Umdlavuza we-Esophageal

Umdlavuza we-Esophageal ngumdlavuza oqala emqaleni. Lesi yishubhu lapho ukudla kuhamba khona kusuka emlonyeni kuya esiswini.

Umdlavuza we-Esophageal awuvamile e-United States. Kwenzeka kakhulu emadodeni angaphezu kweminyaka engama-50.

Kunezinhlobo ezimbili eziyinhloko zomdlavuza wokuqopha; squamous cell carcinoma kanye ne-adenocarcinoma. Lezi zinhlobo ezimbili zibukeka zehlukile komunye nomunye ngaphansi kwesibonakhulu.

Umdlavuza we-squamous cell esophageal uxhunyaniswe nokubhema nokuphuza kakhulu utshwala.

I-Adenocarcinoma uhlobo oluvame kakhulu lomdlavuza wokuqopha. Ukuba ne-Barrett esophagus kwandisa ingozi yalolu hlobo lomdlavuza. Isifo se-Acid reflux (isifo se-reflux se-gastroesophageal, noma i-GERD) singakhula sibe yi-Barrett esophagus. Ezinye izinto ezinobungozi zibandakanya ukubhema, ukuba ngowesilisa, noma ukukhuluphela.

Izimpawu zingafaka noma yikuphi okulandelayo:

• Ukuhamba emuva kokudla ngesilonda futhi mhlawumbe ngomlomo (ukuphinda wenze kabusha)
• Ubuhlungu besifuba abuhlobene nokudla
• Kunzima ukugwinya okuqinile noma uketshezi
• Isilungulela
• Kuhlanza igazi
• Ukwehla kwesisindo

Izivivinyo ezisetshenziselwa ukuxilonga umdlavuza we-esophageal zingafaka:

• Uchungechunge lwama-x-ray athathwe ukuyohlola i-esophagus (barium swallow)
• I-MRI yesifuba noma i-thoracic CT (evame ukusetshenziselwa ukusiza ukuthola isigaba sesifo)
• I-endoscopic ultrasound (futhi kwesinye isikhathi isetshenziselwa ukunquma isigaba sesifo)
• Hlola ukuhlola futhi ususe isampula yolwelwesi lwe-esophagus (esophagogastroduodenoscopy, EGD)
• Ukuskena i-PET (kwesinye isikhathi kuyasiza ekunqumeni isigaba sesifo, nokuthi ukuhlinzwa kungenzeka yini)

Ukuhlolwa kwesitokisi kungakhombisa inani elincane legazi esitokisini.

I-EGD izosetshenziselwa ukuthola isampula lesishubhu esimbeni ukuthola umdlavuza.

Lapho umdlavuza usemzimbeni kuphela futhi ungakasakazeki, kuzokwenziwa ukuhlinzwa. Umdlavuza nengxenye, noma konke, kwesomlomo kuyasuswa. Ukuhlinzwa kungenziwa ngokusebenzisa:

• Ukuhlinzwa okuvulekile, lapho kwenziwa khona ukusikeka okukhudlwana okukodwa noma okungu-2.
• Ukuhlinzwa okuhlasela kancane, lapho kwenziwa ukusikeka okuncane okungu-2 kuye ku-4 esiswini. I-laparoscope enekhamera encane ifakwa esiswini ngesinye sezimbobo.

Ukwelashwa ngemisebe kungasetshenziswa esikhundleni sokuhlinzwa kwezinye izimo lapho umdlavuza ungasakazekanga ngaphandle komphimbo.

Kungaba i-chemotherapy, i-radiation, noma kokubili kungasetshenziselwa ukunciphisa isimila futhi kwenze lula ukuhlinzwa.

Uma umuntu egula kakhulu ukuthi angahlinzwa kakhulu noma umdlavuza ususabalele kwezinye izitho, i-chemotherapy noma i-radiation ingasetshenziswa ukusiza ukunciphisa izimpawu. Lokhu kubizwa ngokuthi ukwelashwa okunciphisayo. Ezimweni ezinjalo, lesi sifo ngokuvamile aselapheki.

Ngaphandle koshintsho ekudleni, ezinye izindlela zokwelapha ezingasetshenziswa ukusiza isiguli ukuthi zikugwinye zifaka:

• Ukwehlisa (ukunweba) i-esophagus usebenzisa i-endoscope. Kwesinye isikhathi kufakwa i-stent ukuze kugcinwe umqala uvulekile.
• Ishubhu lokudla esiswini.
• Ukwelashwa kwe-Photodynamic, lapho kufakwa khona umuthi okhethekile kulesimila bese uvela ekukhanyeni. Ukukhanya kusebenze umuthi ohlasela isimila.

Unganciphisa ukucindezela kokugula ngokujoyina iqembu lokusekela umdlavuza. Ukwabelana nabanye abanokuhlangenwe nakho okuvamile nezinkinga kungakusiza ungazizwa uwedwa

Lapho umdlavuza ungasakazekanga ngaphandle komphimbo, ukuhlinzwa kungathuthukisa ithuba lokusinda.

Lapho umdlavuza ususabalele nakwezinye izindawo zomzimba, ukwelashwa ngokuvamile akunakwenzeka. Ukwelashwa kubhekiswe ekwehliseni izimpawu.

Izinkinga zingafaka:

• Inyumoniya
• Ukwehla kwesisindo okukhulu ngokungadli ngokwanele

Shayela umhlinzeki wakho wezempilo uma unenkinga yokugwinya ngaphandle kwesizathu esaziwayo futhi kungabi ngcono. Fonela futhi uma unezinye izimpawu zomdlavuza wokuqopha.

Ukunciphisa ubungozi bakho bomdlavuza we-esophagus:

• UNGABHALI.
• Nciphisa noma UNGAPHUZI iziphuzo ezidakayo.
• Hlola udokotela wakho uma une-GERD enamandla.
• Thola ukuhlolwa njalo uma uneBarrett esophagus.

Umdlavuza - umphimbo

• I-Esophagectomy - ukukhipha
• Ishubhu yokudla ye-Gastrostomy - bolus
• Ishubhu yokudla yeJejunostomy

• Uhlelo lokugaya ukudla
• Ukuvimbela isilungulela
• Umdlavuza we-Esophageal

Ku GY, Ilson DH. Umdlavuza womphimbo. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, abahleli. I-Abeloff’s Clinical Oncology. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2020: isahluko 71.

Iwebhusayithi yeNational Cancer Institute. Ukwelashwa komdlavuza we-Esophageal (PDQ) - inguqulo yezempilo. www.cancer.gov/types/esophageal/hp/esophageal- ukwelashwa-pdq. Kubuyekezwe uNovemba 12, 2019. Kufinyelelwe ngoDisemba 5, 2019.

Iwebhusayithi ye-National Comprehensive Cancer Network. Imikhombandlela ye-NCCN yokwenza imitholampilo ku-oncology (imihlahlandlela ye-NCCN): umdlavuza we-esophageal kanye ne-esophagogastric junction. Inguqulo 2.2019. www.nccn.org/professionals/physician_gls/pdf/esophageal.pdf. Kubuyekezwe uMeyi 29, 2019. Kufinyelelwe kuSepthemba 4, 2019.