I-Mediastinoscopy kunye ne-biopsy

I-Mediastinoscopy ene-biopsy yinkqubo apho isixhobo esikhanyisiweyo (i-mediastinoscope) sifakwa kwisithuba esifubeni phakathi kwemiphunga (mediastinum). Izicubu zithathwa (i-biopsy) nakuphi na ukukhula okungaqhelekanga okanye ii-lymph node.

Le nkqubo yenziwa esibhedlele. Uya kunikwa i-anesthesia ngokubanzi ukuze ulale kwaye ungaziva buhlungu. Umbhobho (ityhubhu endotracheal) ubekwa empumlweni okanye emlonyeni ukukunceda uphefumle.

Ukusikwa okuncinci kwenziwa ngaphezulu nje kwethambo lesifuba. Isixhobo esibizwa ngokuba yi-mediastinoscope sifakwa ngale ndlela isikiweyo kwaye ngobunono sidluliselwe embindini wenxalenye yesifuba.

Iisampuli zeethishu zithathwa kwii-lymph node ezijikeleze umoya. Umda uyasuswa kwaye ukusikwa kotyando kuvaliwe ngemithungo.

I-x-ray yesifuba iya kuhlala ithathwa ekupheleni kwenkqubo.

Inkqubo ithatha malunga nemizuzu engama-60 ukuya kuma-90.

Kufuneka usayine ifom yemvume unolwazi. Awuyi kuba nakho ukutya okanye ulwelo iiyure ezingama-8 phambi kovavanyo.

Uya kulala ngexesha lenkqubo. Kuya kubakho ukuthamba kwisiza senkqubo emva koko. Unokuba nomqala obuhlungu.

Uninzi lwabantu lunokuphuma esibhedlele ngentsasa elandelayo.

Kwiimeko ezininzi, isiphumo se-biopsy sikulungele kwiintsuku ezi-5 ukuya kwezi-7.

Le nkqubo yenziwa ukujonga emva koko i-biopsy lymph node okanye nakuphi na okunye ukukhula okungaqhelekanga kwindawo engaphambili ye-mediastinum, kufutshane nodonga lwesifuba.

• Esona sizathu siqhelekileyo kukubona ukuba umhlaza wemiphunga (okanye omnye umhlaza) usasazekile kwezi lymph node. Oku kubizwa ngokuba yistage.
• Le nkqubo yenziwa nosulelo oluthile (isifo sephepha, isarcoidosis) kunye nokuphazamiseka komzimba.

Ii-Biopsies zamathambo e-lymph node ziqhelekile kwaye azibonisi zimpawu zomhlaza okanye usulelo.

Iziphumo ezingaqhelekanga zingabonisa:

• Isifo seHodgkin
• Umhlaza wemiphunga
• I-Lymphoma okanye ezinye izidumbu
• I-Sarcoidosis
• Ukusasazeka kwezifo kwelinye ilungu lomzimba liye kwelinye
• Isifo sephepha

Kukho umngcipheko wokugqobhoza i-esophagus, trachea, okanye imithambo yegazi. Kwezinye iimeko, oku kunokukhokelela ekuphumeni kwegazi okungasongela ubomi. Ukulungisa ukulimala, isifuba sesifuba kuya kufuneka sahlulwe kwaye isifuba sivulwe.

• Mediastinum

UCheng GS, uVarghese TK. Amathumba aphakathi kunye nee-cysts. Ku: Broaddus VC, Mason RJ, Ernst JD, et al, ii-eds. Incwadi kaMurray neNadel yeyeza lokuphefumla. Umhla wesi-6. IPhiladelphia, PA: Elsevier Saunders; I-2016: isahluko 83.

U-Putnam JB. Umlenze, udonga lwesifuba, i-pleura, kunye ne-mediastinum. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, ii-eds. Incwadi yeSabiston yoNyango. Umhla we-20. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 57.