Esophagectomy - yakavhurika

Vhura esophagectomy kuvhiya kubvisa chikamu kana yese yegapu. 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 cancer yegurokuro kana dumbu rakakuvara zvakanyanya.

Munguva yekuvhura esophagectomy, imwe kana kupfuura makuru ekucheka ekucheka (incision) anoitwa mudumbu rako, chipfuva, kana mutsipa. (Imwe nzira yekubvisa esophagus ndeye laparoscopically. Kuvhiya kunoitwa kuburikidza nemaitiro akati wandei, uchishandisa chiyero chekuona.)

Ichi chinyorwa chinokurukura matatu marudzi ekuvhiya kwakashama. Nechero kuvhiyiwa, iwe unozogamuchira mushonga (anesthesia) iyo inokuchengetedza iwe kurara uye isina kurwadziwa.

Transhiatal esophagectomy:

• Chiremba anovhiya maviri akacheka makuru. Imwe yakatemwa iri munzvimbo yako yemutsipa uye imwe iri mudumbu rako repamusoro.
• Kubva pakachekwa mudumbu, chiremba anovhiya anosunungura dumbu uye chikamu chepasi cheziso kubva kumatumbu ari pedyo. Kubva pane yakatemwa mumutsipa, iyo yese yeguropu inosunungurwa.
• Chiremba anovhiya anobva abvisa chikamu chegurokuro uko kune gomarara kana rimwe dambudziko.
• Dumbu rako rinozogadzirwazve muhubhu kuti riite esophagus nyowani. Iyo yakabatanidzwa kune yakasara chikamu chenyu yeguropu nesadza kana sisitimu.
• Munguva yekuvhiyiwa, lymph node mumutsipa wako uye mudumbu zvinogona kubviswa kana kenza yapararira kwavari.
• Pombi yekudyira inoiswa mumatumbu ako mudiki kuti iwe ugone kupihwa chikafu paunenge uchipora kubva pakuvhiyiwa.
• Drainage machubhu anogona kusiiwa muchipfuva kubvisa fluid.

Transthoracic esophagectomy: Kuvhiya uku kunoitwa nenzira yakafanana neiyo transhiatal maitiro. Asi iyo yepamusoro yekucheka inoitwa mubhokisi rako rerudyi, kwete mumutsipa.

En bloc esophagectomy:

• Chiremba anovhiya anoita akacheka akakura mumutsipa wako, chipfuva, uye dumbu. Ose ako esophagus uye chikamu chedumbu rako chinobviswa.
• Dumbu rako rese rinogadzirwazve muhubhu uye ndokuiswa muchipfuva chako kutsiva yako esophagus. Iyo dumbu chubhu yakabatana kune yakasara esophagus mumutsipa.
• Chiremba anovhiya zvakare anobvisa ese ma lymph node muchipfuva chako, mutsipa, uye mudumbu.

Mazhinji emabasa aya anotora maawa matatu kusvika matanhatu.

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
• Yakaparadzwa esophagus
• Yakanyanya kukuvara mudumbu

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

Njodzi dzekuvhiya uku, kana yezvinetso mushure mekuvhiyiwa, dzinogona kunge dzakakura kupfuura zvakajairwa kana iwe:

• Havagone kufamba, kunyangwe nhambwe pfupi (izvi zvinowedzera mukana wekugwamba kweropa, matambudziko emapapu, uye maronda ekudzvinyirira)
• Vakura
• Uri munhu anoputa zvakanyanya
• Vakafutisa
• Wakarasikirwa nehuremu hwakawanda kubva kukenza yako
• Ari pamishonga yesteroid
• Wakave uine hutachiona hwakakomba kubva kune yakakuvara esophagus / mudumbu
• Vakagamuchira gomarara zvinodhaka (chemotherapy) vasati vavhiyiwa

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
• Zvakaoma kumedza kana kutaura
• Kuvhiringidza ura

Iwe uchave nekushanya kwachiremba kwakawanda uye bvunzo dzekurapa usati wavhiyiwa, kusanganisira:

• 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 pesimba.
• 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 kurega kuputa mavhiki mashoma usati wavhiyiwa. Mubatsiri wako wehutano anogona kubatsira.

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 mekuvhiyiwa uku. 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 kwemazuva mashanu kusvika kumanomwe ekutanga 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 maexercise ekudzivirira hutachiona hwemapapu.

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 neyakajairwa kudya. Mushure mekupora, vangazofanira kudya zvidiki zvidiki uye nekudya kazhinji.

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

Trans-hiatal esophagectomy; Trans-thoracic esophagectomy; En bloc esophagectomy; Kubviswa kwesophagus - kuvhura; Ivor-Lewis esophagectomy, Blunt esophagectomy; Esophageal cancer - esophagectomy - yakavhurika; Cancer yeguroku - esophagectomy - yakavhurika

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

• Kenza yesophageal

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 19, 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.