine conten\u021bia sfincterian\u0103.<\/p>\n<p>La 3 luni dup\u0103 opera\u021bie, \u021besutul asupra c\u0103ruia s-a intervenit era cicatrizat, iar continen\u021ba aproape normal\u0103.<\/p>\n<p>\u00a0<\/p>\n<p>Pentru program\u0103ri, pacien\u021bii au la dispozi\u021bie num\u0103rul de telefon <strong>0232 920, Call Center Arcadia<\/strong>.<\/p>\n<p><a href=\"http:\/\/www.arcadiamedical.ro\">www.arcadiamedical.ro<\/a><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Dr. Drago\u0219 Chichir\u0103u, medic specialist Chirurgie general\u0103, Arcadia O pacient\u0103 \u00een v\u00e2rst\u0103 de 40 de ani din Boto\u0219ani a ales Spitalul Multidisciplinar Arcadia pentru \u00eenc\u0103 o opinie medical\u0103. Pacienta avusese dou\u0103 na\u0219teri realizate cu epiziotomie, iar \u00een urma celei de-a doua a r\u0103mas cu incontinen\u021b\u0103 anal\u0103 (incapacitate de a controla eliminarea de gaze \u0219i fecale), [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[89],"tags":[174],"class_list":["post-1440951","post","type-post","status-publish","format-standard","hentry","category-romania","tag-suceavanews-ro"],"_links":{"self":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/posts\/1440951","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1440951"}],"version-history":[{"count":0,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=\/wp\/v2\/posts\/1440951\/revisions"}],"wp:attachment":[{"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1440951"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1440951"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/analyse.optim.biz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1440951"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}