Umhlaza wesisu

Umhlaza we-Esophageal ngumhlaza oqala kwi-esophagus. Le yileyhubhu apho ukutya kuhamba khona ukusuka emlonyeni ukuya esiswini.

Umhlaza we-Esophageal awuqhelekanga eMelika. Kwenzeka rhoqo kumadoda angaphezu kweminyaka engama-50 ubudala.

Zimbini iintlobo eziphambili zomhlaza wokuxhaxha; squamous cell carcinoma kunye neadenocarcinoma. Ezi ntlobo zimbini zibonakala zahlukile enye kwenye phantsi kwemicroscope.

Umhlaza wesifo somhlaza es squamous unxulunyaniswa nokutshaya nokusela utywala kakhulu.

I-Adenocarcinoma lolona hlobo luqhelekileyo lomhlaza wokuqina. Ukuba ne-Barrett esophagus kwandisa umngcipheko kolu hlobo lomhlaza. Isifo se-Acid reflux (isifo se-reflux sesifo se-gastroesophageal, okanye i-GERD) sinokukhula sibe yindawo yeBarrett esophagus. Eminye imingcipheko ibandakanya ukutshaya, ukuba yindoda, okanye ukutyeba kakhulu.

Iimpawu zinokubandakanya nayiphi na kwezi zinto zilandelayo:

• Ukubuyela umva kokutya ngokusebenzisa i-esophagus kunye nomlomo (ukuphinda uphinde)
• Intlungu yesifuba engahambelani nokutya
• Kunzima ukugwinya izinto eziqinileyo okanye ulwelo
• Isitshisa
• Ukuphalaza igazi
• Ukuhla ukusinda

Uvavanyo olusetyenziselwa ukufumanisa umhlaza we-esophageal lungabandakanya:

• Uthotho lwee-x-reyi ezithathiweyo ukuvavanya i-esophagus (barium swallow)
• I-MRI yesifuba okanye i-thoracic CT (ihlala isetyenziselwa ukunceda inqanaba lesi sifo)
• I-endoscopic ultrasound (ngamanye amaxesha isetyenziselwa ukumisela inqanaba lesifo)
• Uvavanyo lokuvavanya kwaye ususe isampulu yolusu lwe-esophagus (esophagogastroduodenoscopy, EGD)
• Ukuskena i-PET (ngamanye amaxesha kuluncedo ekumiseleni inqanaba lesifo, kwaye nokuba ngotyando lunokwenzeka)

Ukuvavanywa kwestool kunokubonisa inani elincinci legazi esitulweni.

I-EGD iya kusetyenziselwa ukufumana isampulu yethishu kwi-esophagus yokufumanisa umhlaza.

Xa umhlaza usemngxunyeni kuphela kwaye ungasasazekanga, kuya kwenziwa utyando. Umhlaza kunye nenxalenye, okanye yonke, isopha iyasuswa. Olu tyando lunokwenziwa kusetyenziswa:

• Utyando oluvulekileyo, ngexesha elinye okanye i-2 yokusikwa okukhulu kwenziwa.
• Unyango olungenelelayo oluncinci, ngexesha apho i-2 ukuya kwi-4 incision encinci yenziwa esiswini. I-laparoscope enekhamera encinci ifakwe esiswini ngesinye seziqwenga.

Unyango ngemitha lungasetyenziselwa endaweni yotyando kwezinye iimeko xa umhlaza unganwenanga ngaphandle komqala.

Nokuba yi-chemotherapy, i-radiation, okanye zombini inokusetyenziselwa ukunciphisa ithumba kunye nokwenza utyando lube lula.

Ukuba umntu ugula kakhulu ukuba angenza utyando olukhulu okanye umhlaza usasazeke kwamanye amalungu, ichemotherapy okanye imitha ingasetyenziselwa ukunceda ukunciphisa iimpawu. Oku kubizwa ngokuba yonyango lokunyanga. Kwiimeko ezinjalo, esi sifo asihlali sinyangeka.

Ngaphandle kotshintsho kwindlela otya ngayo, ezinye iindlela zonyango ezinokuthi zisetyenziswe ukunceda umguli aginye zibandakanya:

• Ukwehlisa (ukwandisa) isophagus usebenzisa i-endoscope. Ngamanye amaxesha i-stent ibekwa ukugcina i-esophagus ivulekile.
• Umbhobho wokutyisa ungene esiswini.
• Unyango lwe-Photodynamic, apho ichiza elikhethekileyo litofelwe kwi-tumor lize libonakaliswe ekukhanyeni. Ukukhanya kusebenze iyeza elihlasela ithumba.

Ungaluphelisa uxinzelelo lokugula ngokujoyina iqela lokuxhasa umhlaza. Ukwabelana nabanye abanamava afanayo kunye neengxaki kunokukunceda ungaziva ulilolo

Xa umhlaza ungasasazekanga ngaphandle komqala, utyando lunokuphucula amathuba okusinda.

Xa umhlaza usasazekile kwezinye iindawo zomzimba, unyango alunakwenzeka. Unyango lujolise ekunciphiseni iimpawu.

Iingxaki zinokubandakanya:

• Ukukrala kwemiphunga
• Ukwehla kobunzima obukhulu ngokungatyi ngokwaneleyo

Tsalela umnxeba umboneleli wakho ukuba unengxaki yokuginya ngaphandle kwesizathu esaziwayo kwaye ayibi bhetele. Biza kwakhona ukuba unezinye iimpawu zomhlaza wokuqaqamba kwemiqala.

Ukunciphisa umngcipheko womhlaza wesifo:

• Musa ukutshaya.
• Nciphisa umda okanye UNGASIPHI utywala.
• Jonga ugqirha wakho ukuba uneGERD eqatha.
• Fumana uvavanyo rhoqo ukuba uneBarrett esophagus.

Umhlaza - umqala

• Esophagectomy - ukubhobhoza
• Ityhubhu yokondla isisu - i-bolus
• Ityhubhu yokondla iJejunostomy

• Inkqubo yokwetyisa
• Uthintelo lwentlungu
• Umhlaza wesisu

Ku GY, Ilson DH. Umhlaza womqala. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, ii-eds. I-Oncology yeklinikhi yase-Abeloff. Umhla wesi-6. IPhiladelphia, PA: Elsevier; 2020: isahl. 71.

Kwiwebhusayithi yeZiko loMhlaza weSizwe. Unyango lwe-Esophageal cancer (PDQ) -uhlobo lobungcali kwezempilo. www.cancer.gov/types/esophageal/hp/esophageal-nyango-pdq. Ukuhlaziywa kweyeNkanga 12, 2019. Ifikeleleke ngoDisemba 5, 2019.

Iwebhusayithi yeNethiwekhi yeCancer epheleleyo yoMhlaza. Izikhokelo ze-NCCN zokuziqhelanisa neklinikhi kwi-oncology (izikhokelo ze-NCCN): i-esophageal kunye ne-esophagogastric junction cancers. Inguqulelo 2.2019. www.nccn.org/professionals/physician_gls/pdf/esophageal.pdf. Ukuhlaziywa ngoMeyi 29, 2019. Kufumaneka ngoSeptemba 4, 2019.