Imithi yokwelashwa

Ukwelashwa ngenhloso "yokwelapha" yile:

- Ukuhlinzwa, ngokususwa kwesimila noma kwezinye izimo, ukufakelwa kwesibindi nokuvuselelwa kwesibindi,

- Izindlela zokubhubhisa isimila ngesikhumba (ukugwema ukuvula isisu njengoba sidlula esikhunjeni); okokuqala ngamakhemikhali (utshwala obumsulwa noma i-acetic acid),lezi zindlela zithathelwe indawo izindlela zokubhubhisa isimila ngezindlela zomzimba ezisebenza kahle kakhulu :

        - Izindlela ezishisayo zokubhubhisa isimila :

              - i-cryotherapy (ngamakhaza)

              - i-radiofrequency (ukusabalalisa okushisayo okushisayo),

              - i-microwave (izinga lokushisa eliphakeme kakhulu ku-100 °)

        - Izindlela ezingezona ezishisayo zokubhubhisa isimila:

              - electroporation, inqubo yakamuva kakhulu izifundo zayo ezisaqhubeka.

              - I-chemoembolization ekhethiwe yokuthambeka eye yathathela indawo ukusetshenziswa kobuhlalu obunemisebe ye-radioactive.

Ukukhetha phakathi kokuhlinzwa nokukhishwa kwe-percutaneous, ukwelashwa okuvame ukwelashwa kuncike emibandeleni ethile (isimo sesibindi esiyisisekelo, inombolo nosayizi wezilonda) futhi kuxoxwa ngayo emihlanganweni ehlukahlukene, ehlanganisa okungenani amakhono amathathu. ezahlukene (udokotela ohlinzayo, i-oncologist, i-gastroenterologist) ezikhungweni zokubhekisela.

ukuhlinzwa

Uma kungenzeka, ukuhlinzwa ngu-1^er ukukhetha ukwelashwa futhi kuqukethe ” i-hepatectomy engaphelele »Okungukuthi ukususwa kwengxenye yesibindi. Kumelwe kuhlangatshezwane nezimo ezihlukahlukene: isimila kufanele sibe sincane (<3cm) futhi sibe sodwa. Kufanele kufinyeleleke kalula futhi kufanele kuthathwe ukunakekelwa ukuze kuqinisekiswe ukuthi umthamo wesibindi esinempilo esisele wanele ukuqinisekisa ukusebenza kwesibindi okuvamile.

Izicubu zesibindi zinamandla oku ukuvuselela, okungenani ingxenye. Ngakho-ke, emasontweni alandela i-hepatectomy ngokwengxenye, ubukhulu besibindi buzokhula. Noma kunjalo, isibindi ngeke sibuyele ngosayizi waso wokuqala.

 Ukwelashwa kokuhlinzwa kungaqukatha “Ingqikithi ye-hepatectomy” ulandelwa ngu umsebenzi, ukwelashwa okufanele uma kungenzeka. Isibindi esigulayo sisuswe ngokuphelele, kufakwe isibindi sonke, noma i-lobe yesibindi, kumnikeli ohambisanayo. Iziguli zikhethwa ezikhungweni zochwepheshe. Qaphela ukuthi kuyaqabukela ukuthi kwenzeke ukwenza ukufakelwa kwesibindi ukwelapha umdlavuza oyinhloko wesibindi. Ukulinda impela kukude kakhulu, (ubuncane bezinyanga eziyi-6), futhi nemibandela edingekayo yokutholakala kokufakelwa kuvame ukudlulwa: isifo sesibindi esigula kakhulu (i-cirrhosis esezingeni eliphakeme), isimila esikhulu kuno-3 cm, ngaphezu kwezilonda ezintathu.

Ukukhishwa kwe-Radiofrequency (RFA)

Lapho ukususwa kwesimila ngokuhlinzwa kungenakwenzeka, noma isikhathi sokulinda sokuxhunyelelwa isikhathi eside kakhulu, ukuqedwa kwe-radiofrequency kuyindlela yokwelapha yendawo 1^ubudala inhloso. Le ndlela ifaka ukufaka ama-electrode amancane esibindini ukuze kubangele ukuphuma kwamagagasi amakhulu enza ukunyakaza i-ionic, okuholela, ngesimo esishisayo, i-necrosis ngokuqina kwamaseli angajwayelekile (ukufa kweseli). Ngokuya ngecala, kwenziwa ngaphansi kwe-anesthesia yendawo noma ejwayelekile.

Ukwelapha okuhlosiwe

Ngokwandayo, izindlela zokwelashwa ezibhekiswe kuzo fight izici ezinomthelela ekukhuleni kwesimila. Ngokwesibonelo, amanxusa antiangiogéniques vimba ukwakheka kwemithambo yegazi emisha (angiogenesis) evumela ukuthi isimila sikhule. Lolu hlobo lwezokwelapha lubonisa isithembiso esikhulu. Kuvusa intshisekelo nethemba elikhulu emphakathini wezokwelapha.

Ezinye izindlela

Indlela Thermal:

ukukhala

I-cryosurgery ayisasetshenziswa kulezi zinsuku, ngenxa yokubonakala kwamasu okubhubhisa izicubu zesibindi ngokushisa (ikakhulukazi i-radiofrequency). Le ndlela yayiqukethe ukufaka isibindi iphenyi equkethe i-nitrogen engamanzi ku- -200 ° C ukuze ishiswe yi froid amangqamuzana omdlavuza.

Microwave

Le ndlela ibangela ukunyakaza kwama-molecule weamanzi kumaseli, okwenza kube nokwenzeka ukufinyelela izinga lokushisa eliphakeme kakhulu, u-100 °, ngemizuzwana embalwa. Isasetshenziswa kancane, futhi iyahlolwa maqondana ne-radiofrequency.

Indlela yamakhemikhali: iumjovo onqamulelayo

Le enye indlela ihlala ingenzeka, kepha isetshenziswa kancane nangaphansi. Kuqukethe ukubhubhisa isimila esisodwa noma eziningi ngokujovai-ethanol or i-acetic acid. Lokhu kunomphumela wokubanciphisa emzimbeni futhi kubangele necrosis yabo (ukufa kweseli). Le nqubo ingenziwa ngaphansi kwe-anesthesia yendawo futhi ingaphindwa uma isimila singanyamalali ngokuphelele.

I-Technique entsha: i-electroporation engalungiseki:

Ngaphansi kokuhlolwa, le ndlela idlala ekuthambekeni kweseli, futhi ingakhonjiswa kokuphikisana nobuningi bomsakazo.

Ukwelashwa ngamakhemikhali

I-Chemotherapy yisixazululo lapho ukuhlinzwa noma amasu wokucekela phansi isimila kungenzeki, noma uma kwenzeka kuphindeka.

Uma kwenzeka umdlavuza oyinhloko wesibindi inabile (ilinganisa ngaphezu kuka-3 cm, inezilonda eziningana, kodwa ohlangothini olufanayo lwesibindi (sinesibindi sokunene nesibindi sobunxele), kwesinye isikhathi kuyenzeka ukujova emthanjeni onikezela isimila, ubuhlalu obuqukethe i-chemotherapy ngqo ku-tumor, esiza ukunciphisa imiphumela emibi.

Radiotherapy

Ukwelashwa ngemisebe kuyaqabukela kusetshenziselwe ukwelapha umdlavuza oyinhloko wesibindi. Lolu hlobo lomdlavuza aluzweli kakhulu kwi-radiotherapy. Isikhathi esithile, sazama ukujova ubuhlalu obunemisebe ye-radio ngokufaka umjovo wokukhetha ku-isimila ngomzila we-arterial.

Izindlela ezihambisanayo

Izibuyekezo. Xhumana nefayela lethu leCancer ukuze ufunde ngazo zonke izindlela ezihambisanayo ezifundwe kubantu abanomdlavuza, njengokutholwa kwesikhumba, ukubonwa, ukwelashwa kokubhucungwa kanye neyoga. Lezi zindlela zingahle zilungele uma zisetshenziswa ku- umphelelisi ukwelashwa, hhayi esikhundleni sako.