Opaleshoni Yeniyeni ndi Gawo Lachitatu ndi Gawo la IV Khansa ya Ovarian
Kodi kutanthauzidwa ndi " opaleshoni " yotchedwa cytoreduction kapena opaleshoni yokwanira ya khansa ya ovari?
Kuchulukitsa kapena Kuchulukitsa Opaleshoni
Ngati mwachitidwa opaleshoni ya kansa yapamwamba ya ovari, imodzi mwa mafunso ofunikira kwambiri kufunsa dokotala ndikuti kapena ayi kapena kuti cytoreduction inali yabwino kwambiri. M'mawu ena, kodi chotupa chachikulucho chachotsedwa opaleshoni?
Kodi "Optimal" Kuchotsa kapena Kuchokera kwa Debulking ndi chiyani?
Sikuti nthawi zonse zimatheka kuthetsa khansa yowoneka kwambiri pa opaleshoni ya khansa ya ovarian. Komabe, tazindikira kuti kuphatikizapo opaleshoni yoopsa ndi mankhwala a chemotherapy kwachititsa kuti pakhale mankhwala ochiritsira kwa zaka zoposa 20. Kwa zaka zambiri, mtundu wa mankhwala a chemotherapy wasintha ndipo momwemonso tanthauzo la kupsa mtima kapena "opaleshoni" opaleshoni ikhoza kukhala.
Posachedwapa zaka khumi zapitazo, kutanthauzira kwa opaleshoni "yabwino" kunali kuti matenda osaposa masentimita awiri anatsalira (omwe ali pafupi ¾ za inchi). Izi zikhoza kukhala chimodzi, kapena ziwiri kapena zambiri zotupa, ndipo palibe imodzi yomwe inaposa masentimita awiri muyeso.
Ndi zipangizo zabwino komanso njira zothandizira opaleshoni, tsopano tikudziwa kuti ndizotheka kuti opaleshoni "yabwino" ipitirire kusiya matenda osachepera 1 sentimita, kufika ku miliary (odwala "mchenga" wambiri "mchenga") ambiri mwa odwala ndipo ngakhale matenda aakulu (sangathe kuwona kapena kumverera pambuyo pa opaleshoni) odwala ambiri.
Mmene Mliri Wanu Wamatenda Wonse Ulili Wosintha
Osati odwala onse amapangidwa kuti akhale ofanana. Nthawi zina, wodwala akhoza kukhala wokalamba kwambiri kapena wodwala kuti atha kupirira maola 4-8 zomwe zingatenge kuti akwaniritse zotsatira "zabwino". Ndiponso, kutuluka kwa magazi kapena mavuto ena kungamukakamize dokotalayo kuti asiye opaleshoni kale kuposa momwe akanafunira.
Nthaŵi zambiri, si zaka zomwezo koma osati zowonjezera zomwe wodwala angakhale nazo zomwe zimapereka kutalika kwa momwe opaleshoni ingalekerere.
Amene Dokotala Wanu Wamakono Amachita Zinthu Zosiyana
Osati opaleshoni onse amapangidwa ofanana. Izi ndizoona muzochita zonse ndizochita zamankhwala zonse. Ngakhalenso pakati pa amai odziwa za matenda a mitsempha - omwe ali oyenerera kugwira ntchito pa inu chifukwa cha khansa ya ovari - pali kusiyana kwa maluso. Onse amaphunzitsidwa popanga zisankho zoyenera ndipo ambiri amatha kupanga njira yokwanira yopangira 1-2 masentimita okhala "opaleshoni" opaleshoni ambiri mwa odwala awo. Mosakayikira onetsetsani kuti mzimayi wamagetsi ali ndi, kapena anali, mukuchitidwa opaleshoni yanu.
Kodi Ndikufunikira Opaleshoni Yambiri Kwambiri?
Kafukufuku wa zachipatala wasonyeza kuti zambiri zimene zimachotsedwa bwino pankhani ya opaleshoni ya khansa ya ovari. Palibe chinthu china chomwe sichikupindulanso. Komabe, nthawizina kupita ku miliyari kapena matenda ochepa kwambiri amafunika opaleshoni yowopsya, kuphatikizapo kuchotsa ziwalo za chiwindi, nthenda, mapapo, malo ambiri amagazi, malo ovuta m'madera ovuta ndi opitirira. Osati odwala onse amatha kulekerera bwino izi ndipo si madokotala onse opaleshoni amavomereza kuchita izi.
Ena adatcha opaleshoni yotereyi, yomwe cholinga chake ndi kukwaniritsa mliri wa "mchenga" "opaleshoni" opaleshoni pafupifupi zonse.
Musanapitirize, izi zimafuna kukambirana kwambiri ndi chiopsezo ndi phindu labwino pa gynecologic oncologist. Ngati mwasankha kuvomereza kuchuluka kwa opaleshoniyi, kumbukirani kuti si onse opaleshoni omwe aphunzitsidwa, kapena amachita opaleshoni yokwanira yopanga opaleshoniyi, kuti apindule bwinobwino mosaphatikizapo njira iyi yowonjezera "opaleshoni". Mosiyana ndi zimenezi, iwo sangakhulupirire kuti opaleshoni imeneyi yothandiza odwala awo. Ngakhale kuti pali maganizo osiyana, izi ndizo imvi m'mabuku a zachipatala.
Kodi "Kutentha Kwambiri" Kumatsimikiziridwa?
Akatswiri ena amatsimikizira kuti ngati "opaleshoni" -kuchitidwa opaleshoni yaikulu kwambiri kuti ifike opaleshoni "yabwino", izi zikutanthauza kuti muzochitika za wodwalayo khansa imakhala yochuluka kwambiri.
Choncho, akuganiza kuti opaleshoni imeneyi sichikuthandizani kupeza chithandizo cha mankhwala. Chowonadi ndi chakuti, ngakhale izi zikhoza kukhala zoona kwa odwala ena, sitidziwa kuti ndi odwala ati omwe ali opaleshoni, kapena ngakhale opaleshoni.
Kafukufuku wofalitsidwa amasonyeza kuti amayi ena amapindula kwambiri kuposa ena kuchokera ku opaleshoni yaikulu kwambiri komanso yopambana. Khansa imatha kuzimitsa mankhwala omwe amachititsa kuti munthu asamadziwe bwinobwino. Odwala ena amachiritsidwa. Ena sali.
Amapititsa kwa dokotala wochita opaleshoni kupanga chisankho pazithandizo panthawi ya opaleshoni za momwe angapite ndi opaleshoni zozikidwa pazomwe zingatheke ndipo ngati akuganiza kuti mungathe kulekerera opaleshoni yowonjezera. Izi zikhoza kukhala mbali zina poganiza za kugwidwa ndi khansa yanu.
Kumbukirani kuti nthawi zina sizingatheke kuti mukhale "wabwino" popanda, mwachitsanzo, kuchotsa matumbo onse, omwe mwachiwonekere sagwirizana ndi moyo wabwino. Mofananamo, monga tanenera poyamba, nthawi zina matenda azachipatala kapena mavuto okhudza intraoperative angapangitse kuti asayambe opaleshoni poyamba kuposa momwe anakonzera kapena akufunira. Koma pali kusiyana, komwe ndikuyembekeza kuti mukuyamba kumvetsa, pakati pa "chosatheka" ndi chiweruzo choyitana kapena kusowa kwa luso la opaleshoni.
Ngati n'kotheka, ndizothandiza kukambirana maganizo anu a gynecologic oncologist pa nkhani pamwambapa musanachite opaleshoni. Apanso, mukhoza kapena musasankhe kuti lingaliro lachiwiri likufunika. MUNGADZAKHALA kukhala ndi ubale wabwino ndi mayi wina wokhudzana ndi matenda a mayi omwe mumamukhulupirira mwachindunji. Ngakhale kuti ndikukufooketsani kwambiri kuti musamangogula dokotala, ngati ubalewu ukusoweka, dokotala adziwe kuti mungakhale ndi ubale woterewu.
Nanga Bwanji Gawo 4 Khansara Yamatenda?
Mawu ochepa ponena za khansa ya Stage IV (4) ndi yofunikira. M'mbuyomu, zimaganiziridwa kuti ngati khansara ya ovari imaonekera m'mapapo kapena chiwindi kapena nthendayi, zizindikirozo zinali zosauka kwambiri moti opaleshoni sizingathandize kwambiri. Kafukufuku waposachedwapa amasonyeza kuti, ngakhale kuti zinthu zili zosiyana, izi sizingakhale zoona. Izi zikhoza kukhala zovuta kwambiri kuposa Stage III, koma nthawi zambiri, mankhwala opanga opaleshoni opanga opaleshoni amayenera kuganiziridwa mozama ngati angakwanitse, ngati wodwala amadziwa kuti ali ndi chiopsezo komanso athandizidwe ngati amatha kuchipirira. Ngati opaleshoniyo ndi "yabwino", zizindikirozi zimatha kusintha kwambiri ndikubwera pafupi ndi zotsatira zomwe zawonetsedwa mu Gawo lachitatu.
Chidule cha Opaleshoni ya Cytoreductive Surgery
Kawirikawiri, njira yaikulu yothetsera chithandizo cha khansa ya Stage II mpaka IV ndiyo mlingo umene "bwino" cytoreduction imakwaniritsidwa. Kwa zaka zambiri, umboni wamphamvu wa zachipatala (mapepala ambiri a zamankhwala) amathandiza kuchotsa khansa yambiri ngati n'kotheka pamaso chemotherapy. Pali zokhudzana ndi chilengedwe, zomwe sindingapite mwatsatanetsatane, zomwe zimapindulitsa phindu la cytoreduction pofuna kuthetsa chemo-yankho.
Kwenikweni, opaleshoniyo imathandiza kuti mankhwala a chemotherapy asamavutike kugwira ntchito pochepetsa chiwerengero cha maselo omwe chemotherapy amayenera kupha (kuchokera mabiliyoni / trilioni mpaka mazana / makumi masauzande ...... kapena mochepa ngati palibe chowoneka chotsalira). Kuchita opaleshoni kumalimbikitsanso maselo onse otsala kuti ayambe kugawikana panthawi yomweyi (kusiyana ndi momwe amakulira), zomwe zimapangitsa kuti khungu likhale losavuta kupha nthawi yomweyo.
Malinga ndi mfundoyi, ngati simunayambe kuchita "njira yabwino" yogwiritsira ntchito cytoreduction, kuyankhulana kwachangu / phindu kukuyenera kuganiziridwa pa ntchito yachiwiri kukwaniritsa ntchitoyi. Zovuta zimaphatikizapo zifukwa zamakono ndi zachipatala za "cytoreduction", "kutalika" kwa "zabwino" zomwe muli nazo kale, mtundu wa chemotherapy womwe mukukonzekera, ndi nthawi yochuluka yotani kuyambira opaleshoni yoyamba ndi zina. .
Kawirikawiri, zokambirana za opaleshoni ina zingakhale zoganizira kwambiri ngati opaleshoni yoyamba inali yochepetsetsa chifukwa cha kusowa luso, kapena kusowa kwa chidziwitso cha amayi. Mwachitsanzo, ngati mwachitidwa opaleshoni yomwe inkachitika makamaka ku biopsies yokha, opaleshoni yowonjezera ikhoza kukhala yololera. Komabe, muyenera kulingalira momwe dongosolo la chemotherapy likugwiritsira ntchito chithunzi chonse.
Maphunziro, Thandizo, ndi Mphamvu
Lembani mndandanda wa mafunso omwe mungamufunse mafunso anu opatsirana pogonana . Bweretsani mnzanu ndi inu - nthawi zonse zikuwoneka kuti kukhala ndi munthu wina kumakuthandizani kumva zonse zomwe zanenedwa. Lembani manotsi. Fufuzani chithandizo cha khansa ya ovarian ndi zambiri pa intaneti. Pezani yankho lachiwiri ngati simukudziwa zedi zomwe mungasankhe. Osati kokha kukhala wodziimira nokha ngati wodwala matenda a khansa kukuika iwe mu mpando wa dalaivala - koma kwa anthu ena omwe ali ndi khansa, izo zikuwonetsedwera kuti apangitse kupulumuka.
Zotsatira:
Chern, J., ndi J. Curtin. Malangizo Oyenera a Surgery Debulking mu Gawo la IV Khansara Yopsa. Zochitika Zamakono Zamakono mu Oncology . 2016. 17 (1): 1.
Chiva, L, Lapuente, F., Castellanos, T., Alonso, S., ndi A. Gonzalez-Martin. Kodi Tiyembekezere Chiyani Pambuyo pa Ntchito Yopititsa Katemera Panthawi Yopititsa Ntchito Kapena Kupanga Opaleshoni Yoyamba mu Khansara Yopambana Kwambiri? Zolemba za Oncology Opaleshoni . 2015 Dec 29. (Epub patsogolo pa kusindikiza).
Liu, Z., Beach, J., Agdjanian, H. et al. Zomwe zimagwiritsidwa ntchito poyambitsa matenda a ovarian carcinoma zimagwirizanitsidwa ndi maselo njira zomwe zimapangitsa kuti thupi likhale lopangika, Gynecologic Oncology . 2015. 139 (9): 394-400.
Vidal, F., Al Thani, H., Haddad, P. et al. Kodi ndi Maganizo Otani Ochizira Opanga Kusankha Mwachidule Cha Kusagonjetsedwa kwa Ovarian Carcinomatosis: Pambuyo pa Matenda Okhudzidwa Omwe Amagwiritsidwa Ntchito. Zolemba za Oncology Opaleshoni . 2016. 23 (2): 434-42.