Lobectomy monga Chithandizo cha Khansa ya M'mimba

Mtundu wa Opaleshoni Yopangitsira Khansa

Lobectomy ndi mtundu wa opaleshoni ya khansa ya m'mapapo yomwe imachotsedwa m'mapapo. (Mapapu abwino ali ndi malabe atatu, ndipo mapepala a kumanzere amakhala ndi zikopa ziwiri.) Chilombo cha lobectomy chimapangidwanso nthawi zina, monga chifuwa chachikulu, COPD, kapena kupwetekedwa mtima komwe kumaphwanya mitsempha yambiri yamagazi pafupi ndi mapapo.

Mitundu ya Opaleshoni ya Khansa Yam'mimba

Kodi madokotala amalingalira bwanji kuti lobectomy ndi opaleshoni yabwino ya khansa yamapapu kwa inu?

Mtundu wa opaleshoni ya khansa yamapapo dokotala wanu akuvomereza kuti idzadalira pazifukwa zingapo, kuphatikizapo:

• Malo a chotupa chanu
• Kukula kwa chotupa chanu
• Kaya matumbo anu afalikira kapena ayi ku matenda oyandikana nawo
• Mkhalidwe wanu wathanzi
• Mapapu anu akugwira bwino ntchito musanachite opaleshoni

Kafukufuku amachitidwa kawirikawiri kwa khansa yaing'onoting'ono ya m'mapapo ya m'mapapo imene chotupacho chimangokhala pa lobe imodzi. Sichimawonongeka kwambiri ndipo chimateteza mapapu ambiri omwe amachititsa kuti pneumonectomy , yomwe imaphatikizapo kuchotsa mapapo onse. Mosiyana ndi izo, ndizowonjezereka kwambiri kusiyana ndi mphero yowonjezera , opaleshoni yomwe imachotsa chotupacho ndi zochepa zazingwe.

Mitundu ya Lobectomy

Mphungu ya mapapo anu ikhoza kuchotsedwa ndi njira zingapo zosiyana. Dokotala wanu adzakulimbikitsani chimodzi mwa izi pogwiritsa ntchito zizindikiro za khansara yanu komanso momwe iye alili omasuka ndi njira iliyonse:

• Tsegulani lobectomy: Mu lobectomy yotseguka, mapafu amachotsedwa pamtundu wa chifuwa (thoracotomy).
  
• VATS (opaleshoni ya opaleshoni ya opaleshoni) ya lobectomy: Mwa njirayi, mpweya wa m'mapapo umachotsedwa mwazigawo zing'onozing'ono zomwe zili mkati mwa chifuwa pogwiritsa ntchito zipangizo ndi kamera. VATE lobectomy ingaganizidwe ngati khansa ya mapapu yoyamba ya m'mimba ndipo ili ndi zotupa zochepa (nthawi zambiri zosakwana 3 mpaka 4 cm). Pamene VATS lobectomy ili kotheka, zingapangitse mavuto ochepa kusiyana ndi lobectomy yotseguka.

VATS vs Open Lobectomy

Kodi inu ndi dokotala wanu mumasankha bwanji pakati pa lobectomy yotseguka ndi VATS lobectomy, ndipo kusiyana kotani pakati pa njirayi ndikutani?

Kafukufuku apeza kuti nthawi yowonjezera pambuyo pa VATS lobectomy nthawi zambiri imakhala yofupika, ndi ululu wosachepetseka kwambiri kuposa lobectomy. Matenda a Post-thoracotomy (omwe amatchedwanso postpneumonectomy syndrome) ndi chikhalidwe cha kupweteka kwa chifuwa chopitirirabe chomwe chikuchitika miyezi ndi zaka pambuyo pa opaleshoni ya khansa ya m'mapapo, ndipo zikuwoneka kuti zimakhudza pafupifupi 50 peresenti ya anthu omwe akuchita opaleshoni imeneyi mpaka pamlingo winawake. Ngakhale tilibe maphunziro omwe akuyang'anitsitsa mosamala izi zikutheka kuti njira ya VATS idzapwetekanso kwambiri.

Ngakhale kuti nthawi zambiri amachira mofulumira, nthawi zina VATS sizingatheke. Malo amtunduwu amachititsa kuti zikhale zovuta kwambiri kuchita VATS, ndipo m'mayeserowa ndi lotsegula lobectomy akhoza kukhala otetezeka komanso kuthetsa vuto lonselo.

Osati opaleshoni onse ali omasuka kuchita VATS ndipo izi zingathandize pa chisankho. Onetsetsani kuti mufunse chifukwa chake lobectomy yotseguka imalimbikitsidwa ngati izi ndizo zokha zomwe mwasankha.

Mungafune kuti mutenge kachiwiri kuchokera kwa dokotala wochita opaleshoni yemwe ali wokonzeka kuchita VATS, koma kumbukirani kuti ngakhale opaleshoni yabwino sanachite VATS ngati malo otupa amasonyeza kuti lobectomy yotsegula ndi opaleshoni yabwino. Pali kutsutsana pazomwe njira za VATS zakhalira ndiyeso ya chisamaliro, koma zambiri zomwe zikudetsa nkhaŵa ndizo zomwe madokotala opaleshoni amachita. Kwa khansa ya m'mapapo ya mapapo, VATS lobectomy imakhala njira yabwino, koma ndi khansa yapakhungu yamapapakapo, ndizodziwikiratu kuti dokotala wa opaleshoni amakhala wofunikira kwambiri pamapeto.

Chifukwa china chimene lingaliro lachiwiri lingakhale lofunika ndi khansara yamapapo ndikuti maphunziro amasonyeza kuti zotsatira za anthu omwe ali ndi opaleshoni ya khansa yamapapo pa malo omwe amachita opaleshoni yaikulu ya opaleshoni imeneyi amakhala bwino. Kawirikawiri, kuthekera kwa zotsatira zabwino ndi khansara yamapapu kumakhala bwino pa malo akuluakulu a khansa komanso zipatala zophunzitsa kuposa zipatala zazing'ono.

Kukonzekera

Musanayambe kugonana kwanu, dokotala wanu akufuna kuonetsetsa kuti muli ndi thanzi labwino. Adzafunanso kudziwa kuti mutha kupuma mokwanira mutatha kuchotsa mapapo anu. Kuphatikiza pa mbiri yeniyeni ndi kuyesa magazi ndi magazi, kuyezetsa kupuma ( pulmonary function tests ) kudzachitidwa kuti muwone mapapu anu atagwira ntchito opaleshoni isanakwane. Malingana ndi msinkhu wanu ndi matenda, angapangire mayesero kuti ayang'ane mtima wanu.

Dokotala wanu adzafufuza mosamala mankhwala anu onse paulendo wanu woyamba ndipo angakulimbikitseni kusiya mankhwala anu kwa nthawi yambiri musanachite opaleshoni. Ndizothandiza ngati mutabweretsa mabotolo omwe ali ndi mankhwala ena osamalidwa, osapatsirana, komanso mavitamini omwe mumagwiritsa ntchito.

Ngati mumasuta, adzakulimbikitsani kuti musiye mwamsanga. Kusiya kusuta fodya musanayambe opaleshoni kungachepetse chiopsezo chanu chokwanira ndikupangitsani mwayi kuti opaleshoni yanu idzapambana.

Phunzirani zambiri za momwe mungakonzekerere opaleshoni ya khansa ya m'mapapo .

Ndondomeko

A lobectomy amachitika mu chipinda chogwiritsira ntchito mutatha kupatsidwa mankhwala osokoneza bongo. Pali njira ziwiri zazikulu zomwe nthawi zambiri zimachitidwa pofuna kuchotsa mpweya. Mu lobectomy yotseguka, chotupa cha mapapo chimachotsedwa pamtunda wautali pambali pa chifuwacho. Mu VATS lobectomy, lobe amachotsedwa pogwiritsa ntchito kamera ndi zipangizo zamakono kupyolera mu zingapo zing'onozing'ono zomwe zili mu chifuwa.

Asanatseke mankhwalawa, dokotalayo amaika chifuwa cha chifuwa m'bwalo la opaleshoni kuti alowetse madzi ndi mpweya kunja kwa chifuwa kwa nthawi ndithu.

Kubwezeretsa

Pambuyo pa lobectomy yanu, mudzayang'aniridwa mu chipatala chachikulu (ICU) kwa tsiku limodzi kapena kuti musanapite kuchipatala cha chipatala. Wodwala opaleshoni adzagwira ntchito ndi inu, ndikukupemphani kuti mupume mpweya wabwino ndikupuma mu spirometer yolimbikitsa. Akozesi adzakuthandizani kuti mudzuke ndikuyenda mwamsanga mutangotha. Powonjezera mavuto, anthu ambiri amakhala m'chipatala pakati pa masiku 4 ndi 7, malinga ndi mtundu wa lobectomy yomwe inachitika.

Mavuto

Lobectomy ndi njira yaikulu yopaleshoni, ndipo zovuta zimakhala zosazolowereka. Dokotala wanu adzakambirana ndi inu musanachite opaleshoni. Zina zomwe zingakhale zovuta zingakhalepo:

• Kutuluka kwa mpweya wautali, kufuna kuti chifuwa cha chifuwa chisalowe m'malo m'malo a masiku atatu kapena 4. Izi ndizovuta kwambiri.
• Matenda, monga chibayo.
• Kusuta.
• Matenda a mtima, monga matenda a mtima kapena osasinthasintha mtima.
• Magazi amathyoka miyendo (DVTs) kapena amapita kumapapo ( mapulogalamu a pulmonary ).
• Matenda a Post-thoracotomy . Ululu umene umapitirira pambuyo pa lobectomy ukhoza kukhala wokhumudwitsa, koma zambiri zikuchitidwa kuyesa kupanga kusiyana. Zimakhala zovuta kuchitika pambuyo pa lobectomy yotseguka kuposa njira ya VATS.

Kuthamangitsani

Matendawa omwe amatsatira lobectomy amadalira zinthu zosiyanasiyana. Zina mwa izi zikuphatikizapo sitepe ya khansara yanu yamapapu, ndiko kuti, kufalikira kwake-komanso thanzi lanu lonse komanso ngati muli ndi vuto lina la mapapu kuphatikizapo khansa ya m'mapapo.

Kufa kwa chiwerengero cha anthu (chiopsezo cha imfa) ndi osachepera atatu peresenti, komabe anthu ambiri amakhala ndi mavuto osakhalitsa monga mpweya wothamanga.

Pamene lobectomy imakonzedwa bwino kwa khansa ya m'mapapo ya m'mapapo, imapatsa mwayi wokhala ndi nthawi yaitali popanda khansa.

Chosankha chomwe sichitanganidwa pambuyo poti opaleshoni ya khansa yamapapo ndi kukonzanso mapulaneti. Kukonzekera kwa khansa ya m'mapapo kwa khansa ya m'mapapo kwangoyamba kumene ku malo ena a khansa koma ikuwoneka kuti ikuthandiza ndi zizindikiro za mpweya wochepa komanso zizindikiro zina.

> Zotsatira:

> Chang, J., Sena, S., Paul, M. et al. Kuthandizira Kwambiri Kulimbana ndi Mavuto Omwe Amagwira Ntchito Zolimbana ndi Lobectomy Kwa Gawo Loyendetsa Bungwe Langa Lopanda Kulimbitsa Thupi: Kufufuza Kwadongosolo kwa Mayesero Awiri Osavuta. Lancet Oncology . 2015. 1 (6): 630-637.

> Oncel, M., Sunam, G., ndi H. Yildiran. Vuto Losavuta Kwambiri la Mavidiyo la Lobectomy kwa Khansa Yam'mimba. Annals of Surgery Opera . 2017. 104 (5): 1760.

> Vannucci, R., ndi D. Gonzalez-Rivas. Kodi VATS Lobectomy Standard ya Kusamalira Khansa Yosavuta Kwambiri Yopanda Khansa? . Khansa Yam'mimba . 2016. 100: 114-119.

> Ziarnik, E., ndi E. Grogan. Zolemba Zakale Zosavuta Kuli Mavuto Oyamba. Zipatala Zopha Opaleshoni . 2015. 25 (3): 355-364.