Esophagectomy - zvishoma zvinokanganisa

Zvishoma zvinokanganisa esophagectomy kuvhiya kubvisa chikamu kana yese yegurokuro. Iyi ndiyo chubhu inofambisa chikafu kubva pahuro yako kuenda kudumbu rako. Mushure mekubviswa, iyo esophagus inovakwazve kubva muchikamu chedumbu rako kana chikamu chemuura wako mukuru.

Kazhinji yenguva, esophagectomy inoitwa kurapa kenza yegurokuro. Kuvhiya kwacho kunogona zvakare kuitwa kurapa iyo esophagus kana isisiri kushanda kuendesa chikafu mudumbu.

Pakati peasophagectomy inokanganisa zvishoma, zvidimbu zvidiki zvekuvhiya (incision) inoitwa mudumbu rako repamusoro, chipfuva, kana mutsipa. Chiyero chekutarisa (laparoscope) uye maturusi ekuvhiya anoiswa kuburikidza necustoms yekuvhiya. (Kubviswa kwesophagus kunogona zvakare kuitwa uchishandisa nzira yakavhurika. Kuvhiya kunoitwa kuburikidza nekukwirisa kukuru.)

Kuvhiya kwepaparoscopic kunowanzoitwa nenzira inotevera:

• Iwe uchagamuchira general anesthesia panguva yekuvhiyiwa kwako.Izvi zvinokuchengeta iwe wakarara uye usina kurwadziwa.
• Chiremba anovhiya anoita matatu kusvika mana madiki akacheka mudumbu rako repamusoro, chipfuva, kana mutsipa wezasi. Aya akacheka anenge 1-inch (2.5 cm) kureba.
• Iyo laparoscope inoiswa kuburikidza nechimwe chekucheka mudumbu rako repamusoro. Chiyero chine mwenje uye kamera kumagumo. Vhidhiyo kubva kukamera inoonekwa pane yekutarisa mukamuri yekushandisa. Izvi zvinobvumira chiremba anovhiya kuti aone nzvimbo iri kuvhiyiwa. Zvimwe zvekushandisa zvekuvhiya zvinoiswa kuburikidza nekumwe kucheka.
• Chiremba anovhiya anosunungura dumbu kubva kumatumbu ari pedyo. Zvichienderana nekuti yakawanda sei yako esophagus inorwara, chikamu kana yakawanda yacho inobviswa.
• Kana chikamu chenyu chakabviswa, magumo akasara akabatanidzwa pamwechete achishandisa staples kana stitches. Kana mazhinji esophagus yako yabviswa, chiremba anovhiya anogadzirisazve dumbu rako kuita chubhu yekuita esophagus nyowani. Iyo yakabatanidzwa kune yakasara chikamu cheiyo esophagus.
• Munguva yekuvhiyiwa, lymph node mubhokisi rako uye mudumbu zvingangobviswa kana kenza yapararira kwavari.
• Pombi yekudyira inoiswa mumatumbu ako mudiki kuti iwe ugone kupihwa chikafu paunenge uchipora kubva pakuvhiyiwa.

Dzimwe nzvimbo dzekurapa dzinoita basa iri dzichishandisa marobhoti. Mune urwu rudzi rwekuvhiya, chiyero chidiki uye zvimwe zviridzwa zvinoiswa kuburikidza nekucheka kudiki paganda. Chiremba anovhiya anodzora chiyero uye zviridzwa paanenge agere pakamba yemakomputa uye achiona tariso.

Kuvhiya kunotora maawa matatu kusvika matanhatu.

Chikonzero chakajairika chekubvisa chikamu, kana chese, chesophagus yako kurapa cancer. Iwe unogona zvakare kuve nemwaranzi kurapwa kana chemotherapy usati kana mushure mekuvhiyiwa.

Kuvhiya kubvisa ezasi esophagus kunogona zvakare kuitwa kurapa:

• Mamiriro ezvinhu ayo mhete yemhasuru musophagus isingashande zvakanaka (achalasia)
• Kukuvadza kwakakomba kwemubhedha weiyo esophagus iyo inogona kukonzeresa kugomarara (Barrett esophagus)
• Kushungurudzika kwakanyanya

Uku kuvhiya kukuru uye kune njodzi dzakawanda. Zvimwe zvacho zviri serious. Ive neshuwa yekukurukura njodzi idzi nachiremba wako.

Njodzi dzekuvhiya uku, kana matambudziko mushure mekuvhiyiwa, anogona kunge ari akakwirira kupfuura akajairwa kana iwe:

• Havakwanise kufamba kunyangwe mamafambo madiki (izvi zvinowedzera mukana wekugwamba kweropa, matambudziko emapapu, uye maronda ekudzvinyirira)
• Vakura kupfuura makumi matanhatu kusvika makumi matanhatu nemashanu
• Uri munhu anoputa zvakanyanya
• Vakafutisa
• Wakarasikirwa nehuremu hwakawanda kubva kukenza yako
• Ari pamishonga yesteroid
• Aive nekenza zvinodhaka asati avhiyiwa

Ngozi dzeanesthesia uye kuvhiyiwa kazhinji ndezvi:

• Allergic reaction kumishonga
• Matambudziko ekufema
• Kubuda ropa, kugwamba kweropa, kana hutachiona

Ngozi dzekuvhiya uku ndedzekuti:

• Acid Reflux
• Kukuvara mudumbu, ura, mapapu, kana dzimwe nhengo panguva yekuvhiyiwa
• Kuvuza kwezviri mukati meguropu rako kana mudumbu apo chiremba anovhiya akabatana nazvo pamwechete
• Kudimbudzira kwekubatana pakati pemudumbu wako uye esophagus
• Chirwere chemabayo

Uchave nekushanya kwachiremba kwakawanda uye bvunzo dzekurapa usati wavhiyiwa. Mimwe yacho ndeiyi:

• Kuongorora kwakakwana kwemuviri.
• Kushanya nachiremba wako kuti uve nechokwadi chekuti mamwe matambudziko ekurapa aungave nawo, akadai seshuga, kuwedzerwa kweropa, uye matambudziko emoyo kana emapapu, ari pasi pekutonga.
• Kurairidzwa kwehutano.
• Kushanya kana kirasi kuti udzidze zvinoitika panguva yekuvhiyiwa, zvaunofanira kutarisira mumashure, uye njodzi dzipi kana matambudziko anogona kuitika mumashure.
• Kana iwe uchangobva kurasikirwa uremu, chiremba wako anogona kukuisa iwe pamuromo kana IV kudya zvinovaka muviri kwemavhiki akati wandei usati wavhiyiwa.
• CT scan kutarisa esophagus.
• PET scan kuti uone gomarara uye kana rapararira.
• Endoscopy yekuongorora uye kuona kuti gomarara raenda zvakadii.

Kana iwe uchisvuta, unofanirwa kumira mavhiki akati wandei usati wavhiyiwa. Kumbira mubatsiri wako wehutano kuti akubatsire.

Udza mupiki wako:

• Kana iwe uri kana ungave uine pamuviri.
• Ndeapi mishonga, mavhitaminzi, uye zvimwe zvekuwedzera zvauri kutora, kunyangwe izvo zvawakatenga usina mushonga.
• Kana iwe wanga uchinwa doro rakawanda, zvinopfuura 1 kana 2 zvinwiwa pazuva.

Pakati pevhiki pamberi pekuvhiyiwa:

• Iwe unogona kukumbirwa kumira kutora ropa rakaonda mishonga. Mamwe acho maaspirin, ibuprofen (Advil, Motrin), vhitamini E, warfarin (Coumadin), uye clopidogrel (Plavix), kana ticlopidine (Ticlid).
• Kumbira chiremba wako kuti ndeapi mishonga yaunofanira kutora pazuva rekuvhiyiwa.
• Gadzirira imba yako mushure mekuvhiyiwa.

Pazuva rekuvhiyiwa:

• Tevedzera rairo pamusoro penguva yekurega kudya uye kunwa usati wavhiyiwa.
• Tora mishonga yawakaudzwa nachiremba kuti utore nekunwa mvura shoma.
• Svika kuchipatara nenguva.

Vanhu vazhinji vanogara muchipatara kwemazuva manomwe kusvika gumi nemana mushure mekumiswa esophagectomy. Iwe unogara kwenguva yakareba sei zvinoenderana nerudzii rwekuvhiya kwawaive nako. Unogona kupedza 1 kusvika kumazuva matatu munzvimbo yevanotarisirwa (ICU) uchangobva kuvhiyiwa.

Panguva yekugara kwako muchipatara, ucha:

• Kumbira kugara padivi pemubhedha wako uye ufambe pazuva rimwe chete kana zuva rimwe mushure mekuvhiyiwa.
• Kusakwanisa kudya kweinenge yekutanga mazuva maviri kana manomwe mazuva mushure mekuvhiyiwa. Mushure meizvozvo, unogona kukwanisa kutanga nemvura. Iwe unozopihwa chikafu kuburikidza nechubhu yekudyisa yakaiswa mukati mako mukati mekuvhiyiwa.
• Iva nehubhu ichibuda parutivi pechipfuva chako kuti ubudise zvinwiwa zvinovaka.
• Pfeka masokisi akakosha pamakumbo ako nemakumbo ekudzivirira kuwanda kweropa.
• Gamuchira pfuti kudzivirira kudzivirira ropa.
• Gamuchira mishonga inorwadza kuburikidza neIV kana kutora mapiritsi. Unogona kugamuchira mushonga wako wekurwadziwa kuburikidza nepombi yakakosha. Nepombi iyi, unodzvanya bhatani rekuendesa mushonga wemarwadzo kana uchinge wauda. Izvi zvinokutendera iwe kudzora huwandu hwemishonga yekurwadziwa yaunowana.
• Ita maekisesaizi ekufema.

Mushure mekuenda kumba, tevedzera rairo yekuti ungazvichengete sei iwe uchipora. Iwe uchazopihwa ruzivo nezve kudya uye kudya. Ive neshuwa yekutevera iwo mirairo zvakare.

Vanhu vazhinji vanopora zvakanaka kubva mukuvhiya uku uye vanogona kuve neyakajairika kudya. Mushure mekupora, vangangoda kudya zvidiki zvidiki uye nekudya kazhinji.

Kana iwe ukave nekuvhiyiwa kwekenza, taura nachiremba wako nezve nhanho dzinotevera dzokurapa gomarara.

Zvishoma zvinokanganisa esophagectomy; Robotic esophagectomy; Kubviswa kwesophagus - kushomeka zvishoma; Achalasia - esophagectomy; Barrett sophagus - esophagectomy; Esophageal cancer - esophagectomy - laparoscopic; Kenza yesophagus - esophagectomy - laparoscopic

• Bvisa mvura yekudya
• Kudya uye kudya mushure meesophagectomy
• Esophagectomy - kubuda
• Gastrostomy yekudyisa chubhu - bolus

• Kenza yesophageal

Donahue J, Carr SR. Zvishoma zvinokanganisa esophagectomy. Mune: Cameron JL, Cameron AM, eds. Parizvino Kuvhiya Therapy. 12th ed. Philadelphia, PA: Elsevier; 2017: 1530-1534.

National Cancer Institute webhusaiti. Esophageal cancer kurapwa (PDQ) - hutano nyanzvi vhezheni. www.cancer.gov/types/esophageal/hp/esophageal-treatment-pdq. Yakagadziridzwa Mbudzi 12, 2019. Yakasvika munaNovember 18, 2019.

Spicer JD, Dhupar R, Kim JY, Sepesi B, Hofstetter W. Esophagus. Mu: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Chinyorwa Chekuvhiya. 20th ed. Philadelphia, PA: Elsevier; 2017: chits. 41.