Imibuzo Ephathelene Nezimo Ezijulile Eziphansi E-Argyperi Artery I-Perforator Flap Yokwakhiwa kabusha
Ngemuva kwe- mastectomy , abesifazane abaningi bangakhetha ukuhlinzwa ngokuvuselela ukuthuthukisa ukubonakala kwesifuba ngemuva kokuhlinzwa. Enye yezinqubo ezivame kakhulu ukuvuselelwa kabusha kwe-epigastric artery perforator (DIEP).
Yini Ukuvuselelwa Kwe-DIEP Flap?
I-DIEP ipopu inqubo ye-flap ye-tissue esebenzisa amafutha nesikhumba kusuka emzimbeni wakho ukwenza isilonda sesifuba esisha ngemuva kwe- mastectomy . Le nqubo ithatha igama layo kusuka ku-DIEP endaweni yakho yesisu futhi iyindlela yokwakhiwa kabusha kwe- autologous , ukuhlinzwa okusebenzisa izicubu zakho.
Ngenkathi le nqubo ingathuthukisa ukubukeka kwesifuba sakho, kufanele wazi ngaphambi kwesikhathi ukuthi ngeke kubonakale njengamabele akho emvelo. Ngenkathi abanye besifazane beqala ukuvuselelwa kabusha kwe-DIEP, abanye bakhetha ukuhlinzwa okwakhiwa kabusha ukuze benze ukubonakala kwe- nipple ne-areola .
Yini Engingayilindela Ngenkathi Inqubo?
Udokotela wakho ohlinzayo uzosusa isikhumba namafutha esiswini sakho esifubeni sakho. Akukho muscle wesisu okuyokwaziswa noma ukuhanjiswa phakathi nale nqubo. Abaningi besifazane banezicubu ezanele ngokwanele endaweni yabo yesisu ukuze benze isifuba esisha. Uma kungenjalo, ukufakelwa okuncane kungabekwa ngaphansi kwesikhumba sakho sofuba ukuze udale usayizi wesifu oyifunayo. Ukususa isikhumba namafutha esiswini sakho kufana nenqubo yesisu. I-DIEP i-flap ibuye ihlanganise ukuhamba kwe-artery kanye ne-vein kusuka ku-tissue flap yakho kuya esifubeni ukuze izicubu ezifakelwayo zinganikezwa ngegazi.
Yiziphi Izinzuzo Nezimo eziphuthumayo ze-DIEP Breast Breast Reconstruction?
Ngalendlela, akukho muscle ohanjiswayo noma ophindwe kabusha njengalokho kuzoba ne- TRAM flap . Kukhona ingozi ephansi kakhulu yokuthuthukisa i-hernia yesisu futhi isheshe, ngobuhlungu obuncane, kunokugqama kwe-TRAM. Ukukhipha i-DIEP namafutha kukunika isisu, noma isisu esincane, ngesikhathi esifanayo sokuba amabele akho abuyiselwe kabusha. Inqubo inezinga elingaphansi kwe-1% lokuhluleka.
Nokho, uma kuqhathaniswa ne-TRAM flap, i-DIEP idinga isikhathi esengeziwe ekuhlinzeni. Izibazi ezimbili zizovela ku-DIEP futhi uma inqubo ihluleka, i-flap ye-tishu ingafa futhi kufanele isuswe. Ukwakhiwa okusha kuzodingeka kubanjwe izinyanga ezingu-6-12.
Ngingumkhethi Ohle?
Uma ungenawo amafutha okwanele okwanele noma omncane kakhulu, cishe ngeke ube ngumuntu omele ukhetho kule nqubo. Ukwengeza, uma uphethile osebenzayo, uhlamvu lwakho luzophulukisa kancane kancane futhi izicubu ezinamafutha cishe zikhule zibe izicubu ezinzima.
Kudala Kangakanani Ngemuva Kwesifo Sengqondo Kufanele Ngilinde Ukuvuselelwa?
Ukuvuselelwa kwesisu kungenziwa ngesikhathi sokugaya isisu noma emva kwe-chemo kanye nemisebe. Uma udinga imithi yokwelapha ehlose indawo yakho engaphansi kwegazi noma isifuba, udokotela wakho angase ancome ukuthi ubambezele ukuvuselelwa. Ukuba nenqubo eyenziwe ngaphambi kokuba imisebe igcwaliswe kunciphisa ngempela ikhono lomuthi we-radiation lokuphatha kahle umdlavuza wakho.
Kufanele Ngibuke Nini I-Surgeon Plastic?
Uma ucabanga ngokuvuselela, kuyinto enhle ukubona umhlinzeki wakho wezinambuzane epulasitiki ngaphambi kokuba ahlinzeke ngokuhlinzwa kwe-mastectomy. Lokhu kukunika ithuba lokuba nemilinganiselo eqondile nezithombe ezithathwe ngamabele akho angokwemvelo. Udokotela ohlinzayo wasePlastiki uzosebenzisa lolu lwazi ukwenza isifuba sakho esakhiwe kabusha siseduze nesimo sakho semvelo nosayizi ngangokunokwenzeka. Uma uxoxe naye kusengaphambili, udokotela wakho ohlinzayo we-plastic uzokunika ukukhetha okuhlukahlukene, akusize ugcine isikhumba sebele futhi uvimbele izibazi ezingadingekile.
UDokotela ohlinzayo uzokwenza kanjani uhlelo lweNqubo?
Udokotela wakho ohlinzayo uzofaka isikhumba sakho ukuhlela ngokucophelela ukucubungula kwe-tissue flap. Usebenzisa isikhala sesikhumba, uzokhipha isigaba semi-elliptical esiswini sakho, ngezansi kweveli yakho futhi ngaphezu kwendawo yakho ye-pubic. Leli ellipse elincane lizoba isikhumba sesikhumba esivala ukufakwa kwesifuba sakho esakhiwe kabusha. Uma ukufakwa kwe-flap kuvaliwe, kuyoba umugqa ohamba yonke indlela emzimbeni wakho. Leyo inqubo efanayo elandelwa isisu.
Kuthiwani Ngezikhumba, I-Fat, ne-Blood Supply?
Udokotela wakho ohlinzayo uzokwenza isikhumba esikhwameni esiswini sakho, futhi ukhulise uhlaka lwesikhumba namanoni. Ngaphambi kokuba unqamule lesi sikhumba somzimba, uzosesha umthambo we-perforator ophansi ophansi we-epigastric kanye ne-vein ezoletha ukuthembeka kwegazi okuthembekile esifubeni sakho esisha. Lezi zingxube zegazi zizogcinwa ngokucophelela kanye ne-flap yakho ye-tissue. Ukucubungula isisu sakho kuzovaliwe, futhi amanzi angabekwa ukukhuthaza ukuphulukiswa nokuvimbela ukwakhiwa kwamanzi. Inkaba yakho izohlala isesikhundleni ngaphezu kwe-incision.
I-Breast New yenziwe kanjani?
I-flap yakho ye-tissue, ephelele ngemithambo yegazi, izothunyelwa endaweni yakho ye-mastectomy. Ukuze uqinisekise ukuthi izicubu ziyasinda endaweni yayo entsha, udokotela wakho ohlinzayo uzosebenzisa i-microsurgery ukufaka kabusha imithwalo yegazi emgqonyeni wezicubu emithanjeni yegazi esifubeni sakho. Isikhumba sakho namathishu amafutha aphinde ashintshwe ngokucophelela emgodini webele bese eqhutshwa endaweni. Udokotela wakho ohlinzayo angasebenzisa amasu wokumaka isikhumba phezu kwemithambo yegazi ukusiza abahlengikazi bakho ukuqaphelisisa ukuphulukiswa njengoba uphila. Lindela ukuthi ube nezikhukhula zokuhlinzwa kulokhu ukusiza ukusiza ngokuphulukisa.
Yini engingayilindela ngesikhathi sokubuyiswa?
Kufanele uhlele ukuhlala esibhedlela izinsuku ezintathu noma ezine emva kwalokhu kuhlinzeka, ukuze abahlengikazi bakwazi ukugcina inqubo yakho yokuphulukisa. Phakamisa izingubo ezikhululekile, ezikhululekile zokuhamba kwakho ekhaya, uvumele indawo yokudonsa amanzi. Uma ukwakhiwa kwakho kwamanzi okushisa kunciphile kakhulu, ungase ukwazi ukukhishwa kwamanzi akho cishe ngemva kwesonto emva kokuhlinzwa. Hlela ukuphumula amaviki angu-4 kuya ku-6 ngemuva kwe-DIEP futhi wenze izinhlelo zokuba nomuntu ozohamba naye ukushayela futhi uphakamise noma yiziphi izinto ezinzima kuwe. Cishe uzoba nezincomo eziningana zokulandelela ukuze udokotela wakho ohlinzayo angakwazi ukuhlola inqubekelaphambili yakho yokuphulukisa, ukucubungula, nokushintsha ukugqoka kwakho.
Ingabe i-DIEP Flap Reconstruction i-option emva kwe-Double Mastectomy?
Uma unesikhumba esikwanele namanoni kumzimba wakho ukuze udale amabele amabili amasha, ungaba nokuvuselela kabusha kwe-DIEP ngemuva kwe-mastectomy kabili. Uma usuvele unezicubu zesisu esisetshenziselwa ukuvuselelwa kwebele, cishe kuzodingeka wenze inqubo ehlukile, njenge- flap lat noma ukufakwa .
Ingabe Kukhona Ukucabangela Okukhethekile Okufanele Ngikukwazi?
I-DIEP i- microsurgery , edinga ukuqeqesha okujulile nolwazi, ngaphezu kwezikhungo ezikhethekile namathuluzi okuhlinzeka. I-sutures esetshenziselwa ukuxhuma kabusha imithwalo yegazi ingaba ububanzi obufanayo njengezintambo zezinwele zakho. Ithimba lakho lokuhlinzeka lizosebenzisa i-microscope ephezulu yokubuyisela kabusha imithwalo yegazi, ingxenye ebaluleke kakhulu yale nqubo. Khetha udokotela ohlinzayo ngalolu lungiswa ngokucophelela, ebuza imibuzo eningi uze uzizwe ukhululekile ukwenza isinqumo sokuqhubeka ngenqubo.
> Imithombo:
I-American Cancer Society. Ukwakhiwa Kwebele Isisu Ngemva Kwemastectomy. Izinhlobo ze-Breast Reconstruction.
> National Cancer Institute. Ukwelashwa Izinketho Kwabesifazane Nge-Early Stage Cancer Breast.