Kuvamile ukuzizwa wesaba kancane futhi ukhathazekile lapho udokotela wakho ekutshela noma othile oseduze nawe ukuthi udinga ukuhlinzwa okubizwa ngokuthi "i-Esophagectomy." Ungase ube nemibuzo eminingi efana nokuthi, "Kuyini lokhu kuhlinzwa? Kungani kwenziwa? Kuzokwenzekani ngemva kwalokho?" Kodwa ungakhathazeki. Sizoxoxa ngakho konke ngesiSinhala esilula ongasiqonda, sinobungane kakhulu. Ngesikhathi uqeda ukufunda lesi sihloko, uzobe usukuqonda kahle lokhu.
Kalula nje, kuyini i-Esophagectomy?
Ukususwa kwesisu kuyindlela yokuhlinzwa esusa ingxenye noma yonke i-esophagus yakho. I-esophagus yipayipi elithwala ukudla nokuphuza kusuka emphinjeni kuya esiswini. Kufana nepayipi lamanzi.
Manje ungase uzibuze, "Kungani lokhu kususwa?" Isizathu esiyinhloko umdlavuza womphimbo . Odokotela batusa futhi lokhu kuhlinzwa ezimweni lapho unezimo ezifana nomphimbo kaBarrett, okwandisa ingozi yakho yokuba nomdlavuza, noma lapho umphimbo wakho ungasebenzi kahle futhi unenkinga yokugwinya.
Ngesikhathi sokuhlinzwa, udokotela ohlinzayo ususa ingxenye eyonakele yomhubhe wakho. Uma kungumdlavuza, amanye ama-lymph node aseduze nawo ayasuswa bese ethunyelwa ukuze ayohlolwa. Ngemuva kwalokho, izingxenye ezisele ziyaxhunywa futhi ipayipi lakho lokudla liyabuyiselwa. Lokhu kusho ukuthi isisu siyadonswa kancane bese sixhunywa komunye umhubhe wakho. Ngale ndlela, ipayipi lakho lokudla liyalungiswa ukuze ukwazi ukudla ngendlela evamile futhi.
Yiziphi izindlela ezahlukene zokwenza lokhu kuhlinzwa?
Nakuba zonke izinqubo zokususwa kwe-esophagectomy zihilela ukususa i-esophagus, indlela udokotela wakho ayisebenzisayo ingahluka kuye ngezici ezifana nendawo yesimila sakho noma umonakalo kanye nempilo yakho iyonke.
Kunezindlela ezimbili ngokuyinhloko:
- Ukuhlinzwa Okuvulekile: Lapha, kwenziwa ukusika okukodwa okude esikhumbeni ukuze kufinyelelwe emhubheni.
- Ukuhlinzwa Okungangeni Kakhulu: Lokhu yilokho esikubiza ngokuthi "ukuhlinzwa kwe-laparoscopic." Esikhundleni sokuhlinzwa okukodwa okukhulu, kusetshenziswa ukuhlinza okuncane okuningana okungaba yi-intshi ubude ukwenza ukuhlinzwa, lapho kufakwa khona ikhamera namathuluzi. Ukuhlinzwa kokufinyelela izitho zesisu kubizwa ngokuthi 'ukuhlinzwa kwe-Laparoscopic', kanti ukuhlinzwa kokufinyelela izitho zesifuba kubizwa ngokuthi 'ukuhlinzwa kwe-Thoracoscopic'.
Kunezinhlobo eziningana zokuhlinzwa ezisekelwe kulezi zindlela. Ithebula elingezansi lichaza kabanzi ngazo.
| Indlela Yokuhlinzwa | Izindawo Zokusika |
|---|---|
| Ukususwa Kwesisu Esingenaso Isisu | Entanyeni nasesiswini (esiswini) |
| Ukuhlinzwa Komqala e-Ivor Lewis | Ngakwesokudla kwesifuba nesisu |
| Ukuhlinzwa Komqala KaMcKeown | Entanyeni, esifubeni nasesiswini |
| Ukususwa Kwesisu Esinomlomo Obuhlungu | Ukusikwa okukodwa okude kusukela esifubeni kuya esiswini kanye nokunye ukusikwa entanyeni |
Khuluma nodokotela wakho bese uthola ukuthi iyiphi indlela engcono kakhulu kuwe nokuthi kungani. Lokhu kuzokunikeza ukuqonda okungcono ngesikhathi sokuhlinzwa kanye nesikhathi sokululama.
Silungiselela kanjani ukuhlinzwa okukhulu kangaka?
Ukususwa kwe-Esophagectomy kuyindlela enkulu yokuhlinzwa, futhi kuthatha isikhathi ukululama. Ngakho-ke, kubaluleke kakhulu ukuthi ulungiselele kahle ngaphambi kokuhlinzwa.
- Ukuhlolwa okuhlukahlukene: Ukuze uhlele ukuhlinzwa, udokotela wakho uzo-oda ukuhlolwa okufana ne-CT scan yesifuba sakho nesisu, i-Endoscopic ultrasound (EUS), noma i-PET scan.
- Ukuthola ukwelashwa kokuqala: Uma unomdlavuza, kungadingeka ukuthi wenziwe i-chemotherapy kanye/noma ukwelashwa ngemisebe ngaphambi kokuhlinzwa. Abanye abantu bathola imiphumela engcono ngokuthola lokhu kwelashwa kusenesikhathi.
- Ukulungiselela umzimba wakho ukuhlinzwa: Uma unezimo ezifana nesifo sikashukela noma umfutho wegazi ophakeme, udinga ukuzilawula ngaphambi kokuhlinzwa. Uma ubhema, kufanele uyeke nakanjani. Ukubhema kubambezela kakhulu inqubo yokuphulukiswa.
- Ukulungiselela isikhathi sokululama: Njengoba imikhuba yakho yokudla izoshintsha ngemva kokuhlinzwa, ungacela iseluleko kuchwepheshe wezokudla . Ungafunda futhi kuchwepheshe wezifo zolimi lokukhuluma (SLP) mayelana nokuzivocavoca ukuqinisa imisipha yakho yokuphefumula ukuze uvimbele izinkinga zamaphaphu ngemva kokuhlinzwa.
- Ukulungiselela ukulaliswa esibhedlela:Njengoba uzobe usesibhedlela isonto elilodwa noma amabili, lungisa izingubo ozidingayo, imithi, nezinto ezifana nencwadi nomcamelo ezizokududuza.
- Ngemva kokufika ekhaya: Hlela ukuthi othile abuye ekhaya evela esibhedlela. Kubalulekile futhi ukuba nomuntu ozokusiza ekhaya. Hlela ikhaya lakho ukuze ukwazi ukuthola kalula izinto ozidingayo.
Kwenzekani ngesikhathi sokuhlinzwa?
Ngaphambi kokuhlinzwa, uzonikezwa i-anesthesia ukuze ungezwa ubuhlungu. Lokhu kusho ukuthi uzobe ulele ngokuphelele. Ngemva kokuhlinzwa, ungase ufake nepayipi le-epidural emhlane wakho ukulawula ubuhlungu.
Udokotela ohlinzayo usika ngokwenqubo futhi asuse ingxenye egulayo yomphimbo. Ngezinye izikhathi ingxenye encane yesisu nayo ingasuswa. Ngemuva kwalokho, isisu noma amathumbu amancane alethwa endaweni yesifuba bese exhunyaniswa nomphimbo osele.
Ngemva kokuhlinzwa, ipayipi lokuncelisa lizofakwa esiswini sakho noma emathunjini amancane ukuze likunikeze ukudla okunomsoco uze ukwazi ukugwinya. Ipayipi le-nasogastric lizofakwa ngekhala lakho ukuze lisize ekukhipheni umoya owengeziwe esiswini sakho futhi likusize ululame. Amapayipi esifuba angafakwa futhi ukuze kukhishwe uketshezi esifubeni sakho. Konke lokhu kwenzelwa ukukusiza ukuthi ululame ngokushesha. Ukuhlinzwa kuvame ukuthatha amahora ama-3 kuya kwangu-6.
Kuzokwenzekani ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, uzogcinwa egunjini lokunakekelwa okujulile (ICU) usuku olulodwa noma ezimbili. Uzoqaliswa ngepayipi lokuncelisa. Uzonikezwa imithi yokulawula ubuhlungu. Kungase kudingeke uhlale esibhedlela cishe amasonto amabili.
Ngesikhathi ngisesibhedlela,
- Uzotshelwa ukuthi ugqoke amasokisi okucindezelayo futhi uhambe ukuze uvimbele ukuqhekeka kwegazi .
- Kufanele wenze izivivinyo zokuphefumula ukuze ugcine amaphaphu akho ehlanzekile.
- Uzofundiswa ukuthi ungayigcina kanjani ipayipi lokuncelisa kanye nenxeba kuhlanzekile.
Yiziphi imiphumela emibi kanye nezingozi?
Noma yikuphi ukuhlinzwa kungabangela imiphumela emibi, futhi kubalulekile ukuqaphela izingozi.
| Imiphumela emibi evamile | Izingozi okufanele uziqaphele |
|---|---|
| Ukukhathala | Izinkinga zamaphaphu, ikakhulukazi i-pneumonia |
| Isifiso sokudla | Ukuvuza kwe-anastomotic |
| Ubuhlungu lapho ugwinya | Ukuphazamiseka kokushaya kwenhliziyo (`i-Atrial fibrillation`) |
| Ukungakhululeki okufana negesi nokuqunjelwa | Ubunzima bokukhuluma noma ukugwinya (i-Dysphagia) |
| Isicanucanu nokuhlanza | Ukopha okuvela enxebeni, ukutheleleka, amahlule egazi |
Iningi lalezi zimpawu lizophela njengoba ululama, kodwa uma unenkinga, xhumana nodokotela wakho ngokushesha.
Kufanele ngishayele udokotela ucingo noma ngiye nini esibhedlela?
Kungase kuvele izinkinga ezithile ngesikhathi sokululama. Uma unezinye zezimpawu ezilandelayo, yazisa udokotela wakho ngokushesha.
- Uma ubuhlungu noma umkhuhlane ukhula
- Uma indawo ezungeze imbobo ibomvu futhi izwakala ishisa
- Uma umzimba uba buthakathaka
- Uma unenkinga yokuphefumula noma isifuba sakho sishaya ngamandla
- Uma isisu sikhululekile noma indle imnyama
- Uma unesifo somphimbo
- Uma ukhwehlela njalo
- Uma amhlophe emehlweni noma esikhumbeni ephenduka aphuzi (i-Jaundice)
- Uma unenkinga yokugwinya noma uqhubeka nokunciphisa isisindo
Lalela ngokushesha! Uma okulandelayo kwenzeka, iya eMnyangweni Wezimo Eziphuthumayo (ETU) oseduze ngokushesha noma ushayele u-1990.
* Uma ungakwazi ukugwinya noma ukuphefumula.
* Uma uhlanza igazi.
* Uma uzwa ubuhlungu obukhulu, ikakhulukazi ubuhlungu besifuba.
Umlayezo Wokuya Nawe Ekhaya
- Ukususwa kwe-Esophagectomy kuyindlela ebalulekile, esindisa impilo eyenziwa ezimweni ezithile zezokwelapha.
- Imiphumela emihle ingatholakala ngokuyeka ukubhema nokulawula izifo ezifana nesifo sikashukela ngaphambi kokuhlinzwa.
- Isikhathi sokululama singase sibe side, ngakho-ke yiba nesineke futhi ulandele imiyalelo kadokotela.
- Ngemva kokuhlinzwa, indlela yakho yokuphila, ikakhulukazi imikhuba yakho yokudla, izoshintsha. Jwayela ukudla ukudla okuncane izikhathi eziningana ngosuku.
- Qaphela izimpawu eziyisixwayiso. Uma unenkinga, ungalibali ukufuna iseluleko sezokwelapha.
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