I-radiosurgery yestereotactic- iGamma Knife

I-radiosurgery ye-Stereotactic (i-SRS) luhlobo lonyango lwe-radiation olujolise kumandla amakhulu kwindawo encinci yomzimba.

Ngaphandle kwegama layo, i-radiosurgery ayisiyiyo inkqubo yoqhaqho- akukho kusika okanye ukuthunga, kunoko yindlela yonyango lwemitha.

Ngaphezulu kwenkqubo enye esetyenziselwa ukwenza iiradiosurgery. Eli nqaku limalunga ne-Gamma Knife radiosurgery.

Inkqubo yeGamma Knife radiosurgery isetyenziselwa ukunyanga umhlaza okanye ukukhula entloko okanye kwindawo ephezulu yomqolo. Ngomhlaza okanye ukukhula phantsi kumqolo okanye naphina emzimbeni, enye inkqubo yoqhaqho inokusetyenziswa.

Phambi konyango, ufakelwe "isakhelo sentloko." Esi sisangqa sesinyithi esisetyenziselwa ukubeka ngokuchanekileyo kumatshini ukuphucula ukuchaneka kunye nokukhomba ekujoliseni. Isakhelo siqhotyoshelwe entlonzeni yakho nakwikhakhayi. Inkqubo yenziwa yi-neurosurgeon, kodwa ayifuni ukusikwa okanye ukuthunga.

• Sebenzisa i-anesthesia yendawo (njengodokotela wamazinyo onokuyisebenzisa), amanqaku amane abaliwe kulusu lwentloko.
• Isakhelo sentloko sibekwe phezu kwentloko yakho kwaye izikhonkwane ezine ezincinci kunye neeankile ziqhotyoshelwe. Iiankile ziyilelwe ukuba zibambe isakhelo sentloko endaweni yazo, kwaye uhambe ngokuqinileyo ngesikhumba ungene kumphezulu wokakayi lwakho.
• Unikwe i-anesthetic yendawo kwaye akufuneki uve iintlungu, kunokuba uxinzelelo kuphela. Kananjalo unikwa iyeza lokukunceda uphumle ngexesha lenkqubo efanelekileyo.
• Isakhelo siya kuhlala siqhotyoshelwe kuyo yonke inkqubo yonyango, ihlala iyiyure ezimbalwa, emva koko isuswe.

Emva kokuba isakhelo siqhotyoshelwe entlokweni yakho, kwenziwa iimvavanyo zokucinga ezifana ne-CT, iMRI, okanye i-angiogram. Imifanekiso ibonisa indawo echanekileyo, ubungakanani, kunye nemilo yethumba lakho okanye indawo yengxaki kwaye vumela ukujolisa ngqo.

Emva kwemifanekiso, uya kuziswa kwigumbi lokuphumla ngelixa oogqirha kunye neqela le-physics belungisa isicwangciso sekhompyuter. Oko kungathatha malunga nemizuzu engama-45 ukuya kweyure. Emva koko, uya kuziswa kwigumbi lonyango.

Iinkqubo ezintsha ezingenasiseko zokubeka intloko ziyavavanywa.

Ngexesha lonyango:

• Awuyi kufuna ukulala. Uya kufumana amayeza anokunceda uphumle. Unyango ngokwalo alubangeli zintlungu.
• Ulele phezu kwetafile etyibilika kumatshini ohambisa imitha.
• Isakhelo sentloko okanye imaski yobuso iyangqinelana nomatshini, onesigcina-ntloko esinemingxunya yokuhambisa iiplanga ezincinci zemitha ngqo kwithagethi.
• Umatshini unokuhambisa intloko yakho kancinci, ukuze imiqadi yamandla ihanjiswe kwiindawo ezichanekileyo ezifuna unyango.
• Ababoneleli ngezempilo bakwelinye igumbi. Banokubona kwiikhamera kwaye bakuva kwaye bathetha nawe kwii-microphone.

Ukuhanjiswa kwonyango kuthatha naphina ukusuka kwimizuzu engama-20 ukuya kwiiyure ezimbini. Unokufumana ngaphezulu kweseshoni yonyango. Rhoqo, akukho ngaphezu kweeseshoni ezintlanu ziyafuneka.

Iimbotyi zemitha ezijolise kakhulu ekusebenziseni inkqubo yeGamma Knife kunye nokutshabalalisa indawo engaqhelekanga. Oku kunciphisa umonakalo kwizicubu ezisempilweni ezikufutshane. Olu nyango luhlala luyenye indlela yokuvula i-neurosurgery.

I-Gamma Knife radiosurgery inokusetyenziselwa ukunyanga ezi ntlobo zilandelayo zamathumba obuchopho okanye amathumba aphezulu emqolo:

• Umhlaza osele usasazekile (uhle metastasised) ukuya kwingqondo usuka kwelinye ilungu lomzimba
• I-tumor ekhula ngokukhawuleza yentsholongwane edibanisa indlebe kwingqondo (acoustic neuroma)
• Amathumba ebhinqa
• Olunye ukukhula kwingqondo okanye kwintambo yomgogodla (chordoma, meningioma)

IGamma Knife ikwasetyenziselwa ukunyanga ezinye iingxaki zobuchopho:

• Iingxaki zemithambo yegazi (i-arteriovenous malformation, arteriovenous fistula).
• Ezinye iintlobo zokuxhuzula.
• I-trigeminal neuralgia (iintlungu ezinzima zobuso ebusweni).
• Iinyikima ezinzima ngenxa yenyikima ebalulekileyo okanye isifo seParkinson.
• Ikwanokusetyenziswa njengonyango olongezelelekileyo "olongezelelekileyo" emva kokuba umhlaza sele ususiwe ebuchotsheni, ukunceda ukunciphisa umngcipheko wokuphindeka.

Iiradiosurgery (okanye naluphi na uhlobo lonyango lwalo mbandela), zinokonakalisa izicwili ezijikeleze indawo leyo iphathwayo. Xa kuthelekiswa nezinye iintlobo zonyango lwe-radiation, abanye bakholelwa ukuba i-Gamma Knife radiosurgery, kuba ihambisa unyango olukhombisayo, ayinakufane yenzakalise izicubu ezisempilweni ezikufutshane.

Emva kwemitha ebuchotsheni, ukudumba kwendawo, okubizwa ngokuba yi-edema, kunokwenzeka. Unokunikwa amayeza ngaphambi nasemva kwenkqubo yokunciphisa umngcipheko, kodwa kusenokwenzeka. Ukudumba kuhlala kuhamba ngaphandle konyango. Kwiimeko ezinqabileyo, ukulaliswa esibhedlele kunye notyando kunye nokuqhekezwa (utyando oluvulekileyo) luyafuneka ukunyanga ukudumba kwengqondo okubangelwa yimitha.

Kukho iimeko ezinqabileyo zokudumba ezibangela ukuba izigulana zibe neengxaki zokuphefumla, kwaye kukho iingxelo zokufa kwabantu emva kwe-radiosurgery.

Ngelixa olu hlobo lonyango lungahlaseli kangako kunotyando oluvulekileyo, isenokuba nemingcipheko. Thetha nogqirha wakho malunga nobungozi bonyango kunye nemingcipheko yokukhula kwesisu okanye ukusasazeka.

Amanxeba esikhumba kunye neendawo apho isakhelo sentloko siqhotyoshelwe esikhumbeni sakho sinokuba bomvu kwaye sibuthathaka emva konyango. Oku kuya kuhamba kunye nexesha. Kusenokubakho ukutyumka.

Usuku ngaphambi kwenkqubo yakho:

• MUSA ukusebenzisa naziphi na iinwele okanye ukutshiza.
• Sukutya okanye usele nantoni na emva kobusuku ngaphandle kokuba uxelelwe ngugqirha ngenye indlela.

Umhla wenkqubo yakho:

• Nxiba iimpahla ezintle.
• Yiza namayeza akho esiqhelo amiselweyo esibhedlele.
• SUKUGQIBA ubucwebe, izithambiso, iinzipho, okanye iwigi okanye isihlangu seenwele.
• Uya kucelwa ukuba ususe iilensi zonxibelelwano, iiglasi zamehlo kunye nokufakelwa.
• Uza kutshintsha ube yingubo yasesibhedlele.
• Umgca we-intravenous (IV) uya kufakwa engalweni yakho ukuhambisa izinto ezahlukileyo, amayeza kunye nolwelo.

Rhoqo, ungagoduka kwangolo suku lonyango. Lungiselela kwangaphambili ukuba umntu akugoduse, kuba amayeza owanikwa wona anokukwenza wozele. Ungabuyela kwimisebenzi yakho yesiqhelo ngosuku olulandelayo ukuba akukho ngxaki, njengokudumba. Ukuba uneengxaki, okanye ugqirha wakho ukholelwa ukuba iyafuneka, kungafuneka uhlale esibhedlele ubusuku bonke ukuze ubeke iliso.

Landela imiyalelo oyinikwe ngabongikazi bakho malunga nendlela yokuzikhathalela ekhaya.

Iziphumo zeGamma Knife radiosurgery zinokuthatha iiveki okanye iinyanga ukuba zibonwe. Ukuxela kwangaphambili kuxhomekeke kwimeko yokuphathwa. Umboneleli wakho uya kubeka esweni inkqubela yakho esebenzisa iimvavanyo zokucinga ezinje ngeMRI kunye neCT scan.

I-radiotherapy yestereotactic; Radiosurgery yestereotactic; I-SRT; I-SBRT; I-radiotherapy eqhekezayo; I-SRS; Imela yeGamma; Iigrafikhi zoGamma Knife; I-neurosugery engafunekiyo; Ukuxhuzula - iGamma Knife

I-Baehring JM, iHochberg FH. Amathumba enkqubo yokuqala yeemvakalelo kubantu abadala. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ii-eds. I-Neurology kaBradley kwiKlinikhi yokuziqhelanisa. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2016: isahl. 74.

UBrown PD, uJaeckle K, uBallman KV, et al. Iziphumo zeradiosurgery yodwa vs i-radiosurgery yonyango olupheleleyo lobuchwephesha kwimisebenzi yokuqonda kwizigulana ezine-1 ukuya kwi-3 metastases yengqondo: ulingo lwezonyango olungenamsebenzi. JAMA. Ngo-2016; 316 (4): 401-409. IINKCUKACHA: 27458945 pubmed.ncbi.nlm.nih.gov/27458945/.

UDewyer NA, Abdul-Aziz D, Welling DB. Unyango ngemitha yamathumba abukhali esiseko se-cranial. Ku: IFlint PW, uFrancis HW, uHaughey BH, et al, ii-eds. I-Cummings Otolaryngology: Utyando lweNtloko kunye neNtamo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2021: isahl. 181.

U-Lee CC, uDJ weSchlesinger, uShehan JP. Inkqubo yeRadiosurgery. Ku: Winn RH, ed. Ugqirha we-Youmans kunye no-Winn Neurological. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 264.