Bere a wo duruyɛfo ka kyerɛɛ wo sɛ wowɔ kokoram no, so ɔkaa RPLND oprehyɛn no ho asɛm kyerɛɛ wo? Ebia wotee nka sɛ ehu aka wo kakra na edin no ahyɛ wo so. Nanso mma ɛnhaw wo. Eyi yɛ oprehyɛn a ɛho hia yiye ankasa a wɔyɛ de siw kokoram nkwammoaa a ɛtrɛw wɔ wo nipadua mu no ano. Enti momma yɛnka ho asɛm tiawa, wɔ ɔkwan a wubetumi ate ase so.
Dɛn ne RPLND oprehyɛn?
Sɛ yɛbɛka no tiawa a, RPLND (Retroperitoneal Lymph Node Dissection) yɛ oprehyɛn a woyi ntini a ɛma mogya tu fi wo nipadua no fã pɔtee bi . Wɔfrɛ saa beae yi sɛ ‘retroperitoneal’ beae.
Susuw ho saa kwan yi so: baabi a hwee nni wo yafunu mu wɔ w’akwaa atitiriw no akyi, te sɛ wo mmerɛbo ne wo dwensɔtwaa. Saa beae no ne nea yɛfrɛ no retroperitoneal region.
Afei ma yɛnhwɛ nea saa ntini a ɛma mogya tu yi yɛ. Nokwarem no, eyinom yɛ akwaa nketenkete paa a ɛboa ma yɛn nipadua no mu tumi a ɛko tia nyarewa no kɔ so yɛ den. Wɔte sɛ yɛn nipadua mu awɛmfo. Wɔn mu ɔhaha pii apete yɛn nipadua nyinaa mu.
Enti, bere a wo oprehyɛn ho ɔyaresafo (oprehyɛn ho ɔbenfo a ɔyɛ kokoram) ayi ntini a ɛma mogya tu no bere a wɔreyɛ oprehyɛn yi akyi no, wɔde kɔma ɔyare ho ɔbenfo ma ɔnyɛ nhwehwɛmu. Ɛhɔ no, wɔde afiri a wɔde hwɛ nneɛma nketenkete hwɛ ntini a ɛma mogya tu no hwɛ sɛ kokoram nkwammoaa bi wɔ hɔ anaa. Ɛtɔ da bi a nnuruyɛfo frɛ saa oprehyɛn yi ‘retroperitoneal lymphadenectomy’.
Dɛn nti na ɛsɛ sɛ meyɛ saa RPLND oprehyɛn yi?
Nneɛma pii nti na ebia wo duruyɛfo bɛkamfo oprehyɛn yi akyerɛ. Ma yɛnhwɛ mfaso a ɛwɔ oprehyɛn yi so.
| Ade titiriw nti a ɛte saa | Sɛ yɛbɛka no tiawa a... |
|---|---|
| Hwɛ baabi a kokoram no wɔ | Sɛ woyi ntini a ɛma mogya tu no fi hɔ na wɔhwehwɛ mu a, ebetumi aboa ma wɔahu baabi pɔtee a kokoram no atrɛw wɔ nipadua no mu. Wɔfrɛ eyi sɛ wɔbɛkyerɛ baabi a kokoram no wɔ. |
| Gyae kokoram a ɛretrɛw | Sɛ kokoram nkwammoaa hyɛn ntini a ɛma mogya tu no mu a, etumi fa ntini a ɛma mogya tu no mu kɔ nipadua no afã afoforo. Wɔfrɛ eyi sɛ metastasis. Enti, sɛ woyi saa ntini a ɛma mogya tu yi fi hɔ a, ebetumi aboa ma wɔagyae trɛw no. |
| Tew asiane a ɛwɔ hɔ sɛ kokoram bɛsan aba no so | Sɛ woyi ntini a kokoram nkwammoaa wom fi hɔ a, ebetumi atew asiane a ɛwɔ hɔ sɛ kokoram bɛsan aba daakye no so kɛse. |
| Sɛ́ ayaresa sɛ kokoram no san ba a | Ɛtɔ mmere bi a, sɛ kokoram no san ba bere a wɔasa no yare akyi a, wɔyɛ oprehyɛn yi de yi ntini a kokoram nkwammoaa wom no fi hɔ. |
Titiriw no, ɛtɔ mmere bi a wɔyɛ RPLND de hyɛ awotwaa mu kokoram no gyinabea ne ayaresa nyinaa . Wɔyɛ no nso ma kokoram ahorow afoforo te sɛ asaabo mu kokoram, mmea awo nhyehyɛe mu kokoram ahorow bi, ne sarcomas ahorow bi.
Ɛbɛyɛ dɛn na nnuruyɛfo ahu sɛ mihia RPLND?
Sɛ wo mfoninitwa nhwehwɛmu kyerɛ sɛ ntini a ɛwɔ wo yafunu akyi no ahonhon a, ebia wo duruyɛfo bɛka oprehyɛn yi ho asɛm akyerɛ wo. Saa scan ahorow yi bi ne:
- CT scan a wɔde yɛ adwuma
- MRI scan a wɔde yɛ nhwehwɛmu
- PET scan a wɔde hwehwɛ nneɛma mu
Ebia wo duruyɛfo bɛkamfo oprehyɛn yi akyerɛ wɔ bere foforo mu wɔ wo kokoram ayaresa akwantu no mu. Wo duruyɛfo ne onipa a oye sen biara a ɔbɛkyerɛkyerɛ nea enti a wuhia oprehyɛn yi mu. Ɔno na onim wo tebea no yiye. Enti ntwentwɛn wo nan ase sɛ wubebisa no nsɛm biara a ebia wowɔ.
Ɔkwan bɛn so na wɔyɛ RPLND oprehyɛn yi?
Ansa na wobefi oprehyɛn no ase no, wɔbɛma wo aduru a ɛma obi dwensɔ koraa. Eyi kyerɛ sɛ wobɛda koraa. Enti worente ɛyaw biara.
Afei oduruyɛfo a ɔyɛ oprehyɛn no twa wo yafunu mu na ɔde ahwɛyiye yi ntini a ɛbɛn kokoram no kɛse no.
Oprehyɛn yi botae titiriw ne sɛ wobeyi ntini a ebia kokoram nkwammoaa wom no nyinaa afi hɔ na wɔagyae kokoram no trɛw koraa. Sɛnea ɛbɛyɛ na wɔadu saa botae yi ho no, ɛtɔ mmere bi a, ebia ɛho behia sɛ woyi nneɛma afoforo ka ntini a ɛma mogya tu no ho.
- Ntini afoforo pii a efi nipadua no fã foforo.
- Akwaa foforo, te sɛ asaabo.
- Akisikuru anaa ntini afoforo a ɛwɔ saa beae no.
Mprempren, ayaresabea ahorow bi yɛ oprehyɛn yi sɛ laparoscopic oprehyɛn, a wɔnam ntwitwiridii nketenkete kakraa bi so na ɛyɛ, anaasɛ wɔde robɔt oprehyɛn di dwuma. Wo duruyɛfo bɛkyerɛkyerɛ ɔkwan a ɛfata wo mu.
Saa RPLND oprehyɛn yi betumi agye nnɔnhwerew abiɛsa kosi du .
Dɛn na ɛsɛ sɛ yɛhwɛ kwan wɔ oprehyɛn akyi?
Ɛho behia sɛ wotra ayaresabea hɔ bɛyɛ nnanan kosi ason wɔ oprehyɛn no akyi. Ɛyɛ ade a ɛfata sɛ obi bɛte ɛyaw bi wɔ oprehyɛn no akyi. Wo duruyɛfo bɛma wo nnuru a wɔde kum ɛyaw a ɛho hia ma ɛno. Enti mma ɛyaw no nhaw wo.
Asiane bɛn na ɛwɔ oprehyɛn yi mu?
Te sɛ oprehyɛn kɛse biara no, asiane ahorow bi wɔ RPLND oprehyɛn mu. Wo duruyɛfo no bedi kan akyerɛkyerɛ eyinom nyinaa mu akyerɛ wo.
| Ahudeɛ | Nkyerɛmu |
|---|---|
| Mogya ntini a ɛsɛe | Oduruyɛfo no reyɛ oprehyɛn no wɔ baabi a ɛbɛn nipadua no mogya ntini atitiriw no yiye. Enti, wɔ tebea horow a ɛntaa nsi mu no, mogya ntini yi betumi asɛe na mogya foforo betumi atu. |
| Ɛka awo so nkɛntɛnso | Ɔhaw ahorow a ɛfa ɔbarima ne ɔbea nna ho betumi aba wɔ oprehyɛn akyi. Nea enti a ɛte saa ne sɛ ntini ahorow a ɛhwɛ ɔbarima ne ɔbea nna so no fa baabi a wɔyɛ oprehyɛn no. Mpɛn pii no, nnuruyɛfo a wɔyɛ oprehyɛn bɔ saa ntini ahorow yi ho ban na ansɛe. Nanso, ɛtɔ mmere bi a tebea bi a wɔfrɛ no anejaculation betumi aba. |
| Nsu a ɛwɔ ntini mu a ɛboaboa ano (Lymphocele) . | Nsu a ɛma mogya tu no betumi aboaboa ano wɔ baabi a ntini a ɛma mogya tu a wɔreyi afi hɔ no agyaw no. Sɛnea ɛbɛyɛ na woayi nsu a ɛboro so yi afi hɔ no, ebia wo duruyɛfo de afiri ketewaa bi (drain) bɛhyɛ wo yafunu mu. |
| Nsɛnnennen afoforo | Sɛnea ɛte wɔ oprehyɛn biara mu no, asiane ketewaa bi wɔ hɔ sɛ obi benya ɔyare mmoawa, ɔhome mu ayɛ den, akwaa afoforo asɛe, yafunu ase yaw, ne akisikuru. |
Dɛn na ɛwɔ amanneɛbɔ no mu wɔ oprehyɛn no akyi?
Wo duruyɛfo bɛkyerɛkyerɛ ɔyare ho amanneɛbɔ a wo nsa ka bere a woayɛ wo ntini a ɛma mogya tu no mu nhwehwɛmu awie no mu akyerɛ wo.
Wubetumi de nsɛmfua "positive" anaa "negative" adi dwuma wɔ mu.
- Nea efii mu bae pa kyerɛ sɛ na kokoram nkwammoaa wɔ ntini a ɛma mogya tu no mu a woyii no.
- Nea efii mu bae a enye kyerɛ sɛ na kokoram nkwammoaa biara nni hɔ.
Nea ɛka ho no, amanneɛbɔ no ka ntini dodow a woyii no nyinaa mu dodow a kokoram nkwammoaa wom nso. Nso,
- Kokoram ko a ɛwɔ hɔ.
- Sɛnea kokoram nkwammoaa no yɛ soronko wɔ nkwammoaa a ɛteɛ ho (grade).
- Ahoɔhare a kokoram nkwammoaa mu kyekyɛ (mitotic rate).
Ebia nsɛm afoforo a ɛho hia te sɛ:
Dɛn na ɛba akyi bere a wɔanya nea efi mu ba no?
W’aduruyɛfo kuw no begyina nea ebefi w’amanneɛbɔ no mu aba so asi nea wɔbɛyɛ akyi. Ebia ɛbɛyɛ biribi te sɛ eyi:
- Hwɛ / surveillance a wonni ayaresa biara
- Nnuru a wɔde sa yare
- Mframa a wɔde sa yare
Bere bɛn na ɛsɛ sɛ mefrɛ oduruyɛfo no?
Sɛ wudu fie pɛ a, ɛsɛ sɛ wohwɛ wo ho yiye. Hwɛ yiye titiriw wɔ sɛnea wo oprehyɛn kuru no sa no ho. Sɛ wowɔ sɛnkyerɛnne ahorow a edidi so yi mu biara a, frɛ wo duruyɛfo ntɛm ara.
| Kɔkɔbɔ nsɛnkyerɛnne - bɔ oduruyɛfo amanneɛ ntɛm ara | |
|---|---|
| Akisikuru anaa ɔfe | Sɛ worefe araa ma wuntumi mfa nsu kakraa bi mpo nhyɛ wo yafunu mu a. |
| Yafunu ase yaw | Sɛ wote nka sɛ wo ho ayɛ wo den, wote ɛyaw a emu yɛ den, anaa ɛyaw bere a wode wo nsa ka wo yafunu ase no a. |
| Akisikuru anaa dwensɔtwaa biara nni hɔ | Sɛ wuntumi mfa mframa nkɔ anaasɛ wuntumi mfa wo ho nhyɛ mu a. |
| Pus a ɛretu afi kuru no mu | Sɛ nsu a ɛte sɛ akisikuru bi fi oprehyɛn a wɔatwa no mu reba a. |
| Ɛyaw a emu yɛ den | Sɛ wowɔ ɛyaw a emu yɛ den a wontumi mfa nnuru a wɔde kum ɛyaw mpo nni so a. |
Oprehyɛn biara yɛ hu, titiriw bere a ɛfa kokoram ho no. Nanso kae sɛ RPLND yɛ ɔkwan a wɔfa so gye nkwa a ɛma nnuruyɛfo nya w’akwahosan ho nsɛm a ɛho hia na ebetumi asiw kokoram a ɛretrɛw no ano.
Sɛ woda so ara wɔ adwenem naayɛ anaa ehu wɔ oprehyɛn kɛse a ɛte saa a wobɛyɛ ho a, mfomso biara nni ho sɛ wobɛhwehwɛ adwene a ɛto so abien afi oduruyɛfo foforo hɔ. Ebia sɛ wo ne oduruyɛfo foforo bɛkasa a, ɛbɛma woanya asomdwoe pii na ama woanya adwene mu ahoɔden a wuhia na wode agyina oprehyɛn no ano.
Saa oprehyɛn yi yɛ anammɔn kɛse a wɔatu wɔ w’asetra mu. Nanso ebetumi agye wo nkwa. W’aduruyɛfo kuw no wɔ ha sɛ wɔbɛboa wo. Enti wo ne wɔn nka nsɛmmisa anaa ehu biara a wowɔ ho asɛm.
Nkrasɛm a Wɔde Kɔ Fie
- RPLND yɛ oprehyɛn kɛse a woyi ntini a ɛwɔ yafunu no akyi no fi hɔ.
- Wɔyɛ eyi titiriw de hwɛ sɛ kokoram no atrɛw anaa, asiw ano sɛ ɛntrɛw, na wɔasiw kokoram no ano bio.
- Sɛnea ɛte wɔ oprehyɛn biara ho no, asiane ahorow wɔ hɔ, te sɛ mogya a ɛtɔ ne nkɛntɛnso a enya wɔ awo so. Wo duruyɛfo bɛbɔ wo eyinom ho amanneɛ.
- Egye bere ansa na obi ho atɔ no wɔ oprehyɛn akyi. Ɛho hia paa sɛ wohu sɛnkyerɛnne a ɛkyerɛ sɛ woanya ɔyare mmoawa (atiridiinini, akisikuru a efi kuru no mu, ɛyaw a emu yɛ den).
- Ka wo suro ne wo haw ahorow ho asɛm pefee kyerɛ w’aduruyɛfo kuw no. Mma ntwentwɛn wo nan ase da sɛ wubenya adwene a ɛto so abien sɛ ɛho hia a.
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