Uhlolojikelele lwezokwelapha zokwenziwa kabusha kwebele

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Ukwelashwa Kwemithi Yokuvuselelwa Kwamabele Ngemva Kwesifo Se-Mastectomy

Ukwenziwa kabusha kokubelethwa kwesisu, inqubo yokubuyisela ukubukeka kwemvelo kwesifuba, ivame ukuqhutshwa ngemuva kwezinqubo ezingezansi zesekhondomu zomdlavuza webele . Iziguli ezinezinqubo ze- lumpectomy ngokuvamile azidingi ukuvuselelwa, njengoba inani lamathambo lisusiwe kakhulu. Ezinye iziguli azifisi ukuhlinzwa ukuvuselela isifuba ngemuva kokuthi zisusiwe, kodwa iningi likhetha ukuvuselelwa kabusha kwebele.

Ezingxenyeni eziningi, ukwakha kabusha ngemuva kwesifo se-mastectomy for umdlavuza webele kunembozwa yomshuwalense, njengoba kabusha kwakubhekwa njengengxenye yenqubo ye-mastectomy. Iziguli ezicubungula i-prophylactic, noma yokuvimbela, i-mastectomy ingase ifune ukuqinisekisa ukuthi umshuwalense uhlanganisa kokubili i-mastectomy yokuqala kanye nokwakhiwa kabusha.

Kwabesifazane abakhetha ukungayakhi kabusha, kunezingubo ezikhona ezitholakala ngokufakwa kocansi okunikeza ibhalansi nesifuba esisele.

Uma isinqumo senziwe ukuba sibe nesisindo somzimba, ukukhetha mayelana nokuvuselelwa kufanele kwenziwe ngaphambi kokuhlinzwa. Isinqumo kufanele senziwe ngemuva kokubonisana nodokotela ohlinzekwe ngebhola ephasitiki eqinisekisiwe ebhodini enezimo ezinqubo zokuvuselelwa kwebele. Lokhu kungenxa yokuthi ukuvuselelwa kungaba "okusheshayo" futhi kugcwaliswe ngesikhathi sokuhlinzwa okufanayo njengendlela ye-mastectomy noma "ukubambezeleka" futhi kwenziwa ngosuku oluthile.

Ukwakhiwa kwesisu kuyindlela yokwelashwa futhi kwenziwa ngokusebenzisa i- anesthesia ejwayelekile . Iziguli zihlala esibhedlela okungenani usuku olulodwa ngemuva kokuhlinzwa.

Kwabesifazane abanamabele amakhulu noma amabele azobukeka ahluke kakhulu ngobukhulu noma ukuma kunesifuba esakhiwe kabusha, ukunciphisa kwebele kungadingeka ukunikeza ukulinganisa. Enye indlela yindlela yokufakelwa noma ukuphakamisa isifuba esiswini esisele.

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Ukuvuselelwa Kamuva Kwebele Nezimpande Zomzimba

Ukuvuselelwa ngokushesha kwamabele kwenzeka ngesikhathi esifanayo njenge-mastectomy futhi kuvame ukuhlinzwa odokotela bama-plastic. Ochwepheshe batusa ukuvuselelwa okusheshayo kweziguli ezilindele ukuba zibe nemisebe emva kokulandela isimiso se-mastectomy. Ukuqina kwesikhumba, ikhono lesikhumba ukuphulukisa nokubonakala kwezicubu ezibomvu kungashintshwa ngemithi yokwelashwa. Ngokuqedela ukuvuselelwa ngaphambi kwemisebe, isikhumba sinamandla amakhulu okuphulukisa okuholela ekutholeni umphumela wokuzithokozisa.

Ngesikhathi sokuvuselelwa ngokushesha, ekuphetheni kwesigaba se-mastectomy senqubo, ukufakelwa kwesifuba kufakwa endaweni yezincuba zesifuba esusiwe. Uhlobo lwe-implant, abisiliconsi noma u-saline luvame kakhulu, luyisinqumo esenziwe isiguli ngemuva kokuxoxisana nodokotela ohlinzayo we-plastic.

Enye yezinzuzo zokuvuselelwa ngokushesha ukuthi akukho sidingo sokuhlinzwa okungeziwe ngemva kokuvuselelwa ngokushesha. Le nqubo yenziwa uma ingxenye yokuhlinzwa yokuhlinzwa isenziwa, ukuqeda ingozi ehlobene nokuhlinzwa kwesibili. Abanye besifazane bathola le nketho ukuba ibe ekhangayo kunezinye izinhlobo zokuvuselela izizathu ezingokomzwelo. Isiguli asiboni isifuba phakathi kokususwa kwezicubu nokubekwa kwe-implant.

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Ukwelashwa Kwemithi Yokuvuselelwa Kwamabele Ngezimpande Zebele

Ukwakhiwa kabusha kwesifuba esinyatheliswayo okubili ngokushesha kuyindlela yokwakha kabusha eqala ngesikhathi sokuhlinzwa okufanayo njengendlela ye-mastectomy, kodwa iphelile ngosuku oluthile. Le nqubo ifanele uma isikhumba sesifuba esisele siqinile futhi singakwazi ukufaka isikhala ngesikhathi sokuhlinzwa.

Ngokuvamile, ukufakelwa kwe-balloon e-inflatable kufakwe ngaphansi kwesikhumba futhi kuhliswe isiline ngaphezu kwamasonto noma izinyanga ukululaza isikhumba kanye nezicubu ezingaphansi. Lapho isikhumba selulile ngokwanele ukufaka isitshalo, ukuhlinzekwa kwesibili kwenziwa ukufaka ibhaluni ngesitshalo esiphakade. Kwezinye izimo i-expander ingashiywa esikhundleni esikhundleni salesi sitshalo se-saline noma isiliva se-silicone.

Le nqubo ingasebenzisa i-flap, noma i-graft of tishu evela kwenye indawo emzimbeni, ukufakazela izicubu zesifuba ezisele noma esikhundleni sokufakelwa. Isinqumo sokusebenzisa i-flap kufanele senziwe ngokubonisana nodokotela ohlinzayo wasePlastiki njengoba akufanele bonke abagulayo.

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Ukuhlinzwa Ukwakhiwa Kwebele Kwezinsana Zesibili Ngezibeletho Zebele

Ukunciphisa ukuvuselelwa kwesigaba ezimbili, kufana nokuvuselelwa kokubili kwesiteji, kuyindlela yokuhlinza emibili esetshenziselwa ukuvuselela izicubu zesifuba ngemuva kwesifo se-mastectomy. Ngokungafani nenqubo yesigaba esinezinyawo ezimbili, inqubo yokuhlinza ukufaka i-tissue expander balloon yenziwa ngokuhlukana nokuhlinzwa kwe-mastectomy futhi idinga ukuhlinzwa okwesithathu nokugcina ukuqedela inqubo.

Lapho umxhwele esendaweni ukhona kancane kancane ngokufaka injini yesisombululo saline phakathi kwamasonto noma izinyanga ukuze welule isikhumba sesifuba. Lapho i-expander ihlanjululwe ngokwanele ukuze ifake isitshalo esifanele, kungenziwa ukuhlinzwa ukuze ufake ukufakelwa okuzohlala unomphela. Kwezinye izimo, i-expander ingashiywa esikhundleni esikhundleni se-silicone noma ukufakwa kwe-saline.

Le nqubo ingasebenzisa i-flap, i-tissue graft evela kwenye indawo yomzimba, ukufakazela izicubu zesifuba ezisele noma esikhundleni sokufakelwa. Isinqumo sokusebenzisa i-flap kufanele senziwe ngokubonisana nodokotela ohlinzayo wasePlastiki njengoba akufanele bonke abagulayo.

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Ukwakhiwa Kwebele Isisu Ngaphandle Kokutshala

Ukwakhiwa kabusha kwesifuba ngemva kokushaya isisu kungenziwa nge-flap yokuhlinzwa kunokufakelwa. Lena inqubo lapho izicubu zisuswe kwenye indawo yomzimba ezifana nesisu noma emuva futhi zithuthela esifubeni ukuze zithathele izicubu ezisusiwe. Lolu hlobo lokuvuselela lusebentisa umuthi wesiguli, isikhumba namanoni ukuvuselela isifuba esikhundleni sokufakelwa.

Kunezinhlobo eziningana zenkambiso ye-flap. I-TRAM i-TRAM (i-transverse rectus abdominus muscle) isebenzisa isikhumba esiswini nesisu somzimba ukuze kutholakale izicubu ezintsha zesifuba. Kwezinye izimo izicubu zisuswe ngokuphelele esiswini bese zifakwa endaweni yesifuba. Lolu hlobo lwesiphakamiso, lapho izicubu zisuswa futhi lubekwe kwenye indawo, libizwa ngokuthi i-flap yamahhala.

Olunye uhlobo lwenqubo esebenzisa izicubu zomzimba yisisu sokuhlinzwa kwesisu esiswini. Izicubu zesisu azikhishwa emithanjeni yegazi ezondla, kodwa izitsha ziqondiswa ngaphansi kwesikhumba endaweni yesifuba lapho izicubu zithunjwa khona. Lolu hlobo lwesiphakamiso, olunikezwa ngegazi lugxile emthonjeni walo wokuqala, lubizwa ngokuthi i-pedicle.

I-DIEP flap (ingaphakathi elijulile le-epigastic arter perforator) iphinda isebenzise izicubu zesisu, isuswe futhi isetshenziswe endaweni yebele njengoba i-flap yamahhala. Le nqubo ihlukile ngoba ukususwa kwezicubu kufana nokuphakama kwesisu (tummy tuck) futhi akusebentisi izicubu zesisu, amafutha kuphela nesikhumba kuphela.

Inqubo ye-latissimus dorsi flap isebenzisa izicubu ezivela emisipha enkulu ngemuva ehamba ehlombe. Inqubo ye-pedicle flap, i-latissimus dorsi flap ishiywe ihlanganiswe negazi layo futhi iqondiswa endaweni ngaphansi kwesikhumba sesifuba futhi igxilwe endaweni.

Izinqubo ze-flap azifanelekile ezigulini okwamanje ezibhema, ziyisifo sikashukela noma zinezinye izimo ezinciphisa ukuphulukiswa kwesikhumba.

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Ukuhlinzwa Ukwakhiwa Kwangono

Ngaphandle kokuhlinzwa kokuvuselelwa kwe-nipple isifuba esakhiwe kabusha sinesikhumba sesifuba esivamile, kodwa ingono ne-areola azikho. Iziguli ezithatha ukuhlinzwa ukuvuselelwa kwe-nipple zenza njalo ngosuku olwedlula ukwedlula ukuhlinzwa kabusha.

Ukwakhiwa kwezinyosi kwenziwa ngokuthatha izicubu kusuka kwenye ingxenye yomzimba futhi ukuyihlanganisela esifubeni, ukuyibeka endaweni ngendlela yokuthi i-ingono ikhiwa. Ngalesi sikhathi, i-nipple graft iyinombala yesikhumba ngaphandle kokuthi ukuhlanganiswa kuthathwe kwenye ingono, futhi ayikho i-areola ezungeze ingono. Uma i-areola noma umbala wesikhumba ofanayo nombala wokuqala we-ingono ufisa umbala usetshenziswe unomphela ngokudweba umbala esikhumbeni.

Ngokungafani nokuhlinzwa okuyisisekelo okuyinhloko, ukuvuselelwa kwe-ingono kungenziwa ngokujwayelekile ngesifo sokuphulukiswa kwesifo sengculaza nge-anesthesia yendawo. Abanye besifazane bakhetha ukungabi ne-nipple futhi beola kabusha, isinqumo somuntu siqu, futhi inqubo iwukuphela kwezimonyo, ehlinzeka ibhalansi nesinye isifuba.

Ingxube eyakhiwe kabusha ayinayo ukuzwela okufanayo njengensipho yasekuqaleni, kodwa ihlinzeka ukubonakala komzimba ngokwengeziwe. Ngemuva kokuvuselela ingono ingase ibonakale ivulekile, ivela evela esifubeni, yenza abanye besifazane bazizwe beqaphele ngokubonakala kwekhono ngosuku lokuphila kwansuku zonke. Uma lokhu kukukhathazeka, kufanele kukhulunywe nomhlinzeki wezinambuzane epulasitiki lapho ehlela inqubo.

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Ukuvuselelwa Ngemva Kokuhlinzwa Kwama-Breast Reconstruction

Kungokwemvelo ukuzizwa ushathele amasonto ambalwa emva kokuhlinzwa kwebele. Iziguli zibuhlungu kakhulu emva kwenqubo futhi kungenzeka zanda ubuhlungu ngokuphakamisa noma ukuhamba kwezandla. Iziguli ziyakwazi ukubuyela emisebenzini eminingi zingakapheli amasonto ayisithupha, kodwa umsebenzi onamandla, ikakhulukazi lezo ezikhiqiza ukunyakaza, njengokugijima, kungathatha isikhathi eside. Iziguli zikwazi ukubuyela empilweni yokusebenza ngokobulili ngaleso sikhathi futhi.

Kubalulekile ukuqaphela ukuthi ukwelashwa komdlavuza kungabambezeleka ukuphulukisa futhi ukwandise ukukhathala. Uma isiguli sithola ukwelashwa ngomdlavuza, ukuphola kabusha ekuhlinzekeni kabusha kungase kwandiswe njengoba imiphumela emibi kokubili i-chemotherapy kanye nemisebe ingabandakanya ukukhathala, isifo sohudo, isisindo sezinyosi nokuhlanza. Abanye besifazane bakhetha ukuvuselelwa ngokushesha ngoba nje bangalindeli ukuzwa kahle ngokwanele ukuhlinzekwa kabusha kwezinyanga ezinyangeni ezilandela ngokushesha imastectomy.

Amaqembu amaningi asekela atholakalayo, kokubili ku-intanethi nasemizini ezweni lonke, ukusiza iziguli ukuba zibhekane nezinguquko ezibangelwa umdlavuza webele. Lawa maqembu asekelayo anika iziguli ithuba lokuxhumana nabanye abaye babelane nakho futhi banganikeza ubungane ngaphezu kokusekela nokuqondiswa.

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Ukuya ocansini emva kokuhlinzwa kokuvuselelwa kwebele

Ukubuyela empilweni esebenzayo yocansi ngemuva kokuhlinzwa kokuvuselelwa kwesisu kanye nesifuba kokubili kuyinkinga engokomzimba nengokomzwelo. Ubuhlungu obuvela ekwakhiweni kungavimbela isiguli ukuba singenzi umsebenzi wocansi, njengoba isifuba sizoba sesineke futhi sinethenda ngokunyakaza okuningi. Njengoba ubuhlungu buqeda isinqumo sokubuyela emsebenzini wocansi kungabangela ukukhathazeka nokucindezeleka.

Ubulili bungase bube ngokomzimba kepha inkinga ingahle ikhokhiswe ngokomzwelo. Ukukhathazeka ngokubukeka kwesifuba esisha noma kabusha kungokwemvelo futhi kulindeleke. Iziguli zivame ukukhathazeka mayelana nezibazi zokuhlinzwa nokuzwa kwesifuba, okuvame ukuhluka kunalokho ngaphambili.

Ingxoxo evulekile phakathi kwesiguli nomlingani wayo ingasiza ukusula umoya nokunciphisa ukukhathazeka okwenziwa ngumlingani. Isiguli singase sikhathazeke ngokubukeka nokuzwela ngenkathi umlingani engase abe nokukhathazeka ngokulimaza isifuba noma ukulimaza endaweni yethenda.

Kufaka ingxoxo mayelana nendlela amabele azizwa ngayo, ukuthi ukuzwa kanjani kuhluke ekuzwayo ngaphambi kokuhlinzwa nokuthi yikuphi ukuzwa okujabulisayo kungabasiza lapho uqala kabusha umsebenzi wezocansi.

Kubalulekile ukukhumbula ukuthi ubulili angeke buzizwe njengento ebaluleke kakhulu ekubhekaneni nesifo esongela impilo, futhi ukungabi nokushayela ucansi kungaba yingxenye yesifo sonke, kunokukhathazeka ngesifuba. Ukungabi nesifiso kungase kube nokuningi kokwelashwa kwemithi kanye nemiphumela emibi futhi akuhambisani nokubonakala kwesifuba.

Ukucindezeleka kuvamile ezigulini zomdlavuza webele, cishe uhhafu wabo bonke abantu ababhekene nesifo sokucindezeleka ngonyaka olandela ukuxilongwa. Ukucindezeleka kunganciphisa kakhulu ukushayela ucansi njengoba izimpawu, kuhlanganise ukukhathala nokucasula, kungenza ubulili bube nzima.

> Imithombo:

> Ukucindezeleka Nokukhathazeka Kwabesifazane Abanomdlavuza Webele Wesifuba. Burgess, uCornelius, et al, i-British Medical Journal. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=15695497

> Ukwelashwa kwe-Radiation & You. Izikhungo zezempilo zikazwelonke. http://www.cancer.gov/publications/patient-education/radiationttherapy.pdf

> Izimpawu Nezibonakaliso Zokucindezeleka. Izikhungo zezempilo zikazwelonke. http://www.nimh.nih.gov/health/topics/depression/men-and-depression/signs-and-symptoms-of-depression/index.shtml