Injongo:
Ukulungiswa kwodonga lwebhondi kuyimfuneko xa kukho isiphako kwindawo ye-thoracic okanye esifubeni. Esona sizathu esivakalayo sesiphene sesifuba sesifuba sisifo esinokusuleleka okanye esingaqinisekanga sondotomy. I-mediternomy medium yindlela yokucoca apho kuqhutywe khona ukutshintshela ngokusemgangathweni kunye ne-sternum (eyaziwa nangokuthi i-breastbone), emva koko i-sternum ihlukaniswe okanye iyaqhekeka.
Le nkqubo inika ukufikelela kwintliziyo kunye nemiphunga yeenkqubo zokuqapha.
Etiology:
Iiphene zesibonda se-Chest ziqokelelwe kwiindidi ezibini eziqhelekileyo: zifunyenwe kwaye zizalwa .
Fu maneka:
- I ngxaki
- Ukuxhamla
- Sulelo
- I midiyo
Kuzalwa:
- Poland Syndrome
- Pectus Excavatum
- Pectus Carinatum
Iinjongo:
Iinjongo zokwakha kwakhona zi:
- Susa isilwanyana esingasimpilo, esenziwe ngokusesikweni kwindonga yesifuba
- Buyisela ukuzinza kunye nesakhiwo kwindonga yesifuba
- Zichitha nayiphi na indawo efile (indawo efile yindawo engenanto ephumela emva kokususa inxalenye yomphunga okanye umphunga wonke)
- Ukubonelela ngokukhawuleza kwindonga yesifuba
- Ukufumana iziphumo zobugcisa
Anatomy:
Udonga lwesifuba lunamaqela amathathu:
- Uluhlu lwangaphandle: Izishuzi ezinobumba, ezibandakanya ulusu, i-fat fatcut and muscle
- Uluhlu oluphakathi: I-Skeleton, equka iimbambo, i-cartilage, kunye ne-sternum
- Uluhlu lwangaphakathi: Indawo yokuhlala, eyona ndawo (isikhala) phakathi kwamasipha kunye nemiphunga
Enye, ezimbini, okanye zonke izigaba ezintathu zingaphinde zakhiwe ngokuxhomekeke kwisiphene.
Ulandelelwano olusisiseko luqala ngamancuba anzulu kwaye luya kwintlambo engakumbi - isalathisi sesikhokelo, kwaye ekugqibeleni isisitye esilula.
Ukongezelela, uhlobo lokwakha kwakhona luya kuxhomekeka kwindawo engafanelekanga eludongeni lwesifuba.
Ukuhlaziywa kwakhona kweNgcaciso yangaphakathi:
- Injongo yokwakhiwa kwakhona kwendawo engaphakathi, eyaziwa nangokuthi i-parietal cavity, ukufumana indawo yokuzikhusela.
- Oku kwenziwa ngokugcwalisa indawo efile ukuze ugweme ukuzaliswa ngogesi kunye / okanye ipus.
- Indawo efile izaliswe ngokusebenzisa i- flaps flaps (eyaziwa ngokuba yi-locoregional flaps) kummandla wesiphene okanye usebenzisa i- omentum :
- Latissimus dorsi flap
- USerratus i-flap yangaphambili
- Pectoralis enkulu
- Rectus abdominis flap
- I-flap omental
Ukuhlaziywa kwakhona koMbindi ophakathi:
- Uluhlu lwamathambo lubhekwa njengoluhlu oluphakathi
- Olu luhlu lufunekayo ukukhusela izitho ezibalulekileyo (intliziyo, imiphunga, njl) kunye nokuvelisa ukuphefumla okuqhelekileyo
- Ukuba izibambo ezine okanye ngaphezulu zikhutshwe okanye isiphene sikhulu kuneesentimitha ezintlanu, isalathisi sesigxina kufuneka sivuselelwe kwakhona
- Ukulungiswa kwakhona kwenziwa ngeendlela ezilandelayo:
Kwakhiwa kwe-Alloplastic:
- Ikhonkco iqiniswe nge-methyl methacrylate
- Iibrafu zeethambo
Ukuvuselelwa ngokuzenzekelayo:
- Latissimus dorsi flap
- USerratus i-flap yangaphambili
- Pectoralis enkulu
- Rectus abdominis flap
- I-flap omental
Ukuhlaziywa kwakhona kweCandelo elingaphandle:
- Izicubu ezithambileyo (isikhumba, isikhumba esincinci) sithathwa njengoluhlu lwangaphandle
- Isiphako seethambo ezinotsonkothileyo zinokubaluleka kwinqanaba elithile (inxeba elingenasicatshulwa) okanye linokuthi lugqithise ngokupheleleyo (inxeba ejulile)
Amanxeba enxalenye yokwakha ahlanganiswa ngoku:
- Ulwahlulo lwesikhumba esahlukileyo
- ILocoregional flaps
Amanxeba apheleleyo ahlanganiswayo:
- ILocoregional flaps
- Iifayile ezikhululekile kwiimeko ezinqabileyo
Imithombo:
Din AM, Evans GRD. I-Wall Chest Reconstruction. KwiMcCarthy JG, iGaliano RD, iBoutros SG, ii-eds. Ionyango langoku kwi-Plastic Surgery. Philadelphia: Saunders Elsevier, 2006.
Janis. I-Wall Chest Reconstruction. KuJanis JE (ed). Izinto ezibalulekileyo zoPhengophi lwePlastiki. USt. Louis: I-Quality Medical Publishing inc., 2007.
Chang RR. Ukuvuselelwa kweTraracic. Kwi-Thorne CHM, i-Beasely RW, i-Aston SJ, i-Bartlett SP, i-Gurtner GC, i-Spear S, i-eds. I-Grabb ne-Smith's Plastic Surgery, ngomhla we-6. Philadelphia: Lippincott, 2007.
Pectus Carinatum Medline Plus.
Kufikeleleke ngo-Aprili 2, 2011.
Pomerantz J, Hoffman W. Chest Wall Defects. Kryger, ZB, Sisco M (eds.). Ukuphanda kwePlastiki. E-Austin, eTexas: Landes Bioscience, 2007.
http://www.microsurgeon.org/. Kufikeleleke ngo-Aprili 2, 2011.