Iimbuzo malunga ne-Deeper Inferior Epigastric Artery I-Perforator Flap
Emva kwe- mastectomy , abaninzi abafazi banokukhetha ukuhlinzwa ngokutsha ukuphucula ukubonakala kwebele emva kokuhlinzwa. Enye yeenkqubo eziqhelekileyo yinkqubo engaphantsi kwe-epigastric artery perforator (DIEP).
Yintoni i-DIEP Flap Reconstruction?
I-DIEP i-flap yindlela yokwenza i-tissue flap esebenzisa amanqatha kunye nekhumba kwi-tummy yakho ukwenza isilonda sesifuba esitsha emva kwe- mastectomy . Le nqubo ithatha igama layo kwi-DIEP kwindawo yakho yesisu kwaye luhlobo lwe- autologous reconstruction , utyando olusebenzisa izicubu zakho.
Nangona le nkqubo inokuphucula imbonakalo yakho yebele, ufanele wazi ngaphambi kwexesha ukuba akuyi kubonakala njengamabele akho okwenyama. Ngelixa abanye abafazi baqala ukuvuselelwa kwakhona kwe-DIEP, abanye bakhetha ukufumana uphando olongezelelweyo lwe-reconstructing ukudala ukubonakala kwentsontsho kunye ne-areola .
Yintoni endimele ndiyilindele ngexesha leNkqubo?
Udokotela wakho ugqirha uya kususa isikhumba kunye neenqatha kwisisu sakho esifubeni sakho. Akukho muscle wesisu kuya kunqunyulwa okanye kuhanjiswe ngeli xesha. Uninzi lwabafazi banamathole anele okwaneleyo kwindawo yabo yesisu ukuze benze isifuba esitsha. Ukuba akunjalo, ukufakelwa okuncinci kunokufakwa phantsi kwe-flap yakho yesikhumba ukudala ubungakanani besifuba ofuna. Ukukhutshwa kwesikhumba kunye neenqatha esiswini sakho kuyafana nenkqubo yesisu. I-DIEP ipopu ibandakanya ukunyakaza komthi kunye nomgubo ovela kwi-flap yakho yesikhumba ukuya esifubeni ukwenzela ukuba izicubu ezifakwe kutshintshi zinikezelwe ngegazi.
Ziziphi iingenelo kunye neengxaki zeDIEP yokuvuselelwa kweCarcer Breast?
Ngale ndlela, akukho musisi ohanjiswe okanye uhlaziywe njengokuba kuya kuba ne- TRAM flap . Kunomngcipheko ophantsi kakhulu wokuphuhlisa i-hernia yesisu kwaye ihamba ngokukhawuleza, ngeentlungu ezingaphantsi, kune-flame ye-TRAM. Ukususwa kwe-DIEP kunye neenqatha kukunika i-tummy tuck, okanye isisu esincinci, ngexesha elifanayo lokuba amabele akho akhiwe kwakhona. Inqubo inezinga elingaphantsi kwe-1% lokungaphumeleli.
Nangona kunjalo, xa kuthelekiswa ne-TRAM flap, i-DIEP idinga ixesha elingakumbi ekutyunjeni. Amacwecwe amabini aya kubakho kwi-DIEP kwaye ukuba inqubo ingaphumeleli, i-flap tissue iya kufa kwaye kufuneka isuswe. Ulwakhiwo olutsha luya kubanjwa kwiinyanga ezi-6-12.
Ngaba Ndingumviwa Olungileyo?
Ukuba awunayo i-fat fat suffices okanye ungcini kakhulu, mhlawumbi awuyi kuba ngumviwa ofanelekileyo kule nkqubo. Ukongezelela, ukuba ungumtshayi osebenzayo, utywala lwakho luya kuphulukisa ngokuthe ngcembe kunye neethambo ezinamafutha kunokwenzeka ukuba zibe yintsundu ebomvu.
Kudala Kangakanani Emva Kwemastectomy Ngaba Ndimele Ndilindele Ukuvuselelwa?
Ukwakhiwa kwesisu kunokwenziwa ngexesha le-mastectomy okanye emva kwe-chemo kunye nemitha. Ukuba udinga unyango lwe-radiation olujoliswe kwindawo yakho ye-underarm okanye esifubeni, ugqirha wakho unokuncoma ukuba ubalekele ukuhlaziywa kwakhona. Ukuba nenkqubo eyenziwe ngaphambi kokuba imisebe igqityiwe igqithise ngokwenene umgudu we-radiation ukuba uphathe kakuhle umhlaza wakho.
Xa ndifanele ndibonisane noPhrojekti wePlastiki?
Ukuba ucinga ngokuphinda uhlaziywe, yinto efanelekileyo ukujonga ugqirha weplastiki ngaphambi kokuba utyando lwe-mastectomy. Oku kukunika ithuba lokuba nemilinganiselo echanekileyo kunye nemifanekiso ethathwe ngamabele akho angokwemvelo. Ugqirha weplastiki uza kusebenzisa olu lwazi ukwenza isifuba sakho esakhiwe ngokusondeleyo kwimo yakho yesimo kunye nobukhulu ngangokunokwenzeka. Ukuba uthe waxoxisana naye kwangaphambili, ugqirha wakho wegulana uza kukunika uluhlu lwezinto ezikhethiweyo, kukunceda ugcine isikhumba sebele kwaye ukhusele izicaka ezingadingekile.
Isicwangciso soPhrojekithi sam Senzelwa njani iNkqubo?
Igqirha lakho logqirha liya kuphawula ulusu lwakho ukucwangcisa ngokucophelela ukuchithwa kwe-tissue flap. Ukusebenzisa umakishi wesikhumba, uya kutsala isigaba se-elliptical kwisisu sakho, ngaphantsi kweenamba zakho kunye nangaphezulu kwendawo yakho ye-pubic. Leli-ellipse iya kuba yesikhumba esikhankanya i-incision kwibele yakho. Xa i-flap ishicilelwe, iya kuba ngumgca ohamba kuyo yonke isisu sakho. Le yinkqubo efanayo eya kuqala phambi kwesisu.
Kuthiwani Ngesikhumba, I-Fat, kunye neGesi?
Udokotela wakho ugqirha uya kwenza ukukhangela kwesikhumba esikhankanywe kwisisu sakho, uphakamise umgca wesikhumba kunye namafutha. Ngaphambi kokuba unqamle le ngxube yomzimba, uya kukhangela umgca we-perforator engaphantsi kwe-epigastric umthambo kunye ne-vein eya kuzisa ukuxhomekeka kwegazi ethembekileyo kwibele yakho entsha. Le mijelo yegazi iya kugcinwa ngokucophelela kunye ne-flap yakho. Isibilini sakho sokuvuthwa siya kuvalwa, kwaye i-drains ingafakwa ukukhuthaza ukuphulukiswa nokukhusela ukwakhiwa kwamanzi. Inamba yakho iya kuhlala ephezulu ngaphezu kokubakho.
I-Breast entsha yenziwe njani?
I-flap yakho ye-tissue, epheleleyo kunye nemithambo yegazi, iya kutshintshwa kwindawo yakho ye-mastectomy. Ukuze uqinisekise ukuba izicubu ziya kusinda kwindawo yalo entsha, udokotela wakho ogqirha uya kusebenzisa i-microsurgery ukubeka kwakhona imithwalo yegazi kwi-flap tisses kwiimithwalo zegazi esifubeni sakho. Ikhumba lakho kunye nezicubu ezinamafutha zixhomekeke ngokucokisekileyo kwisilonda sesifuba kwaye sutured endaweni. Ugqirha wakho angasebenzisa iindlela zokumakisha isikhumba phezu kwemithambo yegazi ukunceda abahlengikazi bakho bamele baphilise xa usubuyela. Lindela ukuba neenjini zokuchukumisa kule ngxaki ukunceda ekuphiliseni.
Yintoni endiyilindeleyo ngexesha lokubuyisela?
Kufanele uceba ukuhlala esibhedlele iintsuku ezi-3 okanye ezine emva kokuhlinzwa, ukwenzela ukuba oongikazi banokugcina iliso kwinkqubo yokuphilisa. Phakamisa ipakethe, iingubo ezikhululekile zokuhamba kwakho ekhaya, ukuvumela indawo yokuhambisa amanzi. Xa ukwakhiwa kwamanzi okhewuzileyo kuye kwancipha kakhulu, unokwazi ukuba uchithe amanzi akho emva kweveki emva kokuhlinzwa. Cwangcisa ukuphumla kwiiveki ezi-4 ukuya kwe-6 emva kwe-DIEP kwaye wenze amalungiselelo okuba nomntu ojikelezayo ukuqhuba kwaye uphakamise nayiphi na into enzima kuwe. Uza kuba nokuqokwa kwamanani amaninzi ukwenzela ukuba ugqirha wakho angakwazi ukuvavanya inkqubela yakho yokuphulukisa, ukuboniswa, kunye nokutshintsha kwakho ukugqoka.
Ngaba i-DIEP Flap Reconstruction ikhetho emva kwe-Double Mastectomy?
Ukuba unesikhumba esaneleyo kunye neenqatha kwisisu sakho ukudala amabele amabini amatsha, unokukwazi ukuvuselelwa kwakhona kweDIEP emva kwe-double mastectomy. Ukuba sele usebenzise izicubu zesisu esisetyenziselwa ukuvuselelwa kwebele, kuya kufuneka ukuba wenze inkqubo eyahlukileyo, njenge- flap okanye i- pulp .
Ngaba kukho naziphi iingcamango ezikhethekileyo Ngaba ndiyazi?
I-DIEP i- microphone ye-microsurgery , efuna uqeqesho olubanzi kunye namava, ngaphezu kweendawo ezizodwa kunye nezixhobo zokucoca. I-sutures esetyenziselwa ukuxhuma kwakhona imivenge yegazi ibona ububanzi obufanayo njengentambo yeenwele zakho. Iqela lakho lokugada liya kusebenzisa i-microscope ephezulu yokubuyisela imivenge yegazi, inxalenye ebaluleke kakhulu yale nkqubo. Khetha udokotela ogqithisileyo ngokutsha ngokucokisekileyo, ukubuza imibuzo eninzi uze uzive ukhululekile ukwenza isigqibo sokuba uqhubeke nenkqubo.
> Imithombo:
American Cancer Society. Ukubuyiswa kwesisu emva kweMastectomy. Iintlobo zeBreast Reconstruction.
> INational Cancer Institute. Ugqirha Iinqununu Kwabesetyhini Nge-Early Step Stage Cancer.