Kuqhelekile ukuba uzive unesicaphucaphu kwaye woyika xa usiva igama elithi "utyando lwesibindi." Kuba isibindi sesinye sezitho ezibalulekileyo nezinkulu emzimbeni wethu. Kodwa kwezinye izifo, ingakumbi iimeko ezinzulu ezifana nomhlaza, ukususa inxalenye yesibindi enesifo sesona sisombululo silungileyo sokusindisa ubomi bakho. Ngoko ke namhlanje, masithethe ngale 'hepatectomy', okanye utyando lokususa inxalenye yesibindi, ngendlela elula necacileyo eya kususa onke amathandabuzo akho.
Kutheni kufuneka wenze olu hlobo lotyando?
Kulungile, masiqale sibone ukuba oogqirha bagqiba ekubeni benze olu tyando phantsi kweziphi iimeko. Zimbini izizathu eziphambili. Esinye kunyango lwesifo sesibindi. Esinye kuxa umntu ophilileyo enikela ngenxalenye yesibindi sakhe kumntu ogulayo (iLiving Donor Liver Transplantation).
Ngezifo zesibindi
Olu tyando ludla ngokwenziwa ukuze kususwe iithumba eziye zavela esibindini. Ezi thumba zinokuba ngumhlaza, zingaphambi komhlaza, okanye zibe yingozi. Kukho iintlobo ezimbini zomhlaza wesibindi.
1. Isiseko: Oku kuthetha ukuba umhlaza uqala esibindini.
2. Okwesibini: Oku kuthetha ukuba umhlaza uqale kwenye indawo emzimbeni (umzekelo, ikholoni) kwaye usasazeke esibindini.
Iintlobo eziphambili zomhlaza ezinyangwa ngolu tyando zezi:
- I-Hepatocellular carcinoma - Olu lolona hlobo luphambili lomhlaza oluqala esibindini.
- I-Cholangiocarcinoma - Lo ngumhlaza oqala esibindini.
- Umhlaza we-colon osasazekayo - Ukusasazeka komhlaza we-colon esibindini.
Olu tyando alwenziwa kuphela kumhlaza, kodwa nakwezinye iimeko zonyango:
- Amatye enyongo kwimibhobho yenyongo engaphakathi kwesibindi (imigudu ye-intrahepatic).
- Iithumba eziqhelekileyo ezifana ne-adenoma.
- Iintsholongwane zesibindi.
Umntu ophilileyo unikela ngenxalenye yesibindi sakhe
Le yinto entle kakhulu. Xa isibindi somntu sonakele phantse ngokupheleleyo kwaye sidinga ukufakelwa isibindi, umntu ophilileyo unokunikela ngenxalenye yesibindi sakhe kuloo mguli. Kolu hlobo lomnikelo, inxalenye yesibindi somnikeli iyasuswa ngotyando. Into emangalisayo kukuba isibindi esiseleyo somnikeli kunye nesibindi esitsha somguli ofakelweyo ziyakhula zibuyele kwisibindi esipheleleyo.
Ingaba olu tyando lunzulu kangakanani? Ngaba kukho naziphi na iingozi?
Ewe, utyando lokususa inxalenye yesibindi lutyando oluntsonkothileyo nolunzima kakhulu.Ithathwa njengenjalo. Isizathu esiphambili soku kukuba kukho inani elikhulu lemithambo yegazi esasazeka kwisibindi. Ngenxa yoko, ukopha kakhulu kunokwenzeka ngexesha lotyando. Ngoko ke, oogqirha abenza olu tyando kufuneka babe noqeqesho olukhethekileyo ukuze baphephe ukonakalisa imithambo yegazi kwaye balawule ukopha.
Kodwa kukho oku:
- Ukususwa kwesibindi okuncinci: Ukuba kususwe ngaphantsi kwesiqingatha sesibindi, umngcipheko uphantsi. Olu tyando ngoku lunokwenziwa kusetyenziswa iindlela ezingafunekiyo kangako ezifana ne -laparoscopy okanye utyando lwerobhothi .
- Ukususwa kwesibindi okubalulekileyo: Ukuba kufuneka kususwe isibindi esingaphezulu kwesiqingatha, kunzima kwaye kuyingozi.
Ngoko ke, eyona nto ibalulekileyo ekufuneka uyikhumbule kukuba ukuba uza kwenza olu tyando, kubalulekile ukukhetha isibhedlele esineqela lezonyango elinamava kakhulu neliyingcali .
Kwenzeka ntoni ngaphambi kotyando?
Ngaphambi kokuba wenze olu tyando, iqela lezonyango liza kuqwalasela ngononophelo izinto ezininzi. Kulapho kuphela apho baya kugqiba khona ukuba olu tyando lolona nyango lufanelekileyo kuwe.
Izinto eziqwalaselwa ngoogqirha:
- Ngaba impilo yakho yomelele ngokwaneleyo ukuba ingamelana notyando olukhulu kangaka?
- Ngaba ithumba okanye inxalenye yesibindi enesifo ingasuswa ngotyando?
- Ukuba ngumhlaza, ngaba usasazeke nakwamanye amalungu omzimba ngaphandle kwesibindi?
Ngamanye amaxesha, ukuba ithumba lomhlaza likhulu, kunokwenzeka ukuba utyando lube lula kwaye lukhuseleke ngokunika unyango olufana nonyango lwemitha okanye i-chemotherapy ngaphambi kotyando ukuze kuncitshiswe ithumba.
Kwakhona, oogqirha kufuneka bagqibe ukuba ngaba kufuneka utyandwe isibindi esipheleleyo okanye utyandwe isibindi sonke. Ezi zinto ziya kuchaphazela eso sigqibo:
- Ingakanani i-tumor esasazeke kangaka?
- Isibindi sakho sisempilweni kangakanani?
- Ingaba inxalenye yesibindi eseleyo emva kotyando yanele ukusebenza komzimba?
Uvavanyo lwangaphambi kotyando
Ukuze ukwazi konke oku ngokuqinisekileyo, ugqirha wakho uya kuyalela iimvavanyo ezininzi, ezifana nezi:
- Uvavanyo lwemifanekiso: I-CT scan okanye i-MRI scan.
- Uvavanyo lokusebenza kwesibindi: Olu luvavanyo lwegazi oluqhelekileyo.
- Uvavanyo lwesibindi: Ukuthatha iqhekeza elincinci kakhulu lesibindi ukuze lihlolwe.
Ziziphi iindlela eziphambili zokwenza utyando?
Utyando lwe-hepatectomy lunokwenziwa ngeendlela ezintathu eziphambili. Ugqirha wakho uya kugqiba indlela efanelekileyo kwimeko yakho.
| Indlela yotyando | Inkcazo | Ifanelekile kwi |
|---|---|---|
| Utyando Oluvulekileyo | Olu tyando lwenziwa ngokwenza umngxuma omde, omkhulu esiswini, ovula umngxuma wesisu. Oogqirha banokubona isibindi ngokuthe ngqo. | Kwiithumba ezinkulu nezintsonkothileyo okanye kwiimeko ezimandundu. |
| Utyando lweLaparoscopic | Olu tyando lwenziwa ngokwenza imingxunya emincinci emi-4-6 esiswini, kufakwa ikhamera ngesinye isixhobo kunye nezinye izixhobo ezikhethekileyo. Ugqirha wenza utyando ngelixa ebukele isikrini. | Kwiinkqubo ezincinci nezilula. Ixesha lokuchacha lifutshane. |
| Utyando lweRobhothi | Kufana ne-laparoscopy, kodwa izixhobo zotyando zilawulwa yingalo yerobhothi elawulwa ngugqirha. Oku kuvumela utyando oluchanekileyo ngakumbi. | Nokuba utyando olunzima kakhulu lunokwenziwa ngoku kusetyenziswa le ndlela. |
Kwenzeka ntoni kwinxalenye yesibindi esusiweyo? Ngaba iya kuphinda ikhule?
Ewe! Le yeyona nto imangalisayo ngesibindi. Isibindi sinamandla amangalisayo okuzilungisa nokuzivuselela.
Khawucinge nje, nokuba isibini kwisithathu sesibindi esisempilweni sisusiwe, inxalenye eseleyo esempilweni inokwahlukana kwakhona, ikhule, kwaye ikhule kwakhona ibe kubukhulu bayo bokuqala kwiiveki okanye kwiinyanga ezimbalwa. Njengokuba umsila wecikilishe ukhula kwakhona xa uqhekekile. Kodwa isantya sokukhula kwakhona sixhomekeke kwizinto ezininzi.
- Ukuba ukhe wafumana i-chemotherapy ngaphambili.
- Ukuba kukho ukuqokelelana kwamafutha esibindini (isibindi esinamafutha).
- Ukuba unesifo sesibindi esinganyangekiyo esifana ne-cirrhosis.
Kwiimeko ezinjalo, izinga lokuvuselelwa kwesibindi linokuba lincinci kancinci.
Ngawaphi amanyathelo otyando?
Nangona kukho utshintsho oluncinci ngokuxhomekeke kwindlela yotyando kunye nobungakanani bezicubu ezisusiweyo, utyando ngokubanzi luhamba ngolu hlobo:
1. I-Anesthesia: Uza kulaliswa ubuthongo obupheleleyo (i-anesthesia eqhelekileyo) ngaphambi kotyando.
2. Ukwenza utyando: Kwityando elivulekileyo, kwenziwa utyando olude esiswini. Kwi-laparoscopy, kwenziwa utyando oluncinci oluninzi.
3. Ukulungiselela isibindi: Ugqirha uza kuchonga eyona ndawo yesibindi eza kususwa. I-ultrasound yangaphakathi kotyando ingasetyenziswa ngexesha lotyando. Ukuba indawo eza kususwa ikufutshane nenyongo, inyongo nayo ingadinga ukususwa.
4. Ukususwa kwesibindi: Ugqirha uyahlula ngononophelo izicubu zesibindi, achonge imithambo yegazi kunye nemibhobho yenyongo, aze ayivale ngee-clip okanye ii-staplers. Izixhobo ezikhethekileyo zisetyenziselwa ukulawula ukopha.
5. Ukususwa kwenxalenye: Inxalenye yesibindi esahluliweyo iyasuswa emzimbeni. Kwindlela ye-laparoscopic, kunokufuneka ukusika okongezelelweyo malunga ne-2-5 intshi ukususa le nxalenye.
Ngokwesiqhelo, olu tyando lungathatha iiyure ezimbini ukuya kwezintandathu .
Kwenzeka ntoni emva kotyando? Esibhedlele
Emva kotyando, uza kuqala ugcinwe kwiyunithi ekhethekileyo (iyunithi ye-post-anesthesia) ude uvuke emva kwe-anesthesia, uze udluliselwe kwigumbi eliqhelekileyo. Ukuba utyando belunzima kakhulu, kungafuneka uhlale kwiyunithi yokhathalelo olunzulu (ICU) usuku olunye okanye ezimbini.
Kwiintsuku zokuqala, uya kuba neetyhubhu ezininzi ezifakwa emzimbeni wakho. Ezi ziza kukhupha ulwelo, zinike isiqabu esiswini sakho, kwaye zinike isondlo. Iqela lezonyango liza kuhlala lijonga uxinzelelo lwegazi, amanqanaba eswekile, kunye nokopha kwegazi.
Xa imeko yakho izinzile, kusenokwenzeka ukuba uhlale esibhedlele iintsuku ezimbalwa okanye iveki. Ngeli xesha:
- Kancinci kancinci, beqala ngokutya okumanzi, baza kuqala ukutya ukutya okuqinileyo.
- Uza kuphuma ebhedini aze aqalise ukuhamba.
- Iipayipi ezifakiweyo ziya kususwa kancinci kancinci.
- Uza kunikwa amayeza afunekayo ukulawula iintlungu.
Ndathi ndakufika ekhaya ndivela esibhedlele, ndanikwa umhla wokuba ndize kubona ugqirha kwakhona emva kweeveki ezimbini.
Iingozi kunye neengxaki zotyando
Njengakwezinye iintlobo zotyando olukhulu, kukho iingozi kunye neengxaki ezinokubakho, kwaye kubalulekile ukuba uzazi.
| Ingxaki | Ingcaciso elula |
|---|---|
| Usulelo | Ukusika oku kunokubangela inyumoniya okanye usulelo lomchamo. Amayeza okubulala iintsholongwane anokunyanga oku. |
| Ukopha | Utyando lwesibindi lunomngcipheko omkhulu wokopha. Utofelo-gazi lunokufuneka emva kotyando. |
| Ukuvuza kwenyongo | Ukuba umbhobho wenyongo wonakele ngexesha lotyando, inyongo ingavuza ingene kwisisu. Oku kufuna ukuba kufakwe umbhobho owongezelelweyo ukuze kususwe inyongo. |
| Ukuphuma kwePleural | Ulwelo lunokuqokelelwa lujikeleze imiphunga, nto leyo ebangela iintlungu esifubeni kunye nobunzima bokuphefumla. |
| Ii-Ascites | Ukwanda kolwelo esiswini. Oku kunganyangwa ngamayeza okanye ngokufaka ityhubhu yokukhupha ulwelo. |
| Ukuqhekeka kwegazi (i-deep vein thrombosis) | Amahlwili egazi anokubakho emilenzeni ngenxa yokuba sebhedini ixesha elide emva kotyando. |
| Ukungasebenzi kakuhle kwesibindi | Le meko inokwenzeka ukuba isibindi esiseleyo asanele ukusebenza kakuhle emzimbeni. Kwimeko enjalo, ukufakelwa isibindi okungxamisekileyo kunokufuneka. |
Ngokwezibalo, malunga ne-2% yabantu abenza olu tyando bafa ngenxa yeengxaki. Nangona kunjalo, kumntu onomhlaza, iingenelo zotyando zingaphezulu kakhulu kuneengozi ezinxulumene nomhlaza.
Kuthatha ixesha elingakanani ukuchacha emva kokubuyela ekhaya?
Kungathatha iiveki ezine ukuya kwezisibhozo ukuze uphile ngokupheleleyo ekhaya. Kuya kufuneka uthathe ikhefu emsebenzini ngeli xesha.
- Kuphephe ngokupheleleyo ukuphakamisa izinto ezisindayo kunye nokuzilolonga okunzima .
- Kungathatha malunga neeveki ezili-12 ukuqala kwakhona yonke imisebenzi yemihla ngemihla.
- Ukuba kwenziwe utyando lwe-laparoscopic okanye lwerobhothi, ixesha lokuchacha linokuba likhawuleza kancinci.
Ukuze ukhawulezise inkqubo yokuphiliswa, kubalulekile ukutya ukutya okuneproteni eninzi kwaye wenze umthambo olula (njengokuhamba) . Zama ukuhamba ubuncinane imizuzu engama-30 ngosuku, kodwa phumla ukuba uziva udiniwe.
Ukuba unale mpawu, bonana nogqirha ngokukhawuleza.
Ukuba ufumana naziphi na iimpawu ezingaqhelekanga emva kokubuyela ekhaya, yazisa ugqirha wakho ngoko nangoko.
- Ulwelo olufana negazi okanye ubomvu obuphuma enxebeni.
- Umkhuhlane ongapheliyo.
- Ukuhlanza okanye urhudo.
- Ukuqunjelwa okuhlala ixesha elingaphezu kweentsuku ezintathu.
- Ukudumba kwesisu.
- Ukutyheli kwamehlo nolusu (i-Jaundice).
Umyalezo Wokuya Ekhaya
- Utyando lweHepatectomy, olubandakanya ukususwa kwenxalenye yesibindi, lutyando olukhulu, kodwa yindlela esebenzayo kakhulu yokusindisa ubomi kwizifo ezifana nomhlaza.
- Isibindi sethu sinamandla amangalisayo okuzivuselela, ngoko ke musani ukoyika inxalenye esusiweyo.
- Ukukhetha ugqirha onamava kunye neqela lezonyango kubaluleke kakhulu ukuze olu tyando luphumelele.
- Kuthatha ixesha ukuchacha emva kotyando, ngoko ke mamela umzimba wakho uze uwunike ukuphumla okufunekayo.
- Landela imiyalelo kagqirha wakho rhoqo. Musa ukoyika ukubuza ukuba unemibuzo.
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