Rudzi rweLung Cancer Surgery
A lobectomy rudzi rwemapapu emapapu emapapu umo chirwere chimwe chemapapu chinobviswa. (Pepu yakarurama ine mapundu matatu, uye mapapu ari kuruboshwe ane mabhesi maviri.) Chirwere chetachiona chinowanzoitwa kune dzimwe mamiriro ezvinhu, zvakadai sechirwere chetachiona, chirwere chakanyanya COPD, kana kushungurudzika kunokanganisa mishonga yakanyanya yeropa pedyo nemapapu.
Mhando dzeLung Cancer Surgery
Ko vanachiremba vanoona sei kuti lobectomy ndiyo yakanakisisa yekuvhiya kwemapapu emapapu kwauri?
Rudzi rwemapapu emapapu emapurini chirwere chako chinokurudzira chichatsigira pane zvimwe zvinhu, kusanganisira:
- Nzvimbo yemarara yako
- Ukuru hwemuviri wako
- Zvichida kana kwete maronda ako akapararira kumatumbu ari pedyo
- Mamiriro ako ehutano hwehutano
- Mipapu yako inoshanda sei zvisati zvaitika kuvhiyiwa
A lobectomy inowanzoitwa kune isiri duku duku rekenza yemapapu umo chironda chacho chakavharirwa kune rimwe chete. Icho chisina kupindira uye chinodzivirira mamwe mapapu emabasa ayo pneumonectomy , nzira inosanganisira kubvisa mapapu ose. Kusiyana neizvi, zvakanyanya kupararira kupfuura wedge resection , chirwere chinobvisa tumarara uye zvishoma zviduku zvakapoteredza.
Marudzi eLobectomy
A lobe yemapapu ako inogona kubviswa nemashoma maitiro akasiyana. Chiremba wako achakurudzira chimwe chezvizvi zvichibva pane zvose zvinofananidzira zvekenza yako uye kuti wakasununguka sei pane imwe neimwe yemitemo:
- Vhura lobectomy: Mulobectomy yakazaruka, lobe yemapapu inobviswa kuburikidza nekureba kwenguva yakareba kune rumwe rutivi rwechifuva (thoracotomy).
- VATS (chirwere chinoshandiswa mumavhidhiyo chetachiracoscopic): Lobectomy: Muchiitiko ichi, hobe yemapapu inobviswa kuburikidza nemamwe maduku mashoma mubhokisi pamwe nekubatsirwa kwezviridzwa uye kamera. VATE lobectomy inogona kufungidzirwa pamusana wepamuti 1 yemapapu emapfupa ane tumakumbo tuduku duku (kazhinji zvisingasviki 3 kusvika 4 cm). Apo VATS lobectomy inogoneka, zvinogona kuita kuti zvigadziriswe zvishoma kupfuura lobectomy yakazaruka.
VATS vs Open Lobectomy
Iwe iwe nachiremba wako munosarudza sei pakati pelobectomy yakazaruka uye VATS lobectomy, uye chii chiri musiyano mukudzoka pakati peyi nzira?
Zvidzidzo zvakawana kuti nguva yekudzikinura inotevera VATS lobectomy inowanzova shoma, uye ine hutambudziro hushoma hwemashure-opera kupfuura lobectomy yakazaruka. Post-thoracotomy pain syndrome (inonziwo postpneumonectomy syndrome) chirwere chekurwadziwa kwepfupa kunoramba kuchiitika mwedzi kusvika kumakore mushure mekuvhiyiwa kwekenza yemapapu, uye inoita kunge inokanganisa vanenge 50 muzana yevanhu vane chirwere ichi kune imwe nguva. Kunyange zvazvo tisina zviongorori zvakatarisa kunyatsoziva izvi zvinenge zvichiitika kuti nzira yeVATS ichaguma nekurwadziwa kusingaperi kusingaperi.
Pasinei nekukurumidza kupora, pane nguva apo VATS haigoneki. Nzvimbo yemamwe tumarara inoita kuti zvive zvakaoma kwazvo kuita VATS, uye mune izvi mamiriro uye lobectomy yakasununguka inogona kuva yakachengeteka uye inogona kubvisa chiremera chose.
Havasi vese vanovhiya vane hutano vachiita VATS uye izvi zvinogona kutora chikamu muchisarudzo. Ita chokwadi chekubvunza kuti nei chilobectomy yakashama ichikurudzirwa kana ichi ndicho chete chisarudzo chaunopiwa.
Iwe unogona kunge uchida kuwana rupiri rwechipiri kubva kune chiremba anovhiya anonyatsokwanisa kuita VATS, asi ramba uchiyeuka kuti kunyange vavhiyi vakanakisisa havazoiti VATS kana nzvimbo yechipfuva ichiratidza kuti lobectomy yakashama ndiko kuravhirwa kwakanakisisa. Pane mhirizhonga pamusoro pekuti vatsedzi dzeVATS dzave dzichiva chetsika yekuchengetedza, asi zvizhinji zvekunetseka zviri mune zvakaitika kune vanachiremba vanoita izvi. Kumusana wemapapu emapapu epakutanga, VATS lobectomy inowanzova nzira yakakodzera, asi neyakamera yepamaperembudzi yemapapu, zvichida kuti ruzivo rwechiremba anovhiya runonyanya kukosha mumugumisiro.
Chimwe chikonzero nei pfungwa yechipiri ingave yakakosha nekenza yemapapu ndeyekuti zvidzidzo zvinoratidza kuti migumisiro yevanhu vane chirwere chemapapu emapapu panzvimbo dzinoita zvikuru zvekuvhiya idzi zvinowanzova nani. Nenzira yakawanda, mikana yemigumisiro yakanaka nemukenza wemapapu inowedzera kuva nani pamakirini makuru emukenza uye kudzidzisa zvipatara kupfuura zvipatara zviduku.
Kugadzirira
Pamberi pelobectomy yako, chiremba wako achada kuve nechokwadi kuti iwe une utano sezvinogoneka. Anodawo kuziva kuti iwe uchakwanisa kufema zvakanaka mushure mekuvhara mapapu ako kubviswa. Mukuwedzera kune nhoroondo yekuchenjerera uye kuongorora kwepanyama neropa, kuongorora kufema ( pulmonary function tests ) kuchaitwa kuti uone mapapu ako basa musati mavhiya. Zvichienderana nezera rako uye hutano hwako, anogona kukurudzira miedzo kuti uone mwoyo wako zvakare.
Chiremba wako anonyatsoongorora mishonga yako yose munguva yekushanya kwako kusati yasvika uye anogona kukurudzira kumira mamwe mishonga yako kwenguva yakati vasati vasvika. Zvinobatsira kana iwe uchiuya nemabhodhoro ane mishonga chero ipi zvayo uye mishonga isina mishonga, pamwe chete nemishonga yekuwedzera, kusanganisira mavitamini, ayo waunoshandisa.
Kana ukasvuta, achakurudzira zvakasimba kuti iwe urege nokukurumidza. Kurega kusvuta kusati wambovhiyiwa kunogona kuderedza ngozi yako yezvinetso uye kuwedzera mukana wekuti chirwere chako chichabudirira.
Dzidza zvakawanda nezvekugadzirira kurapwa kwekenza yemapapu .
Nzira
A lobectomy inowanikwa muimba yekugadzirira mushure mekunge iwe upiwa huwandu hwehutano hwehutano. Pane maitiro makuru maviri ayo anowanzoitwa kubvisa lobe yemapapu. Mulobectomy yakazaruka, lobe yemapapu inobviswa kuburikidza nekureba kwenguva yakareba kune rumwe rutivi rwebhokisi. MuVATS lobectomy, lobe inobviswa nekushandiswa kwekhamera uye zvishandiso zvakakosha kuburikidza nezvakawanda zvisingagoni kuonekwa mubhokisi.
Asati apfigira tsvina iyi, chiremba anovhiya achaisa chifukidzo chechipfuva munzvimbo yekuvhiya kubvumira kuti mvura yakasvibiswa nemhepo zvidze kunze kwechifuva kwechinguva.
Kudzorera
Uchitevera wako lobectomy , iwe uchange uchitarirwa muimba huru yekuchengetedza (ICU) kwezuva rimwe kana kuti usati wamboenda kuchipatara chenguva dzose. Murapa wekudzimara uchashanda newe, kukukumbira kuti ufuridzire zvakanyanya uye ufema mukati memhepo inokurudzira. Vaya vanoyamwisa vachakubatsira iwe kusimuka uye kufamba-famba pakarepo iwe unokwanisa. Pasinei nezvinetso, vanhu vakawanda vanogara muchipatara pakati pemakore mana ne7, zvichienderana nerudzi rwelobectomy yakaitwa.
Matambudziko
A lobectomy ndiyo nzira huru yekuvhiya, uye zvinetso hazvishamisi. Chiremba wako achakurukurirana izvi newe asati avhiyiwa. Zvimwe zvinogona kuitika zvinogona kusanganisira:
- Kupera kwemazuva kwenguva refu, zvichida kuti tube yepfuti igare panzvimbo yakapera mazuva matatu kusvika mana. Ichi ndicho chinetso chakajairika.
- Zvirwere, zvakadai sepineumonia.
- Bleeding.
- Zvinetso zvemwoyo, zvakadai sekurwadziwa kwepfungwa kana kusagadzikana kwemwoyo.
- Ropa rinovhara mumakumbo (DVTs) kana kuenda kune mapapu ( pulmonary embolus .)
- Post-thoracotomy pain syndrome . Nhamo iyo inoramba ichingotevera mushure mekunyengedza kunogona kukanganisa, asi zvakawanda zviri kuitwa kuedza kuita mutsauko. Zvinonyanya kuitika mushure mekuvharika kwelobectomy pane VATS chirongwa.
Prognosis
Mafungiro anotevera a lobectomy anobva pane zvinhu zvakawanda zvakasiyana. Zvimwe zvezvi zvinosanganisira danho remukenza wako wemapapu-ndiko kuti, zvakapararira zvakadini-pamwe nehutano hwako hwose uye iwe une mamwe mimwe mapapu emapapu pamwe nekenza yemapapu.
Kufa kwehuwandu (ngozi yekufa) inodarika makumi matatu kubva muzana, asi vanhu vazhinji vane matambudziko epanguva pfupi semhepo inoputika.
Apo lobectomy inobvumirwa kubudirira mukenza yemapapu epakutanga, inopa mukana wekugara kwenguva refu pasina kudzoka kwekenza.
Chimwe chisarudzo chisingaitwi zvakakwana mushure mekuvhiyiwa kwekenza yemapapu chirwere chekugadzirisa zvirwere. Kugadziriswa kwepulmonary yemukenza wemapapu kwakangobva kuiswa kune dzimwe nzvimbo dzekenza asi zvinoita sekubatsira nezviratidzo zvekufema kwepfupi uye zvimwe zviratidzo.
> Sources:
> Chang, J., Sena, S., Paul, M. et al. Stereotactic Ablative Radiotherapy Versus Lobectomy Yekushandisa Simba I-Ndisina-Nyaya-Chirwere Chechirwere Chirwere: Kuongororwa Kwakakanganiswa kweZviri Dzematambudziko Anoshandiswa. The Lancet Oncology . 2015. 1 (6): 630-637.
> Oncel, M., Sunam, G., uye H. Yildiran. Vhidhiyo-Yakabatsirwa Thoracoscopic Lobectomy yeLung Cancer. Annals of Thoracic Surgery . 2017. 104 (5): 1760.
> Vannucci, R., naD. Gonzalez-Rivas. IsVATS Lobectomy Standard yeKuchengetedza Kushandiswa Kwemagetsi Asingasviki Madiki? . Lung Cancer . 2016. 100: 114-119.
> Ziarnik, E., uye E. Grogan. Post-Lobectomy Matambudziko Akutanga. Tichiracic Surgery Makliniki . 2015. 25 (3): 355-364.