I-chemotherapy ehambayo yinkqubo ephumayo kubantu abanomdlavuza ophindaphindiweyo okanye we- metastatic cancer . Ngokusemthethweni, le nkqubo ibizwa ngokuba yi-cytoreduction operesheni (CRS) kunye ne-hyperthermic intraperitoneal chemotherapy (HIPEC). Idibanisa ukuhlinzwa kwesisu kunye ne-peritoneal chemotherapy ukuhlasela umdlavuza wakho ngeendlela ezininzi ngexesha elilodwa.
Ngubani ongumviwa we-HIPEC?
Inqubo ye-HIPEC isetyenziselwa ukunyanga iintlobo ezahlukeneyo zesifo se-metastatic cancers kuquka i-colorectal, isisu, i- ovarian , i- mesothelioma , kunye ne-appendiceal.
Akulona unyango olungaphambili okanye unyango olukhethiweyo kumntu osandul 'ufumene umhlaza wesi-colon. Ukuba ucinga nge-HIPEC, ubudala bakho, impilo jikelele, kunye neyona nto ibalulekileyo, isigaba kunye nebakala lomdlavuza wakho kukunceda ugqirha wakho ukuba acinge ukuba le ndlela yonyango ifanelekile.
Icandelo Lokuqala: Ukunyangwa kwe-Cytoreduction Surgery
Ngaphambi kokuba ufumane i-HIPEC, ugqirha wakho uya kugqithisa zonke izicubu ezibonakalayo ngaphakathi kwesisu sakho esiswini. Uya kususa naziphi na izitho ezinezifo zesifo, njenge-intestine encinci, i-pancreas, okanye i-ovari. Ugqirha unako ukususa okanye ukutshisa amathumba amancinci kwizitho ezibalulekileyo (ezingenako ukususwa), ezifana nesibindi sakho, ngeli xesha. Nangona sele sele ubenomsebenzi wokuthengiswa kweengxube okanye ukunyanzelisa imithwalo yomhlaza kwi-colon yomhlaza ngexesha elidlulileyo, uya kufuna i-CRS ukuqinisekisa ukufumana izibonelelo eziphezulu kwi-HIPEC.
Icandelo lesibini: Inkqubo ye-HIPEC
Ngokukhawuleza emva kokuhlinzwa xa ulala phantsi kwe-anesthesia ugqirha wakho owenza inkqubo ye-HIPEC.
Eyona nto, iinqununu zithetha "zitshisa" - kungekhona ukukhahlela, kodwa zifudumeza kunobushushu bomzimba wakho. Iziyobisi ze-chemotherapy zifudumala kuba ziboniswe ukuba unako ukwandisa ukusetyenziswa kweziyobisi ngokufudumala ngexesha lokunikezelwa.
Igama elithi intraperitoneal libhekisela apho iziyobisi zonyango zilawulwa khona.
Ingaphakathi lesisu sakho liboshwe nge membrane ekhuselayo ebizwa ngokuba yi-peritoneum, ejikeleze indawo ye-peritoneal - indawo apho zonke izibilini zakho (izibilini, isibindi, i-pancreas) zifakwe. Iziyobisi ze-chemotherapy ziqhutyelwa kule ndawo kwaye zivumelekile ukuba zihlambe zize zinyanzele ukuya kwiiyure ezintathu. Esinye isichemotherapy esiqhelekileyo esisetyenziswa kwi-HIPEC yi-cisplatin, ngamanye amaxesha anikezwa nge-mitomycin C. I-Mitomycin C ayikho imichiza yechemotherapy, kodwa isetyenziswe ekuncediseni ukunyuka kwamanqwelana athile, njengomdlavuza obala.
Ukubuyisela kwi-Cytoreduction Surgery kunye ne-HIPEC
Oku kuyinkqubo elukhuni kunye nexesha elide, elinokuba lunokugqibela ukuya kwiiyure ezili-14. Ukubuyiselwa kwakho kuya kufuneka kuhlolwe ngokusesikweni esibhedlele. Ngokukhawuleza emva kokuhlinzwa, uya kuchitha ixesha elide ukuya kwiintsuku ezintlanu kwiCandelo loLondolozo oluPhezulu. Apha uya kufumana iliso elifutshane malunga nenkqubela yakho de uze uzinzile ngokwaneleyo ukuba udluliselwe kwiyunithi yesicatshulwa esiphambili esibhedlele. Ingxelo yezibhedlele zihlala zilandele le nqubo ukusuka kwiveki ukuya ngaphaya kweenyanga.
Iingxaki Zokuba yi-HIPEC
Njengaye nawuphi na utyando oluthile, kulungile ukuqwalasela ingozi ngaphambi kokuba uvume ukuhlinzwa.
Naziphi na iingxaki ezinkulu zivela kwindawo yokuhlinzwa, oko kungenza kube nzima ukusebenza. Unokuba neengxaki ezivela kwiintsuku ezininzi zeetyhubhu okanye ukondliwa kwabazali, okufunekayo emva kokuhlinzwa xa isilonda sakho sihlala. Utyando olwenziwa nge-cytoreduction lubeka umngcipheko wokuphaphaka, ukusuleleka, kunye nokuba neengxaki zezilwanyana okanye isifo se-pneumonia.
I-HIPEC ngokwayo iyanciphise iingxaki njengoko izidakamizwa ze-chemotherapy ziyinxalenye yokuhlala emzimbeni wakho. Ngenxa yoko, kunokwenzeka ukuba inetyhefu yesisu esiswini. Kukhona amandla okuba iziyobisi ziza kufakwa kwaye zijikeleze kulo lonke igazi lakho, kodwa iziphumo ezichaphazelekayo eziqhelekileyo zifana neempembelelo zecandelo le-chemotherapy ezibandakanya:
- Ukulahleka kweenwele
- Amandla aphantsi
- Utshintsho kwintle
- Isihlunu kunye nokuhlanza
- Idayarrhea okanye ukutyunjwa
Ngaba le Nqubo iyakwazi ukwelapha umdlavuza wam?
I-CRS kunye ne-HIPEC ziqwalaselwa kuphela kwizigaba eziphambili zomhlaza kwaye zisetyenziselwa ukwandisa umgangatho kunye nobude bomi bakho, kungekhona njengonyango lokunyanga. Ucwaningo luye lwabonisa ukuba le nkqubo inokukunceda ukwandisa ubomi, kodwa ayikhuthazwa kuwo wonke umntu. Enyanisweni, akukho nzuzo ecacileyo yokusinda kuboniswa nangona nkqubo.
Amaziko amaninzi omhlaza asebenzisa le nkqubo ngophando oluqhubekayo njengoko kuthathwa njengento ethembisayo, kodwa engenakuvuthwa, kunye nefuthe kakhulu. Ngaphambi kokusebenza, ugqirha wakho uya kuchaza ingozi ngokumalunga neenzuzo zale nkqubo, kodwa ubuze imibuzo ukuba kukho na into ongayiqondiyo.
Imithombo:
Alexander, HR et al. (NgoJuni 2013). Izinto Zonyango Ezixhatshazwe Nokusinda Kwangexesha Elide Emva kokuphelelwa yi-Cytoreductive Surgery kunye neSithili seKhemotherapy kubantu abagulayo nge-Malignant Peritoneal Mesothelioma. Ukuhlinzwa; 153 (6): 779-786.
Hanna, Nadar. (nd). Uphando lwe-Cytoreductive kunye ne-HIPEC. Iprogram yaseYunivesithi yaseMaldancial Gastrointestinal Oncology; Webinar.
Khatri, Vijay. (NgoJanuwari 2010). Ugqirha lwe-Cytoreductive kunye ne-Hyperthermic Intraperitoneal Chemotherapy kwiCrorectal Cancer: I-Panacea okanye I-Course Restraint for the patient? Umbhalo we-Clinical Oncology; 28 (1): 5-7.