I-chemotherapy efudumele yindlela yokuvusa abantu abanomdlavuza ophindaphindiwe noma we- metastatic colorectal . Ngokusemthethweni, le nqubo ibizwa ngokuthi i-cytoreduction operation (CRS) nge-hyperthermic intraperitoneal chemotherapy (HIPEC). Ihlanganisa ukuhlinzwa kwesisu nangomuthi we-peritoneal chemotherapy ukuhlasela umdlavuza wakho ngezindlela eziningi ngesikhathi esisodwa.
Ubani Okhethiweyo we-HIPEC?
Inqubo ye-HIPEC isetshenziselwa ukwelapha izinhlobo ezihlukahlukene zemishukela ye-metastatic ezibandakanya imibala, isisu, i- ovarian , i- mesothelioma , ne-appendiceal.
Akuyona ukwelashwa komugqa wangaphambili noma ukwelashwa kokhetho kumuntu osanda kutholakala ukuthi unomdlavuza we-colon ongenayo imetast. Uma ucabangela i-HIPEC, ubudala bakho, impilo ejwayelekile, futhi okubaluleke kakhulu, isigaba kanye nebanga lomdlavuza wakho yilokho okusiza udokotela wakho ukuba anqume ukuthi le ndlela yokwelapha ikulungele yini.
Ingxenye Yokuqala: Ukuhlinzwa Kwe-Cytoreduction
Ngaphambi kokuthola i-HIPEC, udokotela wakho ohlinzayo uzohlinzwa ngokususa zonke izicubu ezibonakalayo ngaphakathi kwesigxobo sakho esiswini. Uzosusa nanoma yiziphi izitho ezinezifo zamathambo, njengezinambuzane ezincane, ama-pancreas noma ama-ovari. Udokotela ohlinzayo angakwazi futhi ukususa noma ukushisa izicubu ezincane ezivela ezingxenyeni ezibalulekile (ezingenakususwa), njengesibindi sakho, ngalesi sikhathi. Ngisho noma ngabe usuvele unomthengisi wezinambuzane noma inqubo ye-debulking yomdlavuza wekoloni esikhathini esidlule, uzodinga i-CRS ukuqinisekisa izinzuzo eziphezulu ezivela ku-HIPEC.
Ingxenye Yesibili: Inqubo ye-HIPEC
Ngokushesha ngemva kokuhlinzwa lapho useselele ngaphansi kwe-anesthesia udokotela wakho ohlinzayo wenza inqubo ye-HIPEC.
Ngokuyinhloko, kusho ukuthi ama- hypertherm "ashisa" - hhayi ama-scalding, kodwa afudumele kunokushisa komzimba wakho. Imithi ye-chemotherapy ifudumele ngoba iboniswe ukuthi ungakwazi ukukhulisa ukusebenza kwezidakamizwa ngokushisa ngesikhathi sokubeletha.
Igama elithi intraperitoneal libhekisela lapho izidakamizwa ze-chemotherapy ziphathwa khona.
Ingaphakathi lesisu sakho liboshwe nge-membrane evikelayo ebizwa nge-peritoneum, ejikeleze isikhala se-peritoneal - indawo lapho zonke izitho zakho zomzimba (izibilini, isibindi, ama-pancreas) zifakwe khona. Izidakamizwa ze-chemotherapy ziphonswa kule ndawo futhi zivunyelwe ukugeza ngokuyisisekelo bese ziwugcoba amahora amathathu. Esinye isidakamizwa samakhemikhali ejwayelekile esetshenziselwa i-HIPEC yi-cisplatin, ngezinye izikhathi esinikezwa nge-mitomycin C. I-Mitomycin C akuyona imithi ye-chemotherapy, kodwa isetshenziselwa ukusiza ukunciphisa ukukhula kwamanye amagciwane, njengomdlavuza wokubala.
Ukubuyiswa okuvela kwi-Cytoreduction Surgery ne-HIPEC
Lokhu kusebenza okulukhuni futhi okude, okungahle kube khona amahora angu-14. Ukutakula kwakho kuyodingeka kuhlolwe eduze esibhedlela. Ngokushesha ngemva kokuhlinzwa, cishe uzochitha izinsuku ezinhlanu ku-Unit Intensive Care Unit. Lapha uzothola ukuqapha okusheshayo kwentuthuko yakho kuze kube yilapho uzinzile ngokwanele ukuba udluliselwe ku-unit unit yokuhlinzwa esibhedlela. Ukuhlala esibhedlela kubikwa kulandela le nqubo ibanga kusukela ngesonto kuya kwenyanga engaphezu kwenyanga.
Izinkinga ezingenzeka ze-HIPEC
Njenganoma yikuphi ukuhlinzwa okukhulu, kuwukuhlakanipha ukucabangela izingozi ezingenzeka ngaphambi kokuvuma ukuhlinzwa.
Noma yiziphi izinkinga ezinkulu ezivame ukufika kusukela ekuhlinzekeni ngokwazo, okungaba ukuhlinzwa okukhulu. Ungase ube nezinkinga ezivela ezinsukwini eziningi ze-tube noma ukuphakela kwabazali, okudingekayo ngemuva kokuhlinzwa ngenkathi ubhulozi lwakho luhlala. Ukuhlinzeka nge-cytoreduction kubeka ingozi yokuphuma kwegazi, ukutheleleka, kanye nokuthi kungenzeka yini izinkinga zamathumbu noma amandla okuba ne-pneumonia.
I-HIPEC ngokwayo inezinkinga ezilinganiselwe njengoba izidakamizwa ze-chemotherapy, ikakhulukazi, zigxile emgodini wakho wesisu. Ngenxa yalokhu, kukhona okungenzeka ukuthi isifo sofuba esisemathunjini. Kukhona amandla ukuthi lezi zidakamizwa zizoxoshwa kancane futhi zijikeleze kulo lonke igazi lakho, kepha imiphumela emibi kulokhu kuvame ukufana nemiphumela emibi ye-chemotherapy ehlanganisa:
- Ukulahlekelwa izinwele
- Ukunciphisa amandla
- Izinguquko ukunambitha
- I-nausea nokuhlanza
- Uhudo noma ukuqotshwa
Ingabe Le Nqubo Ingasindisa I-Cancer Yami?
I-CRS ne-HIPEC zibhekwa kuphela ezigabeni eziphakeme zomdlavuza futhi zisetshenziselwa ukukhulisa ikhwalithi nobude bompilo wakho, hhayi njengomuthi wokwelapha. Izifundo zibonise ukuthi le nqubo ingasiza ukukhulisa impilo, kodwa ayikhuthazwa wonke umuntu. Empeleni, ayikho inzuzo ecacile yokusinda eboniswe nokho ngale nqubo.
Izikhungo eziningi zomdlavuza zisebenzisa le nqubo ekucwaningeni okuqhubekayo njengoba kubhekwa ukwelashwa okuthembisayo, kodwa okungaqinisekisiwe futhi okunomthelela. Ngaphambi kokusebenza, udokotela wakho uzochaza izingozi ezihambisana nezinzuzo zale nqubo, kodwa ubuze imibuzo uma kukhona okungaqondi.
Imithombo:
Alexander, HR et al. (Juni 2013). Izinto Ezihlobene Nezokwelapha Ezihambisana Nokusinda Kwesikhathi Eside Ukulandela Ukwelashwa Kwama-Cytoreductive kanye ne-Regional Chemotherapy yeziguli ezine-Mesothelioma e-Malignant Peritoneal. Ukuhlinzwa; 153 (6): 779-786.
Hanna, Nadar. (nd). Ukwelashwa kwe-Cytoreductive ne-HIPEC. Uhlelo lweYunivesithi yaseMaryland Uhlelo lwezinyosi zezinyosi; I-Webinar.
Khatri, Vijay. (Januwari 2010). Ukwelashwa kwe-Cytoreductive kanye ne-Hyperthermic Intraperitoneal Chemotherapy ye-Colorectal Cancer: I-Panacea Noma Iyindlela Yokuvimbela Isiguli? I-Journal ye-Clinical Oncology; 28 (1): 5-7.