Ukwakhiwa kwakhona kwebele - izicubu zendalo

Emva kwemastectomy, abanye abantu basetyhini bakhetha ukwenza utyando lokuphucula izibele zabo. Olu hlobo lotyando lubizwa ngokuba kukwakhiwa kwakhona kwebele. Inokwenziwa ngaxeshanye njenge-mastectomy (ukwakhiwa kwakhona kwangoko) okanye kamva (ulibaziseko lokwakha ngokutsha).

Ngexesha lokwakhiwa ngokutsha kwebele elisebenzisa izicubu zendalo, ibele liphinda lenziwe ngokutsha kusetyenziswa umsipha, ulusu, okanye amanqatha kwelinye ilungu lomzimba wakho.

Ukuba unokwakhiwa kwakhona kwebele ngexesha elifanayo ne-mastectomy, ugqirha unokukwenza oku kulandelayo:

• Ulusu olusindisa ulusu. Oku kuthetha kuphela indawo ejikeleze ingono yakho kunye nearola isusiwe.
• Ingono yokuthintela ingono. Oku kuthetha ukuba lonke ulusu, ingono, kunye ne-areola zigcinwa.

Kuzo zombini ezi meko, ulusu lushiywe ukwenza ukwakhiwa kwakhona kube lula.

Ukuba uza kuphinda uvuselele amabele kamva, ugqirha wotyando usenokwenza ulusu- okanye ingono yokuthintela imastectomy. Ukuba awuqinisekanga malunga nokwakhiwa kwakhona, ugqirha uya kususa ingono kunye nolusu olwaneleyo ukwenza udonga lwesifuba lube mpuluswa kwaye lucaba ngokusemandleni.

Iindidi zokwakhiwa kwakhona kwamabele zibandakanya oku kulandelayo:

• I-rectus esiswini esiswini esine-myocutaneous flap (TRAM)
• Imilenze yemisipha yeLatissimus
• Ubunzulu obuphantsi be-epigastric artery perforator flap (DIEP okanye DIEAP)
• Icwecwe elizukileyo
• Inqamleza igracilis flap ephezulu (TUG)

Ngayo nayiphi na le nkqubo, uya kuba ne-anesthesia ngokubanzi. Eli yeza likugcina ulele kwaye ungenazintlungu.

Utyando lwe-TRAM:

• Ugqirha usika (ukusika) kwisisu sakho esezantsi, ukusuka esinqeni ukuya kolunye. Isilonda sakho siya kufihlwa kamva luninzi lwempahla kunye neesuti zokuhlamba.
• Ugqirha ukhulula ulusu, amafutha, kunye nezihlunu kule ndawo. Esi sihlunu ke tunneled phantsi kwesikhumba sesisu sakho ukuya kwindawo yebele ukwenza ibele lakho elitsha. Imithambo yegazi ihlala ixhumekile kwindawo apho kuthathwa khona izicwili.
• Kwenye indlela ebizwa ngokuba yinkqubo yasimahla yokuqhwaba, ulusu, amanqatha, kunye nezihlunu zemisipha zisuswe kwisisu sakho esezantsi. Esi sihlunu sibekwe kwindawo yakho yesifuba ukwenza ibele lakho elitsha. Imithambo kunye nemithambo iyanqunyulwa kwaye iphinde ifakwe kwimithambo yegazi phantsi kwengalo yakho okanye ngasemva kwethambo lakho.
• Esi sihlunu senziwe emva koko sibe libele elitsha. Ugqirha uhambelana nobukhulu kunye nokumila kwebele lakho lendalo ngokusondeleyo kangangoko kunokwenzeka.
• Ukuqhekeka kwisisu sakho kuvaliwe ngemithungo.
• Ukuba ungathanda ingono entsha kunye ne-areola eyenziwe, uyakufuna utyando lwesibini, oluncinci kakhulu kamva. Okanye, ingono kunye ne-areola zinokwenziwa nge tattoo.

Ukufakela i-latissimus muscle flap kunye nokufakelwa kwebele:

• Ugqirha usika kumqolo wakho ongasentla, kwicala lesifuba sakho esisusiweyo.
• Ugqirha ukhulula ulusu, amafutha, kunye nezihlunu kule ndawo. Esi sihlunu ke tunneled phantsi kolusu lwakho kwindawo ibele ukwenza ibele lakho elitsha. Imithambo yegazi ihlala ixhunyiwe kummandla osuswe apho izicubu zithathwa khona.
• Esi sihlunu senziwe emva koko sibe libele elitsha. Ugqirha uhambelana nobukhulu kunye nokumila kwebele lakho lendalo ngokusondeleyo kangangoko kunokwenzeka.
• Ukufakwa kungafakwa phantsi kwemisipha yodonga lwesifuba ukunceda ukulinganisa ubungakanani besinye isifuba sakho.
• Imisonto ivaliwe ngemithungo.
• Ukuba ungathanda ingono entsha kunye ne-areola eyenziwe, uyakufuna utyando lwesibini, oluncinci kakhulu kamva. Okanye, ingono kunye ne-areola zinokwenziwa nge tattoo.

Kwi-DIEP okanye kwi-DIEAP flap:

• Ugqirha usika esiswini sakho esezantsi. Ulusu kunye namafutha avela kule ndawo akhululiwe. Esi sihlunu ke sibekwa kwindawo yakho yesifuba ukwenza ibele lakho elitsha. Imithambo kunye nemithambo iyanqunyulwa ize iphinde idityaniswe kwimithambo yegazi ephantsi kwengalo yakho okanye ngasemva kwethambo lakho.
• Izicubu emva koko zenziwe zaba libele elitsha. Ugqirha uhambelana nobukhulu kunye nokumila kwebele lakho lendalo ngokusondeleyo kangangoko kunokwenzeka.
• Imisonto ivaliwe ngemithungo.
• Ukuba ungathanda ingono entsha kunye ne-areola eyenziwe, uyakufuna utyando lwesibini, oluncinci kakhulu kamva. Okanye, ingono kunye ne-areola zinokwenziwa nge tattoo.

Iflethi ebukekayo:

• Ugqirha usika ezinqeni zakho. Ulusu, amafutha, kunye nezihlunu ezivela kule ndawo ziyakhululwa. Esi sihlunu sibekwe kwindawo yakho yesifuba ukwenza ibele lakho elitsha. Imithambo kunye nemithambo iyanqunyulwa ize iphinde idityaniswe kwimithambo yegazi ephantsi kwengalo yakho okanye ngasemva kwethambo lakho.
• Izicubu emva koko zenziwe zaba libele elitsha. Ugqirha uhambelana nobukhulu kunye nokumila kwebele lakho lendalo ngokusondeleyo kangangoko kunokwenzeka.
• Imisonto ivaliwe ngemithungo.
• Ukuba ungathanda ingono entsha kunye ne-areola eyenziwe, uyakufuna utyando lwesibini, oluncinci kakhulu kamva. Okanye, ingono kunye ne-areola zinokwenziwa nge tattoo.

Kwi-TUG flap:

• Ugqirha usika ithanga lakho. Ulusu, amafutha, kunye nezihlunu ezivela kule ndawo ziyakhululwa. Esi sihlunu sibekwe kwindawo yakho yesifuba ukwenza ibele lakho elitsha. Imithambo kunye nemithambo iyanqunyulwa iphinde idityaniswe kwimithambo yegazi ephantsi kwengalo yakho okanye ngasemva kwethambo lakho.
• Izicubu emva koko zenziwe ibele elitsha. Ugqirha uhambelana nobukhulu kunye nokumila kwebele lakho lendalo ngokusondeleyo kangangoko kunokwenzeka.
• Imisonto ivaliwe ngemithungo.
• Ukuba ungathanda ingono entsha kunye ne-areola eyenziwe, uyakufuna utyando lwesibini, oluncinci kakhulu kamva. Okanye, ingono kunye ne-areola zinokwenziwa nge tattoo.

Xa ukwakhiwa kwakhona kwebele kwenziwa ngexesha elinye njenge-mastectomy, lonke utyando lunokuhlala kwiiyure ezisibhozo ukuya kwezili-10. Xa yenziwe njengotyando lwesibini, kunokuthatha ukuya kuthi ga kwiiyure ezili-12.

Wena kunye nogqirha wakho niza kugqiba kunye malunga nokuba nibe nokwakha kwakhona amabele kwaye nini. Isigqibo sixhomekeke kwizinto ezininzi ezahlukeneyo.

Ukuphinda uvuselele amabele akwenzi nzima ukuba ufumane ithumba ukuba umhlaza wamabele ubuyile.

Uncedo lokwakhiwa ngokutsha kwesifuba kunye nezicubu zendalo kukuba isifuba esenziwe ngokutsha sithambile kwaye sinendalo ngakumbi kunezinto ezifakwe ebeleni. Ubungakanani, ukugcwala, kunye nokumila kwebele elitsha kunokutshatiswa kufutshane nelinye ibele.

Kodwa iinkqubo ze-muscle flap zinzima ngakumbi kunokubeka izilwanyana zebele. Kusenokufuneka utofelwe igazi xa usenza le nkqubo. Uhlala uchitha iintsuku ezi-2 okanye ezi-3 esibhedlele emva kolu tyando xa kuthelekiswa nezinye iinkqubo zokwakha ngokutsha. Ixesha lakho lokubuyisela ekhaya liya kuba lide kakhulu.

Abasetyhini abaninzi bakhetha ukungabinakho ukwakhiwa kwakhona kwebele okanye ukufakelwa. Banokusebenzisa iprosthesis (ibele lokufakelwa) kwibragi yabo enika ubume bendalo. Okanye banokukhetha ukungasebenzisi nto konke konke.

Umngcipheko we-anesthesia kunye notyando zezi:

• Impendulo kumayeza
• Iingxaki zokuphefumla
• Ukopha, amahlwili egazi, okanye usulelo

Ingozi yokwakhiwa kwakhona kwebele kunye nezicubu zendalo zezi:

• Ukuphulukana noluvo olujikeleze ingono kunye ne-areola
• Isikhumba esibonakalayo
• Elinye ibele likhulu kunelinye (iasymmetry yamabele)
• Ukuphulukana ne-flap ngenxa yeengxaki zokubonelela ngegazi, kufuna utyando olungakumbi ukugcina i-flap okanye ukuyisusa
• Ukopha kwindawo apho ibele lalifudula likhona, ngamanye amaxesha kufuna utyando lwesibini ukulawula ukopha

Xelela ugqirha wakho wotyando ukuba uthatha nawaphi na amayeza, izongezo, okanye amayeza owathengileyo ngaphandle kommiselo.

Ngexesha leveki ngaphambi kotyando lwakho:

• Unokucelwa ukuba uyeke ukuthatha amayeza okucoca igazi. Oku kubandakanya i-aspirin, ibuprofen (Advil, Motrin), ivithamin E, clopidogrel (Plavix), warfarin (Coumadin, Jantoven), kunye nezinye.
• Buza ugqirha wakho otyandayo ukuba zeziphi iziyobisi ekusafuneka uzithathe ngemini yotyando lwakho.
• Ukuba uyatshaya, zama ukuyeka. Ukutshaya kunokunciphisa ukuphulukisa kunye nokwandisa umngcipheko weengxaki. Buza umboneleli wakho wezempilo ngoncedo lokuyeka.

Ngomhla wotyando lwakho:

• Landela imiyalelo malunga nokungatyi okanye ukusela kunye nokuhlamba phambi kokuba uye esibhedlele.
• Thatha amayeza akho ugqirha akuxelele ukuba uthathe ngamanzi amancinci.
• Fika esibhedlele ngexesha.

Uya kuhlala esibhedlele kangangeentsuku ezi-2 ukuya kwezi-5.

Usenokuba unamadreyini esifubeni sakho xa ugoduka. Ugqirha wakho uza kubasusa kamva xa undwendwela iofisi. Unokuba nentlungu xa usikiwe emva kotyando. Landela imiyalelo malunga nokuthatha amayeza eentlungu.

I-Fluid inokuqokelela phantsi kwesiqwengana. Oku kubizwa ngokuba siseroma. Kuqhelekile. Iseroma inokuhamba yodwa. Ukuba ayiphumi, isenokufuna ukukhutshwa ngugqirha wotyando ngexesha lotyelelo eofisini.

Iziphumo zolu tyando zihlala zilungile. Kodwa ukwakhiwa ngokutsha akuyi kubuyisela uvakalelo oluqhelekileyo lwebele lakho elitsha okanye ingono.

Ukwenza utyando lokwakha amabele emva komhlaza wamabele kunokuphucula imeko yakho yempilo-ntle kunye nomgangatho wobomi.

I-rectus esiswini esiswini se-muscle flap; TRAM; I-latissimus muscle flap kunye nokufakelwa kwebele; I-DIEP flap; I-DIEAP flap; I-flap yamahhala ezukileyo; Inqamleza igracilis ephezulu; TUG; Mastectomy - ukwakhiwa kwakhona kwebele kunye nezicubu zendalo; Umhlaza webele - ukwakhiwa kwakhona kwebele kunye nezicubu zendalo

• Utyando lwebele lokuthambisa-ukukhupha
• I-Mastectomy kunye nokwakhiwa kwakhona kwebele-yintoni oza kuyibuza ugqirha wakho
• Mastectomy - ukubhobhoza

IBurke MS, iSchimpf DK. Ukwakhiwa kwakhona kwesifuba emva konyango lomhlaza wamabele: iinjongo, ukhetho kunye nokuqiqa. Ku: UCameron JL, uCameron AM, ii-eds. Unyango lwangoku lonyango. Umhla we-12. IPhiladelphia, PA: Elsevier; Ngo-2017: 743-748.

Amandla KL, Phillips LG. Ukwakhiwa kwakhona kwebele. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, ii-eds. Incwadi yeSabiston yoNyango: Isiseko sebhayiloji yoQeqesho lwangoku. Umhla we-20. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 35.