I-Esophagectomy -ukungenelela kancinci

Ubuncinane be-esophagectomy obungenayo i-esophagectomy utyando lokususa inxenye okanye yonke i-esophagus. Le yile ityhubhu ehambisa ukutya ukusuka kumqala wakho ukuya esiswini sakho. Emva kokuba isusiwe, umqala uphinde wakheke kwinxalenye yesisu sakho okanye kwinxalenye yamathumbu akho amakhulu.

Uninzi lwexesha, i-esophagectomy yenziwa ukunyanga umhlaza we-esophagus. Utyando luyakwenziwa kwakhona ukunyanga i-esophagus ukuba ayisasebenzi ukuhambisa ukutya esiswini.

Ngethuba le-esophagectomy encinci ye-esophagectomy, ukusikwa okuncinci kotyando (ukusikwa) kwenziwa kwisisu sakho esingaphezulu, esifubeni, okanye entanyeni. Umda wokubukela (i-laparoscope) kunye nezixhobo zoqhaqho zifakwa ngokwendlela yokwenza utyando. (Ukususwa komqala kungenziwa kusetyenziswa indlela evulekileyo. Utyando lwenziwa ngokusikwa okukhulu.)

Utyando lweLaparoscopic lwenziwa ngale ndlela ilandelayo:

• Uya kufumana i-anesthesia ngokubanzi ngexesha lotyando lwakho.Oku kuyakukugcina ulele kwaye ungabi nazintlungu.
• Ugqirha wenza ukusikeka okuncinci oku-3 ukuya kwesine esiswini sakho, esifubeni, okanye entanyeni esezantsi. Oku kusika kumalunga ne-intshi enye (2.5 cm) ubude.
• I-laparoscope ifakwe ngenye yokusika kwisisu sakho esiphezulu. Ubungakanani bunokukhanya kunye nekhamera ekugqibeleni. Ividiyo evela kwikhamera ibonakala kwiliso kwigumbi lokusebenza. Oku kuvumela ugqirha wotyando ukuba abone indawo ekusetyenzwa kuyo. Ezinye izixhobo zotyando zifakwa ngakwamanye amanxeba.
• Ugqirha ukhulula umqala kwizicubu ezikufutshane. Kuxhomekeke kubungakanani besifo sakho esigulayo, inxenye okanye uninzi lwayo lususiwe.
• Ukuba inxalenye yesifo sakho isuswe, iziphelo ezisele zihlanganiswe kunye usebenzisa iziqu okanye iziqu. Ukuba uninzi lwe-esophagus yakho luyasuswa, ugqirha uyasibumba kwakhona isisu sakho sibe yityhubhu yokwenza umqala omtsha. Idityaniswe kwinxalenye eseleyo yomqala.
• Ngexesha lotyando, ii-lymph node esifubeni sakho nasesiswini kunokwenzeka ukuba zisuswe ukuba umhlaza usasazekile kubo.
• Umbhobho wokutya ubekwa emathunjini akho amancinci ukuze ukondliwe ngelixa uchacha kutyando.

Amanye amaziko onyango enza olu tyando kusetyenziswa utyando lweerobhothi. Kolu hlobo lotyando, kufakwa umda omncinci kunye nezinye izixhobo ngokusika okuncinci kulusu. Ugqirha ulawula ubungakanani kunye nezixhobo ngelixa uhleli kwisikhululo sekhompyuter kwaye ujonge ukubek'esweni.

Ugqirha luhlala luthabatha iiyure ezi-3 ukuya kwezi-6.

Esona sizathu sixhaphakileyo sokususa inxenye, okanye konke, kwesopha sakho kukunyanga umhlaza. Unokuba nonyango lwe-radiation okanye i-chemotherapy ngaphambi okanye emva kotyando.

Ugqirha lokususa i-esophagus esezantsi linokwenziwa ukunyanga:

• Imeko apho iringi yemisipha engasebenziyo ingasebenzi kakuhle (achalasia)
• Umonakalo omkhulu womda womphetho onokubangela umhlaza (iBarrett esophagus)
• Umonzakalo omkhulu

Olu luqhaqho olukhulu kwaye lunobungozi obuninzi. Ezinye zazo zinzulu. Qiniseka ukuba uxoxa ngale ngozi kunye nogqirha wakho.

Umngcipheko kolu tyando, okanye ngeengxaki emva kotyando, unokuba phezulu kunesiqhelo ukuba:

• Abakwazi ukuhamba nokuba imigama emifutshane (oku kwandisa umngcipheko wamahlwili egazi, iingxaki zemiphunga kunye nezilonda zoxinzelelo)
• Ngaphezulu kweminyaka engama-60 ukuya kuma-65
• Ngaba utshaya kakhulu
• Batyebile
• Uphulukene nobunzima obuninzi kumhlaza wakho
• Ngaba amayeza steroid
• Ngaba wayenamayeza omhlaza ngaphambi kotyando

Umngcipheko we-anesthesia kunye notyando ngokubanzi zezi:

• Ukunyanga kwamayeza kunyango
• Iingxaki zokuphefumla
• Ukopha, amahlwili egazi, okanye usulelo

Iingozi zolu tyando zezi:

• Reflux yeasidi
• Ukwenzakala kwisisu, amathumbu, imiphunga, okanye amanye amalungu ngexesha lotyando
• Ukuvuza kwesiqulatho somqala okanye isisu sakho apho ugqirha wazihlanganisa kunye
• Ukunciphisa unxibelelwano phakathi kwesisu sakho kunye nomqala
• Ukukrala kwemiphunga

Uya kuba notyelelo oluninzi kugqirha kunye novavanyo lonyango ngaphambi kokuba wenze utyando. Ezinye zazo zezi:

• Uvavanyo olupheleleyo lomzimba.
• Ukutyelelwa ngugqirha wakho uqiniseke ukuba ezinye iingxaki zonyango onokuba nazo, ezinjengesifo seswekile, uxinzelelo lwegazi kunye neengxaki zentliziyo okanye zemiphunga ziphantsi kolawulo.
• Iingcebiso ngezondlo.
• Undwendwelo okanye iklasi yokufunda okwenzekayo ngexesha lotyando, into omele uyilindele emva koko, kwaye zeziphi iingozi okanye iingxaki ezinokubakho emva koko.
• Ukuba kutshanje uye waphulukana nobunzima, ugqirha unokukubeka kwisondlo ngomlomo okanye nge-IV kwiiveki ezimbalwa ngaphambi kotyando.
• Iskena se-CT ukujonga umqala.
• Ukuskena i-PET ukufumanisa umhlaza kwaye ukuba sele usasazekile.
• I-Endoscopy ukuxilonga kunye nokuchonga ukuba umhlaza uye kude kangakanani.

Ukuba uyatshaya, kuya kufuneka uyeke iiveki ezininzi ngaphambi kotyando. Buza uncedo lwakho lwezempilo.

Xelela umboneleli wakho:

• Ukuba ukhulelwe okanye unokukhulelwa.
• Ngawaphi amayeza, iivithamini kunye nezinye izongezo ozithathayo, kwanezo uzithengileyo ngaphandle kommiselo.
• Ukuba ubusele utywala obuninzi, ngaphezu kwesiselo esinye okanye ezi-2 ngosuku.

Ngexesha leveki ngaphambi kotyando:

• Unokucelwa ukuba uyeke ukuthatha iziyobisi ezincinci zegazi. Ezinye zezi aspirin, ibuprofen (Advil, Motrin), vitamin E, warfarin (Coumadin), kunye ne-clopidogrel (Plavix), okanye i-ticlopidine (Ticlid).
• Buza ugqirha wakho ukuba ngawaphi amayeza ekufuneka uwathathe ngosuku lotyando.
• Lungisa ikhaya lakho emva kotyando.

Ngomhla wotyando:

• Landela imiyalelo yokuba uyeke nini ukutya nokusela ngaphambi kotyando.
• Thatha amayeza ugqirha wakho akuxelele ukuba uwathabathe ngesiphuzo esincinci samanzi.
• Fika esibhedlele ngexesha.

Uninzi lwabantu luhlala esibhedlele kangangeentsuku ezisi-7 ukuya kwezi-14 emva kokuqunjelwa. Ukuhlala kwakho ixesha elide kuya kuxhomekeka kuhlobo luni lotyando onalo. Unokuchitha i-1 ukuya kwiintsuku ezi-3 kwigumbi lokunyamekela abagulayo (ICU) emva kotyando.

Ngexesha lokuhlala kwakho esibhedlele, uya:

• Celwa ukuba uhlale ecaleni kwebhedi yakho kwaye uhambe ngosuku okanye ngemini enye emva kotyando.
• Ungabinakho ukutya ubuncinci iintsuku ezi-2 ukuya kwezi-7 zokuqala emva kotyando. Emva koko, unokukwazi ukuqala ngolwelo. Uya kutyiswa ngombhobho wokutyisa owawubekwe emathunjini akho ngexesha lotyando.
• Yiba nombhobho ophuma ecaleni kwesifuba sakho ukukhupha ulwelo olwakhayo.
• Nxiba isitokhwe esikhethekileyo ezinyaweni nasezinyaweni ukukhusela amahlwili egazi.
• Fumana iifotsholo ukunqanda amahlwili egazi.
• Fumana amayeza entlungu nge-IV okanye uthathe iipilisi. Unokufumana iyeza lakho leentlungu ngempompo ekhethekileyo. Ngale mpompo, ucofa iqhosha ukuhambisa amayeza entlungu xa uwufuna. Oku kukuvumela ukuba ulawule inani lamayeza eentlungu owafumanayo.
• Yenza imithambo yokuphefumla.

Emva kokuba ugodukile, landela imiyalelo yendlela yokuzikhathalela njengoko uphilisa. Uya kunikwa ulwazi malunga nokutya kunye nokutya. Qiniseka ukuba uyayilandela loo miyalelo ngokunjalo.

Abantu abaninzi bachacha kakuhle kolu tyando kwaye banokutya ukutya okuqhelekileyo. Emva kokuchacha, kuya kufuneka batye iinxalenye ezincinci kwaye batye rhoqo.

Ukuba uye wahlinzwa umhlaza, thetha nogqirha wakho malunga namanyathelo alandelayo onyango lomhlaza.

Ubuncinane be-esophagectomy engenayo; Irobotic esophagectomy; Ukususwa kwe-esophagus - encinci encinci; I-Achalasia - i-esophagectomy; IBarrett esophagus - esophagectomy; Umhlaza wokudumba - isophagectomy - laparoscopic; Umhlaza we-esophagus-esophagectomy-laparoscopic

• Sula ukutya okungamanzi
• Ukutya kunye nokutya emva kwesophagectomy
• Esophagectomy - ukubhobhoza
• Ityhubhu yokondla isisu - i-bolus

• Umhlaza wesisu

UDonahue J, uCarr SR. Ubuncinane be-esophagectomy. Ku: UCameron JL, uCameron AM, ii-eds. Unyango lwangoku lonyango. Umhla we-12. IPhiladelphia, PA: Elsevier; Ngo-2017: 1530-1534.

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 ngoNovemba 18, 2019.

USpicer JD, uDhupar R, uKim JY, uSepesi B, uHofstetter W. Esophagus. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, ii-eds. Incwadi yeSabiston yoNyango. Umhla we-20. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 41.