Abacwaningi bahlole i-Lobectomy noma i-Total Thyroidectomy ye-Papillary Cancer
Ngo-2017, i-American Cancer Society inquma ukuthi cishe amacala amasha angu-56 870 omdlavuza wegciwane uyotholakala: 42,470 kubesifazane, no-14,400 ngamadoda.
Ukwelashwa okujwayelekile komdlavuza wegciwane kungukuhlinzwa ukukhipha umdlavuza. Ngokujwayelekile, ochwepheshe batusa ukuthi ukuhlinzeka kususwe lonke igciwane le-thyroid. Ukususwa okugcwele kwegciwane le-thyroid kuyaziwa ngokuthi i- thyroidectomy yakho yonke .
Kusukela ngo-2017, imihlahlandlela ye-American Thyroid Association yomdlavuza wegciwane ikhuthaza ukuthi isiguli sithole i-thyroidectomy yakho yonke imithi yomdlavuza wegciwane . Okuwukuphela kwendlela eyenziwa ngayo izicubu ezincane kakhulu ze-thyroid ezingaphansi kuka-1 cm ububanzi.
E-United States, cishe amaphesenti angaba ngu-80 azo zonke umdlavuza we-thyroid kukhona umdlavuza we-papillary, obizwa nangokuthi i-papillary carcinoma noma i-adenocarcinoma yamaphepha. Umdlavuza we-Papillary cishe ubonakala ngakolunye uhlangothi lwe-thyroid-owaziwa ngokuthi i-lobe-futhi lolu hlobo lomdlavuza we -roid lukhula kancane kancane. Umdlavuza we-papillary ungasakazeka emagqabini amancane lensimbi entanyeni. Ngisho nalapho isakaze kuma-lymph nodes, izibalo zibonisa ukuthi umdlavuza we-papillary uphathwa kahle, futhi awuvamile ukubulala.
Imiphumela yokucwaninga yocwaningo eyethulwa ngo-2016 Clinical Congress ye-American College of Surgeons yasikisela ukuthi iziguli eziningi zomdlavuza wegciwane le-papillary zizozuza ngokuhlinzwa okungenalutho okungabizi, okungenasisindo, nokuphumelelayo okuyingxenye ebizwa ngokuthi i-lobectomy, ngokumelene nesifo sakho se-thyroidectomy.
Ku-lobectomy, kuphela i-lobe ethintekile isuswa ngokuhlinzwa.
Ngokuqondile, abaphenyi abavela eTulane University School of Medicine eNew Orleans naseJohn Hopkins School of Medicine eBaltimore banquma ukuthi iziguli eziningi zomdlavuza wegciwane lesandulela ngculazi, i-thyroidectomy yakho iyabiza futhi ibangela ukwehlisa izinga lokuphila uma kuqhathaniswa ne-lobectomy.
Umphenyi oholayo u-Zaid Al-Qurayshi, MD, MPH, we-University of Iowa Hospital, wathi:
Izinto esizifunayo zibonisa ukuthi kusukela embonweni wezomnotho, ukwenza i-lobectomy esikhundleni se-thyroidectomy esiphelele kuziguli eziye zalahlwa yi-biopsy ye-papillary thyroid carcinoma zihambisana nezindleko eziphansi nokusebenza kangcono. Kubalulekile ukuphawula, lokhu okutholayo akusho ukuthi i-lobectomy yindlela ephumelelayo kuphela; sidinga isu 'elibiza izindleko' uma kuqhathaniswa nenye indlela uma kubiza okungaphezulu, noma okufanayo, kodwa kuhlotshaniswa nokusebenza okungcono.
Esinye isifundo saqhathanisa ukusinda komdlavuza we-thyroid kanye nokuphindaphinda kwamazinga ezigulini ezinesifo sakho se-thyroidectomy ngokuvumelana ne-lobectomy. Ucwaningo lwama-10 lwaluqhutshwa yiSikhumbuzo seCreattering Kettering eChristal Sloan eNew York. Kulolu cwaningo, abacwaningi bahlola iziguli ezinegciwane lesifo sengculaza ngaphansi kwezingu-4 cm ngobukhulu obungasakaze ngaphandle kwe-lobe. Abacwaningi abatholanga ukuhlukana okuphawulekayo ekusindeni kweminyaka engu-10 noma izinga lomdlavuza wegciwane lesandulela ngculaza kula maqembu amabili. Lolu cwaningo lubonise ukuthi ngokuhamba kwesikhathi, ngokusinda komdlavuza wegciwane kanye nengozi yokuphindaphindiwe, i-lobectomy yayisebenzisekile njenge-thyroidectomy yakho yonke yamakhansela amancane wegciwane.
Imiphumela ye-Lobectomy
Ngokusho kwabacwaningi, ngeqembu elihlosiwe leziguli zomdlavuza we-papillary, i-lobectomy ingcono kune-thyroidectomy engqikithi ngezizathu eziningi, kufaka phakathi:
- I-Lobectomy ukuhlinzwa okufishane kune-thyroidectomy esiphelele, futhi ngokuvamile ingenziwa ngesikhathi sokugula .
- I-Lobectomy inengozi encane yokucindezeleka kokuhlinzwa uma kuqhathaniswa ne-thyroidectomy yakho yonke.
- Ukuphelelwa emva kwe-lobectomy kuyashesha uma kuqhathaniswa ne-thyroidectomy yakho yonke
- Ngemuva kwe-lobectomy, kungenzeka ukuthi awudingi i-hormone ye-thyroid esikhundleni (noma uma wenza, umthamo ungase uphansi). Uma une-thyroidectomy esiphelele, uzodinga imithi yokwelapha i-hormone yokuguqula impilo yonke.
- Iziguli ze-Lobectomy zibika ikhwalithi engcono yokuphila ngemva kokuhlinzwa uma kuqhathaniswa ne-thyroidectomy yakho yonke.
Ingabe Ungumuntu Omele Lobectomy?
Ucwaningo lubonise ukuthi i-lobectomy ingasebenza uma umdlavuza wegciwane we-papillary uhlangabezana nemigomo emithathu eyinhloko:
- Umdlavuza we-papillary we-thyroid isigaba I noma II kuphela
- I-tumor isendaweni eyodwa kuphela ye-thyroid
- Isisu sinama-4 cm noma ngaphansi kwesayizi
Uma unomdlavuza wegciwane we-papillary ohambisana nalezi ziminganiso, ungase ufune ukuxoxa nge-lobectomy ngokulingana ne-thyroidectomy yakho kanye nodokotela wakho ohlinzayo wegciwane.
Olunye Ukwaziswa Ngeziguli
Inkinga yezihlinza ezihlinzayo zegciwane iveza iphuzu elibalulekile. Ngisho ne-lobectomy, izinkinga zingase zenzeke uma udokotela wakho ohlinzayo enesipiliyoni esincane esenza ukuhlinzwa kwe-thyroid. Kubalulekile ukufunda okuningi ngangokunokwenzeka futhi ukhethe udokotela ohlinzayo onokuhlangenwe nakho okubanzi ekuhlinzekeni kwegciwane .
> Imithombo:
> Nixon, IJ et al. I-lobectomy ye-thyroid yokwelapha ukulimala okungafani kahle kwe-intrathyroid. Ukuhlinzwa. 2011. Okthoba 14, 2011
> Noureldine, S. noKandil, E. "Ukususwa kwe-lobe esikhundleni se-thyroid yegciwane kungase kuzuze iziguli zomdlavuza we-thyroid." I-American College of Surgeons: 2016 Clinical Congress Proceedings.