Imithi yokwelashwa

Ukwelashwa kwe umdlavuza wesisu ziyahlukahluka kuye ngesiteji kanye nezinga lobubi (ibanga) lomdlavuza. Imvamisa, kuhlanganiswa izindlela zokwelapha eziningana, njengokuhlinzwa, i-radiotherapy noma i-chemotherapy.

Ukukhethwa kokwelashwa kungaphansi ukubonisana kwemikhakha eminingi (okungenani ochwepheshe abahlukene aba-3 kumele babe khona: i-gastroenterologist, oncologist, udokotela ohlinzayo. uhlelo lokwelapha lomuntu siqu ithuthukiswa kumuntu ngamunye onomdlavuza wesisu, kuye ngebanga nezinga lesifo sakhe.

La ukuhlinzwa ukuphela kokwelashwa okungaqeda isimila futhi kuholele ekwelapheni kwangempela. Kwesinye isikhathi akwenzeki ukusikhipha ngokuphelele isimila ngenxa yobukhulu baso noma ngenxa yokuthi umdlavuza usudlulele kwezinye izitho zomzimba. Kulezi zimo, ukwelashwa kuyatholakala ukuze kubambezele ukukhula kwesifo futhi kukhulule izimpawu.

ukuhlinzwa

Ukuhlinzwa kuhilela ukususa ingxenye yesisu ethintekile kanye nama-lymph nodes aseduze.

Uma isimila singaphezulu kakhulu (kulinganiselwe ku-mucosa ngaphansi kokulawulwa kwe-echo endoscopic, nakubantu abakhethiwe), ukukhishwa kwe-endoscopic kungenzeka esikhungweni sokudlulisela. Lokhu kuhilela ukukhipha isimila ngaphandle kokuvula isisu, kodwa ukudlulisa ishubhu eligobekayo ngomlomo liye esiswini ukuze uslayide izinsimbi.

Ngokuya ngendawo yesimila esiswini, udokotela ohlinzayo ususa ingxenye ye-esophagus (umdlavuza oseduze), noma ithumbu elincane (umdlavuza we-distal). Kunamasu ama-2: ingxenye ye-gastrectomy, umdlavuza wengxenye ekude yesisu, noma i-gastrectomy ephelele.

udokotela ohlinzayo wenza i-oeso-gastric anastomosis, ehlanganisa ukuhlanganisa izingxenye ezimbili zokuhlinzwa kumminzo kanye nesisu ukuze kubuyiselwe ukuqhubeka. Lokhu kusiza ukugcina “isiphunzi sesisu” (ucezu lwesisu) noma ukuthola i-eso-jejunal passage lapho umminzo uxhumeke khona ngqo emathunjini amancane (anastomosis of the esophagus kuya emathunjini amancane).

Uma u umdlavuza lubanzi kakhulu, luthinta ezinye izitho eziseduze, kungase kudingeke ukuba kwenziwe ukuhlinzwa okubanzi futhi okuphathelene nezitho ezingomakhelwane, ikakhulukazi ubende.

Ngemva kokwenza a i-gastrectomy ngisho isiyonke, kusengenzeka idla kahle. Kodwa-ke, njengoba umthamo wesisu uncishisiwe (ukuba khona kwe-gastric stump noma ukungabikho ngokuphelele kwesisu), umuntu ohlinzayo kufanele aguqule ukudla kwakhe, isibonelo ngokuthatha ukudla okuncane, kodwa ngaphezulu ngenombolo. Iziguli eziye zaba ne-gastrectomy kufanele nazo zithathe okuthile Ukwengeza kokudla, njenge-vitamin B12.

Ukwelashwa ngamakhemikhali

Kumdlavuza wesisu, i-chemotherapy imvamisa isetshenziselwa ukubulala amangqamuzana omdlavuza.

Endabeni yomdlavuza wendawo, ithimba lezokwelapha lingase linikeze ukwelashwa ngamakhemikhali ngaphambi kokuhlinzwa (i-chemotherapy preoperative) okwehlisa usayizi wesimila, okwenza kube lula ukukhipha isimila ngemva kwalokho Ukwelashwa ngamakhemikhali nakho kungenziwa ngemva kokuhlinzwa (i-chemotherapy). ngemuva kokuhlinzwa) Emavikini angu-6 kuya kwangu-8 ngemva kokuhlinzwa, ukuze kuncishiswe ingozi yokuphinda.

Endabeni yomdlavuza we-metastatic noma isimila esingasebenzi, ukwelashwa ngamakhemikhali kuwukwelashwa okujwayelekile. Ihlose ukunciphisa ukuqhubeka kwesifo, ukukhulula izimpawu, ukuthuthukisa izinga lokuphila. Lokhu kubizwa nge-chemotherapy nobumnene.

Kunemithetho elandelwayo eminingi, kanye nezinhlolo ezimbalwa eziqhubekayo zokuchaza izindlela zokwelapha ezihamba phambili nezisebenza ngempumelelo.

La i-microbiology yamaselula yenze kwaba nokwenzeka ukuqonda kangcono izindlela zokukhula kwesimila, nokuthuthukisa izindlela zokwelashwa eziqondisiwe. Kuye kwaboniswa kumaseli omdlavuza wesisu kanye nama-metastases amaprotheni "HER2". Endabeni ye-receptor enhle, i-chemotherapy yengezwa "kumasosha omzimba we-monoclonal", okuvimbela inqubo yokuhlukaniswa nokuthuthukiswa kwamangqamuzana omdlavuza. Aphinde akhuthaze amasosha omzimba ukuze asize ukucekela phansi amangqamuzana omdlavuza.

I-Chemotherapy inganikezwa ngomjovo noma ngomlomo. Imithi yokwelapha ngamakhemikhali ihlasela amangqamuzana omdlavuza, kodwa futhi ilimaza namaseli athile anempilo. Ukunikeza umzimba isikhathi sokululama, i-chemotherapy inikezwa umjikelezo. I Okuqhamuka uma udla imishanguzo ziningi: isicanucanu, ukuhlanza, ukukhathala, ukungakuthandi ukudla, ukuqothuka kwezinwele kanye nengozi eyengeziwe yokutheleleka.

Radiotherapy

La i-radiotherapy isetshenziswa kancane ezimweni ze umdlavuza wesisu. Kungenziwa ngaphambili, kodwa kaningi ngemva kokuhlinzwa, kuhlanganiswe noma cha nge-chemotherapy, okuhloswe ngayo ukuthuthukisa i-radiotherapy. Lokhu kubizwa ngokuthi “i-radio sensitizing chemotherapy”. Ingase futhi isetshenziselwe ukukhulula ubuhlungu obuhambisana nesimila esingakwazi ukususwa.

Lokhu kwelashwa kuhilela ukuqondisa imisebe ye-ionizing endaweni ethile emzimbeni ukuze ibhubhise amangqamuzana omdlavuza awakhe lapho. Njengoba imisebe yamandla ephezulu ilimaza namaseli anempilo, lokhu kwelashwa kunehlukile Okuqhamuka uma udla imishanguzo okuyizinto ezikhathazayo kakhulu, kuye ngokuthi umuntu olashwayo. Angase azizwe ekhathele, noma aqaphele ukuthi isikhumba endaweni ekhishwe imisebe sibomvu futhi siyazwela. Ukwelashwa ngemisebe yesimila esiswini kungabangela isifo sohudo, ukungagayeki kahle kokudla, noma isicanucanu. Imiphumela engemihle yokwelashwa ngemisebe iyaphela ngemva kokwelashwa, lapho amaseli anempilo evuselelwe.

Izindlela ezihambisanayo

Bheka ifayela lethu Lomdlavuza ukuze ufunde ngazo zonke izindlela ezihambisanayo eziye zacwaningwa nabantu abanomdlavuza, njengokutshopa, ukubona ngeso lengqondo, ukubhucungwa kanye ne-yoga. Lezi zindlela zingase zifaneleke uma zisetshenziswa ngokuhlanganyela umphelelisi ukwelashwa, hhayi esikhundleni sako.