Kuvhiya Kwepurasitiki Kudzorera Chimiro cheSymmetry
I TRAM flap (transvers rectus abdominus myocutaneous) inzira inoshandiswa inoshandiswa iyo inoshandisa musuru, mafuta uye ganda kubva pamimba yako kuti uite chifuva chitsva mushure mushure mekuita mastectomy . Iyi nzira inotora zita rayo kubva kune rectus rectus abdominus muscle mumimba yako. Pane nzira mbiri dzekuita chironga che TRAM - sechinhu chisina kusununguka (chakavharwa) chikafu chinoputika, uye se pedicle (yakanamatirwa uye yakanyongedzwa) mavara. Chifuva chako chekugadzirisa hachina kutarisa uye kunzwa zvakangofanana nehutanda hwako rwepanyama, uye iwe unoda kuvhiyiwa mamwe maitiro kuti ugadzire mbambo uye isola.
TRAM Flap Reconstruction
Munguva yeruzivo rweTRAM, ganda, mafuta, uye mutsvuku zvichabviswa kubva mumimba yako kusvika kumapfupa ako, uye yakashandiswa kugadzira chifuva chezamu. Vakadzi vakawanda vane mazamu akakwana mumumimba yavo kuti vagadzire chifuva chitsva. Asi kana pasina mishonga yakakwana, kuiswa zvishoma kunogona kuiswa kuti uzadze hukuru hwehwamanda itsva. Nzira mbiri dzinoshandiswa kutamisa mhuka yako kubva mumimba yako kusvika pachifuva chako - pasina ruvara uye pedicle flap.
Free and Pedicle Flap Method
- Pedicle Flap - Iyi nzira haifaniri kudzvora ruvara rweganda, mafuta, mishonga yeropa, uye musumbu pasina nzvimbo yaro mudumbu rako. A pedicle pfupa ichaendeswa mumugwagwa uri pasi peganda rako kusvika kumapfupa ako.
- Free Flap - Chiremba wako achacheka chikamu cheganda, mafuta, mutezo weropa, uye musumbu pasina nzvimbo yaro mudumbu rako. Ichi chikamu chichaendeswa kunzvimbo yako chechifu uye chigadziriswa kuwedzerwa ropa uchishandisa microsurgery (yakafanana neDIEP flap procedure). Izvi zvinotora nguva yakawanda kupfuura pedicle flap nzira, asi vanachiremba vakawanda vanonzwa kuti inogadzira chimiro chezvakawanda zvemazamu.
Kubatsirwa kwe TRAM Flap
Chirwere cheTBP chinogadziriswa chichaita sehunhu chaiyo kune munhu wese anokugunzva iwe: Zvichava zvitsva uye zvinyorovesa nokuti zvichava nekuparadzirwa kwakanaka uye mafuta akakwana kuti afukidze uye asvike sezvakaita bonde rako rekutanga. Nemhaka yokuti mimba yemakumbo nemafuta zvinoshandiswa muchipfuva chako chitsva, iwe uchange uine mutezo, zvichiita kuti uve nemimba yakadzika.
Kukanganiswa kwe TRAM Flap
Chifuva chako chitsva hachizovi nekunzwa nokuti mitsipa yakanga iri muchifuva chako chokutanga yakabviswa. Nzira yekufambisa TRAM inoda nguva yakawanda mukuvhiya uye kupora pane kuisa kuiswa. Dzimwe njodzi dzinobatanidzwa neTram flap - mimba yake yepamuviri uye mudumbu bundu (nekuti musumbu inotsigira mimba yakatamiswa). Nzira yeTram flap inokwana 5% kusagadzikana kwepamwero iyo iyo iyo inogona kufa, uye inofanira kubviswa zvachose. A pedicle flap, iyo isati yakabviswa kubva muropa rayo, inenge isingakwanise kukanganisa.
Iwe Hausi Mutevedzeri Kana:
- uri kuwandisa kana kuora - iwe uri pangozi yakakura yepamuviri hernia mushure me TRAM, sezvo pane zvishoma musumbu kuti ubatsire mimba yako kuoma
- iwe unenge wakaonda - iwe hauzove nehunhu hwemimba yakakwana
- iwe utsi - chirwere chako chepamuviri chinotora nguva yakareba kupora, uye mafuta ako ane mafuta anowedzera kukura kuva mutsvuku
Chibereko Chekuvakazve Iye zvino kana kuti gare gare
Kugadziriswa kwebonde kunogona kuitwa panguva yekuita mastectomy kana mushure mekurapa. Kana uchida chirwere chemajeri kune nzvimbo yepasi kana chifukidzo, unofanira kunonoka. Zvisinei, zvakakodzera kumirira: Kuva nemitambo yakaitwa musati mishonga isati yapera zvakanyanya kunogadzirisa kukwanisa kwemazuva ano kukwanisa kukubata.
Kana iwe uri kufunga nezvekuvakazve, iyo pfungwa yakanaka yekutaura nemupurisa wako wepurasitiki asati aita mastectomy. Izvi zvinokupa mukana wekuti uwane zviyero uye mifananidzo yakatorwa mazamu ako chaiwo , kuitira kuti chifuva chako chigadziridzwe chinogona kudzokororwa sezvakanyatsoita. Nyaya yako yekuvhiya yeplastiki ichakupa mararamiro ezvimwe, uye inogona kubatsira kuchengetedza ganda uye kudzivirira zvipfunga zvisingakoshi kana iwe uchitarisana naye kare kare.
Zvaungatarisira Panguva ye TRAM Flap Breast Reconstruction
Iwe hausi kuzove wakamuka munguva yako yekuita mastectomy kana kuvakazve, saka iwe uchava neve intravenous sedation kana mukuru anesthesia . Taura nechiremba wako chiremba uye anesthesiologist pamusoro pekushanda zvakakunakira iwe. Kana iwe wakambovhiyiwa dambudziko uye usati wambova neruzivo neanesthesia, bvunza kana iwe unogona kutorwa kare nekuda kwekutsvaga. Kana iwe uine maitiro ekugadzirisa uye kuvakazve panguva imwechete (kukurumidza kuvakazve), chiremba wako wekuvhiya achatanga kubvisa mazamu ako, achivhara seganda rakawanda sechave rakachengeteka kuchengeta.
Kuzvigadzirira TRAM Flap Breast Reconstruction
Nyaya yako yekuvhiya yeplastiki inoshandisa chivara cheganda kuti ugadzire zvakanyatsogadziriswa kwekudzivirira kuchaita kuti ganda rako rive. Chimwe chidiki chinenge chakakonzerwa chichakwevedzwa pamuviri wako, pane rectus yako abdominus muscle. Izvi zvingava chivara cheganda chinovhara kusungirirwa kwezamu rako rakavakwazve. Kana kuiswa kwechivharo ichivharwa, ichava mutsetse unodarika mimba yako kubva pachiuno kusvika kune hip.
Kufambisa Tsvina uye Ganda
Pachivara cheganda, chirwere chako chepurasitiki chichaita kuti munhu asvike, uye achasimudza ganda uye mutsvuku. Imwe nzira inenge yakasikwa pasi peganda rako kuitira kuti ruzha rukwanise kutamiswa. Izvi zviputi zvinopinda mumugwagwa unoenda kune yako mastectomy incision. Cherechedza kuti mufananidzo uyu unoratidza kusununguka kusununguka - ganda, mafuta, mishonga yeropa, uye musimba zvakatemwa.
Kuumba Brese Yenyu Idzva
Dumbu remuviri wepachiviri (rinenge rakabatanidzwa kumusana) richave rakagadzirirwa kuitira kuti rizadze paganda rakange rarasika panguva yako yekuita mastectomy. Kana iwe uine pedicle flap, chirwere chako chepurasitiki chinopfigira kuvhara kweganda kuumba chifuva chitsva. Uye kana iwe uine rusununguko rusununguko, chiremba wako anovhiya achishandisa microsurgery kuti adzokere zvakare midzi yeropa kutanga, obva apfigira zvigadzirwa zveganda.
Kuwana kubva ku TRAM Flap Breast Reconstruction
Iwe unogona kunge uchigara muchipatara mazuva 4 kusvika ku7 apo iwe unotanga kuporesa kubva pakuberekwa kwemazamu. Kana uine chirwere chinoshandiswa , unodzidza kuvhara iyo uye kuchengeta zvinyorwa zvehutachiona hwehuwandu. Taurira kurwadziwa kana uine chero kuitira kuti iraswe. Usadzokera shure kuti ushande - ronga kuronga kuitora zviri nyore kwemavhiki matatu kusvika matanhatu kuti uwane. Iva nechokwadi kuti uve nemumwe munhu wepamusoro kuti akubatsire kukufambisa uye kuita chero kupi nekusimudza. Uyewo, iva nechokwadi chekuenda kunzvimbo dzako dzekutsvaga kuitira kuti chiremba wako arambe akatarisa pane zvaunofungidzirwa uye kupfeka, uye kubvisa matanho ako. Cherechedza kuti mufananidzo uyu unoratidza chirongwa che TRAM chakagadzirwa nekopi yakagadzirwa uye isola.
TRAM Flap yeDecided Mastectomy
Iyo TRAM flap inogona kushandiswa pakuvakazve mazamu mushure, kana, ne, kaviri mastectomy . Iwe unofanirwa kunge uine zvigunwe zvemuviri zvakakwana zvemazamu maviri. Dumbu rako remuviri rinoputika richaparadzaniswa muhafu yehafu, uye rinoshandiswa kuvhara mastectomy imwe incision. Iyi kaviri TRAM nzira inotora kaviri kana yakareba seTram imwe chete, uye nguva yekudzikinura ichawedzera zvakare. Iwe unganzwa uine simba uye unorwadziwa kwemavhiki mashomanana gare gare.
Kufungisisa Kunokosha Nezve TRAM Flap
- Chikwata chimwe-chepfuti - chiremba wako anogona kubvisa mishonga yemimba kamwe chete. Kana iwe uchida imwezve yezvekudzidzira mazamu, iwe uchafanira kusarudza nzira yakasiyana.
- Bikini tsvina - tsvina yako yepamuviri ichave yakareba. Kana iwe usina kupfeka bikinis zvakadaro, hazvina dambudziko. Asi kana iwe usingadi ruvara kubva pachiuno kuenda kune chiuno chako, TRAM haisi iwe.
- Kushandura mavhinga - bhomba yako bhomba inogona kutariswa kana kutama-kure pakati peTram. Chiremba wako anogona kukwanisa kuumba ruvara rutsva kwauri.
- Unotarisa zvakanaka, unonzwa wakanaka - chifuva chako chitsva chinonzwa sechinhu chaicho kumunhu wako (chaunodziya, chinoshanduka, chinononoka) asi iwe hauchazove nemanzwiro mamwechete kubva mairi kubva pachifuva chako chepakutanga. Mitsipa yakave yakatemwa, saka chirwere chepfungwa chinowanzosakara.
Sources
Tsvaka Mapurisa / Purojekiti Inowanikwa Munharaunda Yako
Sources:
American Cancer Society. Chibereko Chekuvakazve Pashure peMastectomy. Mhando dzeBeast Reconstruction. Yakarongedzwa: 09/06/2007.
Dr Susan Love Research Foundation. Kuberekwa kwebonde. Yakavandudzwa: April 21, 2008.