Ukuqwalaselwa kweeNgqungquthela zokwenziwa kweeBreast

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Ukugqithwa kweBester Reconstruction emva kweMastectomy

Ukuhlinzwa ngokutsha kwesisu, inqubo yokubuyisela imbonakalo yemvelo yesifuba, idlalwa rhoqo emva kweenkqubo eziqhelekileyo zesistim somhlaza wesifuba . Izigulane ezineenkqubo ze - lumpectomy azifuneki ukulungiswa kwakhona, njengoko isixa semathambo sisuswe sincinci. Ezinye izigulana azikhange zenze utyando lokuvuselela isifuba emva kokuba isuswe, kodwa uninzi ukhetha ukuvuselelwa ngokuzenzekelayo.

Kwiinkoliso ezininzi, ukuvuselelwa emva kwesifo somhlaza wesifuba senziwa ngumshuwalense, njengoko kwakhiwa njengento yenkqubo ye-mastectomy. Izigulane ziqwalasela iprophylactic, okanye inthintelo, i-mastectomy inokufuna ukuqinisekisa ukuba i-inshorensi ifaka i-mastectomy yokuqala kunye nokwakhiwa kwakhona.

Kuyabasetyhini abakhetha ukungayakhi kwakhona, kukho iibras ezikhoyo ezifakwe kwi-prosthetic ezinika ibhalansi kunye nesifuba esisele.

Emva kokuba isigqibo senziwe ukuba sibe ne-mastectomy, ukhetho malunga nokuvuselelwa kufuneka lenziwe ngaphambi kokuhlinzwa. Isigqibo kufuneka senziwe emva kokuthintana nebhodi yeplastiki eqinisekisiwe enebhodi kunye namava kwenkqubo yokuvuselelwa kwebele. Oku kungenxa yokuba ukuhlaziywa kwakhona "kunokukhawuleza" kwaye kugqitywe ngexesha lotyando olufanayo njengoluhlu lwe-mastectomy okanye "ukulibazisa" kwaye lwenziwa emva komhla.

Ukwakhiwa kwesisu kuyinkqubo yokungenasiphene kwaye kwenziwa ngokusebenzisa i- anesthesia jikelele . Izigulane zihlala esibhedlele ubuncinane olunye usuku emva kokuhlinzwa.

Kwabesetyhini abanamafuba amakhulu okanye amabele abaya kubonakala behluke ngokukodwa ngobukhulu okanye ubunjani kunesibindi esakhiwa kwakhona, ukuncitshiswa kwebele kunokuba kuyimfuneko ukubonelela ukulinganisa. Enye inketho yinkqubo yokumisela okanye ukuphakamisa isifuba esiseleyo.

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Ukuvuselelwa kwangaphambili kweBreast nge Implants

Ukuphinda kwakhiwe ngokukhawuleza amabele kwenzeka ngexesha elifanayo njengendlela ye-mastectomy kwaye iqhutyelwa ngugqirha we-plastic. Iingcali zincoma ukuvuselelwa ngokukhawuleza kwizigulane ezilindele ukuba zibe ne-radiation emva kwenkqubo yokwenza i-mastectomy. Ukunyaniseka kwesikhumba, ubuchule besikhumba ukuphilisa kunye nokubonakala kwesikhumba sesicu kunokuguqulwa yimithi yokwelashwa. Ngokugqiba ukuhlaziywa phambi kombane, isikhumba sinamandla amakhulu ekuphiliseni okukhokelela kwisiphumo sokwenza iziqhamo.

Ngethuba lokuvuselela ngokukhawuleza, ekugqibeleni isahlulo se-mastectomy yenkqubo, ukufakelwa kwesifuba kufakwa endaweni yesikhumba esisusiweyo. Uhlobo lwe-implant, i-silicone okanye i-saline yinto eqhelekileyo, yinto ekhethiweyo eyenziwa ngumguli emva kwengxoxo kunye nodokotela ogqirha weplastiki.

Enye yeenzuzo zokuvuselelwa ngokukhawuleza kukuba akukho mfuneko yokuhlinzwa okongeziweyo emva kokuvuselelwa ngokukhawuleza. Inkqubo yenziwa xa inxalenye yesigxina sokuhlinzwa, yenze umngcipheko ophathelene nokuhlinzwa okwesibini. Amanye amabhinqa ayafumana ukuba le ndlela ikhangele ngakumbi kunezinye iintlobo zokwakha kwakhona ngezizathu zengqondo. Isigulane asiboni ibhokhwe phakathi kokususwa kweethambo kunye nokubekwa kwe-implant.

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Ukugqithwa Kwebhedlele Yokwenziwa Kwebhedlele Ngezimpembelelo Zebele

Inyathelo ezimbini ngokukhawuleza ukuhlaziywa kwesifuba yinkqubo yokwakha kwakhona eqala ngexesha lotyando olufanayo njengendlela yokwenza i-mastectomy, kodwa iphelile ngomhla ozayo. Le nkqubo ifanelekile xa isikhumba esiseleyo sinyanzele kwaye asikwazi ukufumana ukufakelwa ngexesha lotyando.

Ngokuqhelekileyo, ukufakelwa kwebhaluni e-inflatable kufakwe phantsi kwesikhumba kwaye kuhlonywe nge-saline ngaphezu kweeveki okanye iinyanga ukulula ulusu kunye nezicubu ezisezantsi. Xa ulusu lusele ngokwaneleyo ukuba lube nelokufakela, ukuhlinzwa okwesibini kuqhutyelwa ukuba kufakwe ibhaluni ngokufakelwa ngokusisigxina. Kwezinye iimeko i-expander ingashiyelwa endaweni esikhundleni se-saline ejwayelekile okanye ukufakelwa kwebele le-silicone.

Le nkqubo inokusebenzisa i-flap, okanye i-graft of tissue ukusuka kwenye indawo emzimbeni, ukuncedisa iisifuba zesifuba esele okanye endaweni yokufakelwa. Isigqibo sokusebenzisa i-flap kufuneka senziwe ngokubonisana kunye nodokotela wengcali yeplastiki njengoko akufanelekanga zonke izigulane.

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Ubunjineli bokuBukwa kweBester Breast Reconstruction With Breast Implants

Ukunciphisa ukuhlaziywa kwamatyala amabini, kufana nokwakhiwa kokuqala kwesibini, yinkqubo yokuhlinzwa ezimbini esetyenziselwa ukuvuselela izicubu zesifuba emva kwesifo se-mastectomy. Ngokungafani nenkqubo yesibini ehamba phambili, inkqubo yokuhlinzwa yokufaka i-tissue expander ibhaluni yenziwa ngokuhlukileyo kwi-mastectomy ukuhlinzwa kwaye idinga ukuhlinzwa okwesithathu nokugqibela ukugqiba inkqubo.

Emva kokuba i-expander isendaweni iyahluthwa ngokunyanga ngokufakela isisombululo se-saline phezu kweeveki okanye kwiinyanga ukunweba isikhumba sebele. Xa i-expander ihluthwe ngokwaneleyo ukuba ikwazi ukufakwa kwisitshixo esifanelekileyo, utyando luyakwenziwa ukuze kufakwe ukufakelwa okuza kuhlala kusigxina. Kwezinye iimeko, i-expander ingashiyelwa endaweni esikhundleni se-silicone okanye ukufakelwa kwe-saline.

Le nkqubo ingasebenzisa i-flap, i-graft ye-tissue evela kwenye indawo yomzimba, ukuxhasa iisifuba zesifuba esele okanye endaweni yokufakelwa. Isigqibo sokusebenzisa i-flap kufuneka senziwe ngokubonisana kunye nodokotela wengcali yeplastiki njengoko akufanelekanga zonke izigulane.

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Ukubuyiswa kwesisu ngaphandle kokuveliswa

Ukwakhiwa kwakhona kwesifuba emva kokuba i-mastectomy inokwenziwa ngophulo ophenyayo endaweni yokufakelwa. Le yinkqubo apho izicubu zisuswa kwenye indawo yomzimba ezifana nesisu okanye umva kwaye zifudukela kwibele ukuze zitshintshe izicubu ezisuswe. Olu hlobo lokuphinda lusetyenziswe isiguli sesiguli, isikhumba kunye neethambo ezinamafutha ukuze kulungiswe kwakhona isifuba endaweni yokuvelisa.

Kukho iintlobo ezininzi zeenkqubo zokuphambuka. I-TRAM i-TRAM (i-transverse rectus abdominus muscle) isebenzisa isikhumba esiswini kunye nezicubu ze-muscle ukudala izicubu ezintsha zesifuba. Kwezinye iimeko izicubu zisuswe ngokupheleleyo kwisisu kwaye zifakwe kwindawo yebele. Olu hlobo lwesiphakamiso, apho izicubu zisuswa kwaye zifakwa kwenye indawo, kuthiwa yi-flap ezamahala.

Olunye uhlobo lwenkqubo esebenzisa izicubu zesisu ngumzimba wokuhlinzwa opilini. Iisisu zesisu asiswanga kwimida yegazi esondlayo, kodwa iinqwelo zikhokelwa phantsi kwesikhumba ukuya kwindawo yebele apho izicubu zitshintshwa khona. Olu hlobo lwesiphakamiso, kunye nokunikezelwa kwegazi okusele kumthombo walo wokuqala, ubizwa ngokuba yi-pedicle.

I-DIEP flap (intsimbi yangaphakathi epigastic arter perforator) iphinda isebenzise izicubu zesisu, isuswe kwaye ithathelwe indawo kwindawo yebele njengophawu olukhululekile. Le nkqubo iyingqayizivele kuba ukususwa kweethambo kufana nesiphakamiso sesisu (isisu) kwaye ayisebenzisi izicubu ze-muscle, ioli kunye nesikhumba kuphela.

Inqubo ye-latissimus dorsi flap isebenzisa izicubu kwi-muscle enkulu kumqolo ohambisa ihlombe. Inkqubo ye-pedicle flap, i-latissimus i-dorsi flap ishiywe ifakwe kwi-blood supply yayo kwaye ikhokelwa endaweni eya phantsi kwesikhumba sesifuba kwaye igxinwe endaweni.

Inkqubo ye-flap ayifanelekanga kwizigulane ezibhekisayo okwangoku, ziyisifo sikashukela okanye zineyiphi na imeko ephucula ukuphulukiswa kwesikhumba.

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Ukuvuthwa kweeNpple Reconstruction

Ngaphandle kokutyunjwa kwenzeni yokuvuselelwa kwakhona isifuba esakhiwe ngokutsha sinesikhumba sesifuba esiqhelekileyo, kodwa iimbumba kunye ne-areola azikho. Izigulane ezikhethwa ukuba zenze utyando lokuvuselelwa ngokuphindaphindiweyo zenza njalo emva komhla ogqithisiweyo ukwedlula uphando lokwakha.

Ukwakhiwa kweengono kuqhutywe ngokuthatha izicubu ukusuka kwenye inxalenye yomzimba kwaye uyifumanisa kwibele, ukuyixubusha endaweni ngendlela enokuthi yenziwe ingxobo. Kule ngongoma, i-ingxube ye-ingxube yenziwe ngombala ngaphandle kokuba i-graft ithathwe kwenye ingxowa, kwaye akukho nto i-areola ejikeleze ingono. Ukuba i-orola okanye umbala wesikhumba ohambelana nombala we-inguntshu we-ingqungqwenela unqwenela umbala usetyenziswa ngokusisigxina ngokubhala tattoo umbala phezu kwesikhumba.

Ngokungafani nokuhlinzwa okwakhiwa ngokutsha, ukuvuselelwa kweentsimbi kungenziwa ngokusisigxina nge-anesthesia yendawo. Abanye abesifazana abakhethi ukuba babe ne-nipple kunye ne-awaola kwakhona, isigqibo somntu siqu, kwaye le nkqubo ihamba ngokuzenzekelayo, inika ibhalansi kunye nesinye isifuba.

Ingxowa eyakhiwe ngokutsha ayinalo uvakalelo olufanayo njengentsimbi yasekuqaleni, kodwa ilungiselela ukubonakala kwendalo. Emva kokuphinda kwakhiwe umlenze ungabonakala uphakamise, uqikelele kwibele, wenze abanye abafazi bazive benomdla ngokubonakala kwimbalo emini yemihla ngemihla. Ukuba le nto iyinkxalabo, kufuneka ixoxwe kunye nodokotela ophandle eplastiki xa ecwangcisa inkqubo.

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Ukubuyiselwa Emva koBucholo Bokuvuselelwa Kwesisu

Kuqhelekile ukuba uzive unxinzekile kwiiveki ezimbalwa emva kokuhlinzwa kwebele. Izigulane zibuhlungu kakhulu emva kwenkqubo kwaye zinokunyuka intlungu ngokuphakamisa okanye ukuhamba kweengalo. Izigulane ziyakwazi ukubuyela kwimisebenzi emininzi kwiiveki ezintandathu, kodwa imisebenzi enamandla, ingakumbi ezovelisa ukunyakaza, njengokusebenza, zingathatha ixesha elide. Izigulane zikwazi ukubuyela ebomini bokusebenza ngokwesini kunye naloo nto.

Kubalulekile ukuqaphela ukuba unyango lomhlaza lunokulibazisa ukuphulukisa nokunyusa ukhathala. Ukuba isigulane sithola imithi yomhlaza, ukuphinda kuphuluke ekusebenziseni ukuvuselelwa kwakhona kunokusondeka njengoko iimiphumo zomphumo zesibini kunye ne- radiation zingabandakanywa ukukhathala, isifo sohudo, isisongela kunye nokuhlanza. Abanye abesetyhini bakhetha ukuvuselelwa ngokukhawuleza nje kuba bengalindele ukuba bazive kakuhle ngokwaneleyo ukuhlinzwa ngokutsha kwiinyanga ezizayo emva kwe-mastectomy.

Amacandelo amanxaso amaninzi ayatholakala, kwi-intanethi nakwiidolophu kulo lonke ilizwe, ukunceda izigulane zijamelane neenguqu ezibangelwa ngumhlaza wesibele. La maqela enkxaso anika izigulana ithuba lokusebenzisana nabanye abaye babelane ngamava abo kwaye banokunika ubungqina ngaphezu kokuxhasa nenkxaso.

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Isondo emva koBucholo Bokuvuselelwa Kwesisu

Ukubuyela kwimpilo yobomi obusebenzayo emva kokuhlinzwa ngokutsha kwesisu kunye neengxube zesisu kubini umba womzimba kunye nomoya. Ubuhlungu obuvela ekuhlaziyweni kunokuthintela isigulane ukuba singabandakanyeki kwisenzo socansi, njengoko isifuba siza kuba sisinyameko kunye nesithintelo ngokunyuka kwamanye amaninzi. Njengoko ubuhlungu bugqithisa isigqibo sokubuyela kwisenzo sesondo kunokubangela uxhalabo kunye noxinzelelo.

Ubundlobongela bunokuba lunokwenzeka ngokwenyama kodwa umba ungahlawuliswa ngokomzwelo. Ukukhathazeka ngokubonakala kwesobeleko esandul 'ukuvuselelwa okanye amabele kungokwemvelo kwaye kulindeleke. Izigulane zihlala zixhalabele malunga nezikrakra zokugqitywa kunye nevakalelo kwibele, ehlala ehlukileyo kunokuba yayingaphambili.

Ingxoxo evulekileyo phakathi kwesigulane kunye nomlingane wayo inokukunceda ukucima umoya kunye nokunciphisa uxhalaba okanye iqabane elinalo linalo. Isigulane sinokukhathazeka malunga nokubonakala kunye neentlungu ngelixa iqabane lingenalo uxhalaba malunga nokulimaza ibele okanye ukubetha intlungu kwindawo yethenda.

Kubandakanywa ingxoxo malunga nendlela amabele aziva ngayo, indlela uvakalelo oluhluke ngayo kwintlungu ngaphambi kokuhlinzwa kunye nokokuvakalelwa kukuncedisa kunokuba luncedo xa uphinde uqalise umsebenzi wesondo.

Kwakhona kubalulekile ukuba ukhumbule ukuba isondo asizivezi njengento ephambili xa sibhekene nesifo esisongela ubomi, kwaye ukungabikho kwesini sokuqhuba isondo kunokuba yinxalenye yesifo sonke, kunokukhathazeka ngenxa yesifuba. Ukungabikho komnqweno kunokubanokukwenza ngokunyanga kwamayeza kunye nemiphumo engaphantsi nokungenzi nto ngokubonakala kwebele.

Ukuxinezeleka kuqhelekileyo kwizigulane ezineengxaki zomhlaza wesibeleko, malunga nesiqingatha sabo bonke abantu abavavanyelwe ukuvalelwa kwengxaki kunyaka olandelayo ukuxilongwa. Ukuxinezeleka kunokunciphisa kakhulu umbane njengoko iimpawu, eziquka ukukhathala nokugwenxa, zingenza isondo singapheli.

> Imithombo:

> Ukuxinezeleka kunye nokuxhalabisa kwabasetyhini abanomdlavuza webele waseBrazil. Burgess, uCornelius, et al, iBritish Medical Journal. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=15695497

> Ukunyanga kwamayeza kunye nawe. AmaZiko eZiko lezeMpilo. http://www.cancer.gov/publications/patient-education/radiationttherapy.pdf

> Izimpawu kunye nezibonakaliso zokudandatheka. AmaZiko eZiko lezeMpilo. http://www.nimh.nih.gov/health/topics/depression/men-and-depression/signs-and-symptoms-of-press/index.shtml