So kokoram a "jelly" ahyɛ mu ma yi wɔ wo yafunu mu? Momma yensua Pseudomyxoma Peritonei (PMP) ho ade!

So wo yafunu ayɛ wo yaw, woate nka sɛ wo ho ayɛ wo ma, anaasɛ wo ho ayɛ wo hyew bere nyinaa pɛn? Ɛtɔ mmere bi a yesusuw sɛ eyinom yɛ nneɛma a ɛfata, nanso wɔ nsɛm a ɛntaa nsi mu no, ebia ntease foforo bi wɔ saa sɛnkyerɛnne ahorow yi akyi. Ɛnnɛ yɛrebɛka kokoram tebea bi a ɛntaa nsi, nanso ɛho hia yiye ho asɛm. Ɛno yɛ tebea bi a wɔfrɛ no `Pseudomyxoma Peritonei`, a yɛsan frɛ no `(PMP)` tiawa.

Dɛn ne Pseudomyxoma Peritonei (PMP)?

Sɛ yɛbɛka no tiawa a, `Pseudomyxoma Peritonei` yɛ kokoram a ɛntaa nsi koraa. Nea ɛba wɔ eyi mu ne sɛ kokoram nkwammoaa ahyɛ wo yafunu mu, kyerɛ sɛ, yafunu no ne nea atwa ho ahyia (`(peritoneal cavity)`) ma. Saa kokoram nkwammoaa yi yɛ ade a ɛte sɛ jelly, a ɛyɛ slimy a wɔfrɛ no ``mucin`` pii. Fa no sɛ, ɛte sɛ nea jelly ahyɛ wo yafunu mu ma! Eyi nti na nnipa binom nso frɛ saa yare yi ``jelly belly.``

Edin "Pseudomyxoma Peritonei" kyerɛ biribi te sɛ "atoro mucinous tumor of the peritoneal cavity." Nnuruyɛfo frɛ eyi "atoro akisikuru" efisɛ ɛnte sɛ kokoram afoforo a efi ase wɔ beae biako na ɛtrɛw. Ɛfiri aseɛ ankasa wɔ akuru ketewa bi a wɔfrɛ no ``polyp'' a ɛba wo appendix mu, appendix .

Sɛ saa polyp yi fi appendix no mu a, kokoram nkwammoaa a ɛyɛ saa ade a ɛte sɛ jelly a mekaa ho asɛm no fi ase trɛw kɔ yafunu no mu nyinaa. Bere kɔ so no, eyi betumi aka wo aduan mu nneɛma.

Dɛn ne sɛnkyerɛnne ahorow a yenya bere a yɛanya PMP no?

PMP ho sɛnkyerɛnne no taa ba mpofirim koraa. Ebia mfiase no worenhu wɔn, anaasɛ ebia wubesusuw sɛ wɔyɛ biribi a ɛfata, te sɛ akisikuru anaa aduan a wontumi nnyae. Nanso sɛ saa sɛnkyerɛnne ahorow yi kɔ so anaasɛ ɛyɛ kɛse a, ɛsɛ sɛ ɛhaw wo.

Nsɛnkyerɛnne atitiriw no bi ni:

• Yafunu mu a ɛtrɛw: Ɛte sɛ nea yafunu no ahonhon na ɛyɛ kɛse ma ɛda adi.
• Yafunu mu yaw: Saa ade a ɛte sɛ jelly a ɛwɔ yafunu no mu yi betumi ate nka sɛ ɛyɛ yaw anaa ɛyaw wɔ ɔkwan a ɛkɔ akyiri so.
• Akisikuru: Akisikuru betumi asiw dwensɔtwaa kɛse no ano na ama ayɛ den sɛ wobɛfa nsu mu.
• Ɛyɛ den sɛ wobenyinsɛn: Wɔ mmea fam titiriw no, ebetumi ayɛ den sɛ wobenyinsɛn abofra esiane nhyɛso a awotwaa a jelly ahyɛ mu ma yi anaa awo akwaa a ɛyɛ hyew de ba nti.
• Hernias: Nhyɛso a ɛkɔ soro wɔ yafunu no mu no betumi ama w’akwaa biako apia afa ntini no mu akɔ. Wɔ mmarima mu no, inguinal hernia yɛ PMP ho sɛnkyerɛnne a ɛtaa ba.
• Aduan no nyɛ dɛ.
• Abofono.

Ɛtɔ da bi a, oduruyɛfoɔ bi bɛtumi akyere saa `PMP` tebea yi ntɛm wɔ wo afe afe nhwehwɛmu mu anaa berɛ a ɔresɔ wo ahwɛ sɛ wowɔ tebea foforɔ bi. Nanso nnipa dodow no ara hu ho asɛm bere a wɔn yafunu mu haw no kɔ so na ɛyɛ kɛse no.

Dɛn nti na saa PMP yi ba? Dɛn nti na ɛte saa?

Nokwarem no, abenfo da so ara nnim nsɛm a esisi nkɔnsɔnkɔnsɔn a ɛde PMP ba no ankasa. Nanso wonim sɛ efi ase denam onyin ketewaa bi a wɔfrɛ no polyp a ɛwɔ akyi berɛmo no mu so. Efi hɔ no, kokoram nkwammoaa a ɛma mucin no tu kwan kɔ yafunu no mu.

Kae sɛ, `PMP` yɛ yare a ɛntaa nsi koraa, yiye . Ɛka nnipa bɛyɛ biako kosi baanan wɔ ɔpepem biako mu afe biara. Enti mma ehu a ɛho nhia denam eyi ho asɛm a wobɛte so.

Ɔkwan bɛn so na nnuruyɛfo hu sɛ wɔwɔ PMP anaa?

Sɛ wokɔ oduruyɛfo nkyɛn a, wobebisa wo wo yare no ho sɛnkyerɛnne ahorow ho asɛm. Bere tenten ahe na woanya bi, na sɛ ebia ɛreyɛ kɛse anaa? Afei wɔbɛyɛ nipadua mu nhwehwɛmu. Wɔbɛkra nso sɛ wɔnyɛ mogya mu nhwehwɛmu ne mfoniniyɛ mu nhwehwɛmu.

Mogya mu nhwehwɛmu

Ebia wo duruyɛfo bɛhyɛ sɛ wɔnkan mogya a edi mũ (CBC). Ebia wɔbɛhyɛ sɛ wɔnyɛ mogya mu nhwehwɛmu nso mfa nhwehwɛ akisikuru agyiraehyɛde ahorow. Eyinom yɛ nneɛma a ebetumi akyerɛ sɛ wowɔ kokoram wɔ wo nipadua mu.

Mfoninitwa sɔhwɛ ahorow

Wobetumi ayɛ nhwehwɛmu de ahwɛ sɛ wo yafunu akwaa no ayɛ kɛse, nsu ahyɛ mu ma (ascites), anaasɛ mucin ayɛ mu ma, te sɛ "jelly belly":

• Yafunu mu ultrasound a wɔde yɛ nhwehwɛmu.
• CT scan a wɔde yɛ nhwehwɛmu.
• MRI scan a wɔde yɛ nhwehwɛmu.

Nea ɛka ho no, oduruyɛfo betumi ayɛ ade a wɔde twitwiw wo nipadua mu, a nea ɛka ho ne sɛ obegye nsu anaa ntini ketewaa bi afi wo yafunu mu. Aduruyɛ mu ɔyare ho ɔbenfo de afiri a wɔde hwɛ nneɛma nketenkete (cytology) bɛhwehwɛ nhwɛsode no mu. Ɛtɔ mmere bi a wobetumi ayɛ laparoscopy de ahwɛ wo yafunu mu na wɔafa ntini ahorow.

Dɛn ne ayaresa ahorow a wɔde sa PMP? So wobetumi asa no yare?

Ayaresa no gyina nneɛma pii so, a wo tebea ne w’akwahosan nyinaa ka ho. Wɔ tebea horow bi mu no, nnuruyɛfo betumi asa Pseudomyxoma Peritonei na wɔasa mpo .

Mpɛn pii no, ayaresa yi hwehwɛ sɛ wɔyɛ oprehyɛn. Nea ɛka eyi ho ne sɛ wobeyi akwaa a kokoram nkwammoaa wom no nyinaa afi hɔ. Wobetumi nso ama wo nnuru a wɔde sa yare (intraperitoneal chemotherapy) bere a wɔreyɛ oprehyɛn no. Nanso sɛ oprehyɛn no tumi yi kokoram anaa mucin no nyinaa anaa ne fã kɛse no ara nkutoo a, oduruyɛfo a ɔyɛ oprehyɛn no bɛyɛ eyi. Wosi saa gyinae no bere a wɔreyɛ no oprehyɛn no.

Oprehyɛn ahorow wɔ hɔ a wɔde sa PMP.

Sɛ nhwɛso no, sɛ wowɔ mucin wɔ wo dwensɔtwaa ketewa anaa wo dwensɔtwaa kɛse mu a, wo duruyɛfo no betwa wo dwensɔtwaa . Oprehyɛn ahorow afoforo nso wɔ hɔ a woyi akwaa pɔtee bi fi hɔ:

• Cholecystectomy: Woyi wo gallbladder no fi hɔ.
• Hysterectomy with bilateral salpingo-oophorectomy : Woyi wo fallopian tubes, ovaries, ne awotwaa no fi hɔ.
• Liver capsulectomy: Woyi wo mmerɛbo no ani fã bi .
• Omenectomy: Woyi srade a ɛwɔ yafunu no anim no fi hɔ .
• Peritonectomy : Ntini a ɛyɛ wo yafunu ne wo hwene mu (peritoneum) a woyi fi hɔ.
• Splenectomy : Woyi wo akyi berɛmo no fi hɔ.

Nsɛnnennen bɛn na ebetumi aba bere a wɔreyɛ oprehyɛn no?

Sɛ wɔyɛ wo oprehyɛn de yi akwaa ahorow fi hɔ a, hokwan wɔ hɔ bere nyinaa sɛ nsɛnnennen te sɛ mogya a ɛbɛtɔ dodo , ɔyare mmoawa, anaasɛ anastomotic leak . Oprehyɛn akɛse nso betumi de ɔhaw ahorow a ɛde nkwa to asiane mu aba. Wɔkyerɛ sɛ ayarefo bɛyɛ ɔha biara mu biako kosi abien (1-2%) wuwu wɔ oprehyɛn kɛse akyi. Enti, ɛho hia sɛ wo ne wo duruyɛfo susuw eyinom nyinaa ho.

So ayaresa afoforo wɔ hɔ a ɛnyɛ oprehyɛn?

Ɛtɔ mmere bi a, wo duruyɛfo betumi akamfo ayaresa afoforo a ɛnyɛ oprehyɛn, te sɛ:

• Active surveillance : Sɛ wowɔ PMP a edi kan, anaasɛ ɛyɛ ɔkwan a ɛyɛ hu yiye, na asiane a ɛwɔ hɔ sɛ wobɛyɛ oprehyɛn no sõ sen asiane a ɛwɔ hɔ sɛ wubenya yare no a, wo duruyɛfo betumi ahyɛ nyansa sɛ fa w’ani si wo so denneennen. Eyi hwehwɛ sɛ wo duruyɛfo hwɛ w’akwahosan so daa. Ebia wɔbɛyɛ mfoninitwa nhwehwɛmu ne mogya mu nhwehwɛmu de ahwɛ sɛ ebia PMP no retrɛw anaa.
• Ɔhwɛ a ɛma wo ho dwo : Sɛ wuntumi nyɛ oprehyɛn a, wo duruyɛfo betumi akamfo ayaresa te sɛ nnuru anaa mframa a wɔde sa yare a ebetumi adi PMP tebea no so na atew sɛnkyerɛnne ahorow no so akyerɛ wo.

Mprempren, nnuruyɛfo nso reyɛ nhwehwɛmu wɔ dwensɔtwaa ketewaa a wɔde si ananmu ho sɛ aduru a wɔde sa nnipa a wɔwɔ PMP wɔ dwensɔtwaa ketewaa mu.

Daakye bɛn na obi a ɔwɔ PMP betumi ahwɛ kwan?

Wɔ tebea horow bi mu no, oprehyɛn a wɔyɛ de yi kokoram nkwammoaa a ɛwɔ yafunu no mu nyinaa betumi aboa ma wɔadi yare no so bere tenten . Ayaresa afoforo betumi aboa wo ma woatra ase ne yare no akyɛ.

Sɛ yɛreka ``survival rate`` ho asɛm a, adeɛ a ɛho hia paa sɛ yɛkae ne sɛ yei yɛ yareɛ a ɛntaa nsi koraa. Eyi kyerɛ sɛ nnipa kakraa bi pɛ na wonya bi. Nhwehwɛmufo resua nea wonim fa ho afi nnipa akuw nketewa paa hɔ. Sɛ wowɔ saa yareɛ yi a, ɛyɛ papa sɛ wobɛbisa wo duruyɛfoɔ saa ``survival rate`` nhwehwɛmu yi ne sɛdeɛ ɛka wo tebea no ho asɛm.

Mɛyɛ dɛn ahwɛ me ho? (Ne ho a wɔhwɛ) .

Sɛ wɔayɛ wo oprehyɛn de ayi kokoram nkwammoaa anaasɛ wɔayi akwaa bi afi hɔ a, ɛho hia sɛ wokae sɛ wo nipadua no hia bere ne ahomegye na ama ayɛ yiye. Sɛ nhwɛso no, sɛ wɔyɛ wo oprehyɛn de yi w’akyi a, wo duruyɛfo bɛkyerɛkyerɛ sɛnea eyi bɛka wo no mu.

Sɛ wopaw ayaresa a ɛma wo ho tɔ wo a, ebia ɛsɛ sɛ woyɛ kokoram ayaresa te sɛ nnuru ne mframa a wɔde sa yare wo nkwa nna nyinaa. Ɛho hia sɛ wokɔ so yɛ den na wudi wo duruyɛfo akwankyerɛ akyi yiye.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wowɔ `PMP` a, akyinnye biara nni ho sɛ ɛsɛ sɛ wobɔ wo duruyɛfo amanneɛ wɔ nsɛm a edidi so yi mu:

• Sɛ nsɛnnennen ba wɔ ayaresa akyi a. Sɛ nhwɛso no, sɛ mogya tu dodo wɔ oprehyɛn akyi, anaasɛ sɛ ɔyare mmoawa ho sɛnkyerɛnne bi wɔ oprehyɛn kuru no mu a.
• Sɛ ayaresa no mu nsunsuanso bɔne no nye sen sɛnea na wohwɛ kwan a.
• Sɛ sɛnkyerɛnne ahorow bi wɔ hɔ a ɛkyerɛ sɛ `Pseudomyxoma Peritonei` san ba bio wɔ oprehyɛn akyi a.

Awiei koraa no, nkrasɛm a ɛho hia sen biara (Take-Home Message) .

Pseudomyxoma Peritonei (PMP) yɛ yare a ɛntaa nsi koraa na ɛyɛ den. Abenfo da so ara nnim nea enti a ɛba no ankasa. Ebia wubenya bi akyɛ na wunhu nsakrae kɛse biara wɔ wo nipadua mu. Sɛ sɛnkyerɛnne ahorow no da adi ampa a, ebetumi ayɛ mmerɛw te sɛ akisikuru anaa akisikuru.

Enti, ebetumi ayɛ ahodwiriw sɛ wubehu sɛ yare a ɛntaa nsi saa na ɛde wo sɛnkyerɛnne ahorow no ba. Ebetumi ayɛ den sɛ wɔbɛka akyerɛ wo sɛ ayaresa no bɛhwehwɛ sɛ wɔyɛ oprehyɛn de yi akwaa biako anaa nea ɛboro saa wɔ wo yafunu mu. Ebetumi ayɛ den sɛ yɛbɛte eyinom nyinaa ase prɛko pɛ.

Nanso mma ɛnhaw wo. Wo nnuruyɛfo te ase sɛ ebia wowɔ nsɛmmisa pii – ebia mpo nsɛmmisa koro no ara mpɛn pii. Bere a wusua ayaresa a wubetumi apaw ho ade na wosusuw anammɔn a edi hɔ a wobɛfa so no ho no, wɔpɛ sɛ wɔte biribiara a ɛwɔ w’adwenem. Ɛno ne wo hokwan. Adwene tebea pa a obi wɔ nso boa kɛse wɔ ayaresa mu.

` Pseudomyxoma Peritonei, PMP, kokoram, yafunu mu, mucin, jelly yafunu, appendix, oprehyɛn