Uhlobo Lokuhlinza I-Cancer Lung
I-lobectomy uhlobo lokuhlinzwa komdlavuza wamaphaphu lapho i-lobe eyodwa yamaphaphu isuswa khona. (Iphaphu elungile linama-lobes amathathu, futhi i-lung yangakwesokunxele ine-lobes amabili.) I-lobectomy iphinde yenziwe ngezinye izimo, njenge-TB, i-COPD enamandla, noma ukuhlukumezeka okuphazamisa imikhumbi emikhulu yegazi eduze namaphaphu.
Izinhlobo Zokuhlinzwa Kwama-Lung Cancer
Odokotela banquma kanjani ukuthi i-lobectomy iyindlela engcono kakhulu yokuhlinza umdlavuza wamaphaphu kuwe?
Uhlobo lokuhlinzekwa komdlavuza wamaphaphu udokotela wakho uncoma ukuthi luzoxhomeka ezintweni eziningana, kubandakanya:
- Indawo yesikhumba sakho
- Ubukhulu besisu sakho
- Kungakhathaliseki ukuthi ubuhlungu bakho buye basakazeka yini kumathissi aseduze
- Isimo sakho sezempilo jikelele
- Amaphaphu akho asebenza kanjani kahle ngaphambi kokuhlinzwa
I-lobectomy ivame ukuqhutshwa kwamangqamuzana angamancane amaphaphu wamaphaphu lapho i-tumor igcinwe khona ku-lobe eyodwa. I-invasive encane futhi igcina umsebenzi wamaphaphu amaningi ukuthi i- pneumonectomy , inqubo ehilela ukususa lonke iphaphu. Ngokuphambene nalokho, likhulu kakhulu kunomthengisi wezinhlanga, ukuhlinzeka okukhipha isisu nesamba esincane sezingcubu ezizungezile.
Izinhlobo ze-Lobectomy
I-lobe yamaphaphu akho ingasuswa ngezindlela ezimbalwa ezahlukene. Udokotela wakho ohlinzayo uzocoma enye yalezi zisekelwe kuzo zombili izici zomdlavuza wakho othize nokuthi ukhululekile kangakanani ngalunye lwenqubo:
- Vula i-lobectomy: E-lobectomy evulekile, i-lobe yamaphaphu isuswe ngokukhipha isikhathi eside eceleni kwesifuba (thoracotomy).
- I-VATS (ukuhlinzeka nge-thoracoscopic) nge-video (assisted by thoracoscopic): i-lobectomy: Kule nqubo, i-lobe yamaphaphu isuswa ngemibono embalwa encane esifubeni ngosizo lwezinsimbi kanye nekhamera. I-VATS lobectomy ingacatshangelwa isiteleka somdlavuza wesigaba se-1 nge-tumors ezincane (ngokuvamile ngaphansi kwama-3 kuya ku-4 cm). Uma i-VATS lobectomy inokwenzeka, ingabangela izinkinga ezimbalwa kune-lobectomy evulekile.
VATS vs Open Lobectomy
Wena nodokotela wakho ukhetha kanjani phakathi kwe-lobectomy evulekile ne-VATS lobectomy, futhi yini umehluko ekubuyiseleni phakathi kwalezi zinqubo?
Ucwaningo luye lwathola ukuthi isikhathi sokutakula esilandelayo i-VATS lobectomy kaningi kufushane, ngebuhlungu obuncane bokuthunyelwe ngaphandle kwe-lobectomy evulekile. I-Post-thoracotomy pain syndrome (ebizwa nangokuthi i-postpneumonectomy syndrome) yisimo sobuhlungu besifuba esiqhubekayo esenzeka ezinyangeni kuya eminyakeni emva kokuhlinzwa komdlavuza wamaphaphu, futhi kubonakala sengathi kuthinta cishe amaphesenti angu-50 abantu abahlinzwa ngale ndlela. Ngenkathi singenayo izifundo ezibheke ngqo lokhu kukhathazeka kungenzeka ukuthi inqubo ye-VATS izoholela ebuhlungu obukhulu obungapheliyo.
Naphezu kokuphumula okusheshayo, kunezikhathi lapho i-VATS ingenakwenzeka. Indawo yezinye izicubu yenza kube nzima kakhulu ukwenza i-VATS, futhi kulezi zimo futhi i-lobectomy evulekile kungenzeka ibe kokuphephile futhi kungenzeka ukuthi isuse sonke isisu.
Akuwona wonke odokotela abahlinzayo abakhululekile ukwenza i-VATS futhi lokhu kungabamba iqhaza esinqumweni. Qinisekisa ukuthi ubuza ukuthi kungani i-lobectomy evulekile inconywa uma lokhu kuphela okukhethwa kwakho.
Ungase ufise ukuthola umbono wesibili kudokotela ohlinzayo okhululekile okwenza i-VATS, kodwa khumbula ukuthi ngisho nabahlinzayo abahlinzayo abakhulu ngeke benze i-VATS uma indawo yesikhumba iphakamisa ukuthi i-lobectomy evulekile iyindlela yokuhlinzwa engcono. Kukhona ukungqubuzana ngokuthi ngabe izinqubo ze-VATS ziba yizinga lokunakekelwa, kodwa okuningi okukhathazayo kusekuhlangenwe nakho kwabahlinzayo abaqhuba inqubo. Ukuze umdlavuza wamaphaphu asheshe, i-VATS lobectomy ngokuvamile iyindlela enhle, kodwa ngezokwelapha zamaphaphu eziphambili, kungenzeka ukuthi isipiliyoni somhlinzeki ohlinzayo sibaluleke kakhulu emphumela.
Esinye isizathu sokuthi umbono wesibili ungabalulekile ngomdlavuza wamaphaphu yilokho ukuhlola kubonisa ukuthi imiphumela yabantu abahlinzekwa umdlavuza wamaphaphu ezindaweni ezikwenza ukuhlinzwa okukhulu kakhulu kulezi zindlela zokuhlinzwa zivame ukuba ngcono. Ngokuvamile, amathuba omphumela omuhle ngomdlavuza wamaphaphu uvame ukuba ngcono ezingxenyeni ezinkulu zomdlavuza nokufundisa ezibhedlela kunezibhedlela ezincane zomphakathi.
Ukulungiselela
Ngaphambi kwe-lobectomy yakho, udokotela wakho uzofuna ukuqinisekisa ukuthi uphilile ngangokunokwenzeka. Uzophinde afune ukwazi ukuthi uzokwazi ukuphefumula ngokunethezeka ngemuva kokuthi i-lobe yamaphaphu yakho isuswe. Ngaphandle komlando oqaphileyo nokuhlolwa kwegazi nangokwenyama, ukuhlolwa kokuphefumula ( ukuhlolwa komsebenzi wamaphayiphu ) kuzokwenziwa ukuhlola umsebenzi wakho wamaphaphu ngaphambi kokuhlinzwa. Kuye ngobudala bakho nesimo somzimba, angase ancoma izivivinyo ukuze ahlole inhliziyo yakho.
Udokotela wakho uzobukeza ngokucophelela yonke imithi yakho ngesikhathi sokuvakasha kwakho kwangaphambi kokusebenza futhi angase ancoma ukumisa iminye yemithi yakho isikhathi esithile ngaphambi kokuhlinzwa. Kuyasiza uma uletha amabhodlela aqukethe noma yimiphi imithi kadokotela kanye nemithi engekho imithi, kanye nanoma yimaphi ama-supplements, okufaka amavithamini, oyisebenzisayo.
Uma ubhema, uzocoma ngokuqinile ukuthi uhambe ngokushesha ngangokunokwenzeka. Ukuyeka ukubhema ngaphambi kokuhlinza kunganciphisa ingozi yakho yezinkinga futhi kwandisa amathuba okuhlinzwa kwakho kuyophumelela.
Funda kabanzi mayelana nendlela yokulungiselela ukuhlinzwa komdlavuza wamaphaphu .
Inqubo
I-lobectomy yenziwa ekamelweni lokusebenza ngemuva kokuba unikezwe isifo sokubulala umzimba. Kunezinqubo ezimbili ezinkulu ezivame ukwenziwa ukuze kususwe i-lobe yamaphaphu. Esikhathini se-lobectomy evulekile, i-lobe yamaphaphu isuswe ngokuchotshozwa isikhathi eside eceleni kwesifuba. Esikhathini se-VATS lobectomy, i-lobe isuswa ngokusetshenziswa kwekhamera kanye nezinsimbi ezikhethekile ngokusebenzisa imibono emincane emincane esifubeni.
Ngaphambi kokuvala ukushisa, udokotela ohlinzayo uzofaka ithubhu yesifuba endaweni yokuhlinzeka ukuvumela uketshezi oludlulayo nomoya ukukhipha ngaphandle kwesifuba isikhathi esithile.
Ukubuyisela
Ukulandela i-lobectomy yakho , uzobe uhlolwe enyunithi yokunakekela kakhulu (i-ICU) usuku noma ngaphezulu ngaphambi kokuya ekamelweni lesibhedlela. Umuthi wokuphefumula uzosebenza nawe, akucele ukuthi uphefumule kakhulu futhi uphefumule ku-spirometer yokukhuthaza. Abanakekeli bazokusiza ukuba uvuke futhi uhambe ngokushesha uma usukwazi. Njengoba kunenkinga, abantu abaningi bahlala esibhedlela phakathi kwezinsuku ezingu-4 no-7, kuye ngokuthi uhlobo lwe-lobectomy olwenziwe.
Izinkinga
I-lobectomy iyindlela enkulu yokuhlinzwa, futhi izinkinga azivamile. Udokotela wakho uzoxoxa ngalokhu ngaphambi kokuhlinzwa. Ezinye izinkinga ezingase zibandakanye:
- Ukufudumala kwomoya okude isikhathi eside, kudinga ukuthi ithubhu yesifuba ishiywe endaweni engaphezu kwezinsuku ezintathu ukuya kwezingu-4. Lokhu kuyinkimbinkimbi evamile kakhulu.
- Izifo, njenge-pneumonia.
- Ukuphuza.
- Izinkinga zenhliziyo, ezifana nesifo senhliziyo noma izilinganiso ezingenangqondo zenhliziyo.
- Ama-blood clots emilenzeni (i-DVTs) noma ehamba emaphashini (ama- pulmonary embolus .)
- I-post-thoracotomy pain syndrome . Ubuhlungu obuphikelela ngemuva kwe-lobectomy kungabangela ukukhathazeka, kodwa kwenziwa okuningi ukuzama ukwenza umehluko. Kungenzeka ukuthi kwenzeke ngemuva kwe-lobectomy evulekile kunenqubo ye-VATS.
Isibikezelo
I-prognosis elandela i-lobectomy incike ezintweni eziningi ezihlukene. Ezinye zazo zihlanganisa isiteleka somdlavuza wakho wamaphaphu-okungukuthi, ukuthi usakaze kangakanani-kanye nempilo yakho jikelele nokuthi unanoma yimiphi enye izinkinga zamaphaphu ngaphezu komdlavuza wamaphaphu.
Ukufa okuphelele (ingozi yokufa) kungaphansi kwamaphesenti amathathu, kodwa abantu abaningi banenkinga yesikhashana njengokungathi umoya uvuza.
Uma i-lobectomy yenziwe ngempumelelo emdlalweni wamaphaphu emapulazini, ihlinzeka ithuba lokuphila isikhathi eside ngaphandle kokuphindaphinda umdlavuza.
Okukhethwa okungaxoshwa ngokwanele emva kokuhlinzwa komdlavuza wamaphaphu kungukuvuselelwa kwepulmonary. Ukuvuselelwa kwamapulmonary for umdlavuza wamaphaphu usanda kuqaliswa kwezinye izikhungo zomdlavuza kodwa kubonakala kusiza ngezimpawu zokuphefumula kanye nezinye izimpawu.
> Imithombo:
> Chang, J., Sena, S., Paul, M. et al. I-stereotactic Ablative Radiotherapy Versus Lobectomy yeSigaba Esisebenzayo I-Can-Small-Cell Cell Cancer Lung: Ukuhlaziywa Okuhlanganiselwe Kwezilingo Ezinzima Ezihleliwe. I-Lancet Oncology . 2015. 1 (6): 630-637.
> Oncel, M., Sunam, G., no H. Yildiran. I-lobectomy ye-Thoracoscopic exhaswe ngevidiyo nge-Cancer Lung. Ama-Annal of Surgery Thoracic . 2017. 104 (5): 1760.
> Vannucci, R., noD. Gonzalez-Rivas. Ingabe i-VATS Lobectomy Standard yokunakekela i-Canable Small-Small Cell Lung Cancer? . I-Cancer Lung . 2016. 100: 114-119.
> Ziarnik, E., no-E. Grogan. I-Post-Lobectomy Izinkinga Zokuqala. Imitholampilo yezokwelapha . 2015. 25 (3): 355-364.