I-Endoscopic thoracic sympathectomy

I-Endoscopic thoracic sympathectomy (ETS) ukuhlinzwa ukwelapha ukujuluka okusinda kakhulu kunokujwayelekile. Lesi simo sibizwa nge-hyperhidrosis. Imvamisa ukuhlinzwa kusetshenziselwa ukwelapha ukujuluka ezintendeni noma ebusweni. Izinzwa ezizwelayo zilawula ukujuluka. Ukuhlinzwa kusika lezi zinzwa engxenyeni yomzimba ejuluka kakhulu.

Uzothola i-anesthesia ejwayelekile ngaphambi kokuhlinzwa. Lokhu kuzokwenza ulale futhi ungabi nezinhlungu.

Ukuhlinzwa kuvame ukwenziwa ngale ndlela elandelayo:

• Udokotela ohlinzayo usika okungu-2 noma okungu-3 okuncane (ukusikeka) ngaphansi kwengalo eyodwa ohlangothini lapho kwenzeka khona ukujuluka okweqile.
• Iphaphu lakho kulolu hlangothi liqaqekile (liwile) ukuze umoya ungangeni futhi uphume kulo ngesikhathi sokuhlinzwa. Lokhu kunikeza udokotela ohlinzayo indawo eyengeziwe yokusebenza.
• Ikhamera encane ebizwa nge-endoscope ifakwa kokunye kokusikeka esifubeni sakho. Ividiyo evela kukhamera ikhombisa kuqapha egumbini lokusebenza. Udokotela ohlinzayo ubheka umqaphi ngenkathi enza ukuhlinzwa.
• Amanye amathuluzi amancane afakwa ngokusebenzisa okunye ukusikeka.
• Esebenzisa la mathuluzi, udokotela ohlinzayo uthola izinzwa ezilawula ukujuluka endaweni enenkinga. Lokhu kuyasikwa, kusikwe noma kubhujiswe.
• Iphaphu lakho kulolu hlangothi ligcwele umoya.
• Ukusikeka kuvaliwe ngemithungo (ama-sutures).
• Ishubhu elincane lokuhambisa amanzi lingasala esifubeni sakho usuku noma ngaphezulu.

Ngemuva kokwenza le nqubo ngakolunye uhlangothi lomzimba wakho, udokotela ohlinzayo angenza okufanayo kolunye uhlangothi. Ukuhlinzwa kuthatha cishe ihora elilodwa kuya kwele-3.

Lokhu kuhlinzwa kuvame ukwenziwa kubantu abanezintende zezandla ezijuluka kakhulu kunokujwayelekile. Kungasetshenziselwa ukwelapha ukujuluka okwedlulele kobuso. Isetshenziswa kuphela lapho ezinye izindlela zokwelapha ukunciphisa ukujuluka zingasebenzi.

Izingozi ze-anesthesia nokuhlinzwa ngokujwayelekile yilezi:

• Ukungezwani komzimba nemithi
• Izinkinga zokuphefumula
• Ukopha, amahlule egazi, noma ukutheleleka

Izingozi zale nqubo yilezi:

• Ukuqoqwa kwegazi esifubeni (hemothorax)
• Ukuqoqwa komoya esifubeni (pneumothorax)
• Ukulimala kwemithambo noma izinzwa
• I-Horner syndrome (kwehle ukujuluka kobuso kanye namajwabu amehlo alengayo)
• Ukujuluka okwengeziwe noma okusha
• Ukujuluka okwengeziwe kwezinye izindawo zomzimba (ukujuluka okulingene)
• Kunciphise ukushaya kwenhliziyo
• Inyumoniya

Tshela udokotela wakho ohlinzayo noma umhlinzeki wezempilo:

• Uma ukhulelwe noma ungakhulelwa
• Imiphi imithi, amavithamini, amakhambi, nezinye izithako ozithathayo, ngisho naleyo oyithenge ngaphandle kadokotela

Phakathi nezinsuku ngaphambi kokuhlinzwa:

• Ungacelwa ukuthi uyeke ukusebenzisa imishanguzo emincane yegazi. Ezinye zazo i-aspirin, ibuprofen (Advil, Motrin), ne-warfarin (i-Coumadin).
• Buza udokotela wakho ohlinzayo ukuthi imiphi imithi okufanele usayiphuza ngosuku lokuhlinzwa kwakho.
• Uma ubhema, zama ukuyeka. Cela umhlinzeki wakho akusize uyeke. Ukubhema kwandisa ubungozi bezinkinga ezinjengokuphulukiswa kancane.

Ngosuku lokuhlinzwa kwakho:

• Landela imiyalo yokuthi ungakuyeka nini ukudla nokuphuza.
• Thatha imithi udokotela wakho ohlinzayo akutshele ukuthi uyiphuze ngesiphuzo esincane samanzi.
• Fika esibhedlela ngesikhathi.

Iningi labantu lihlala esibhedlela ubusuku obubodwa bese liya ekhaya ngakusasa. Ungaba nobuhlungu cishe isonto elilodwa noma amabili. Thatha umuthi wezinhlungu njengoba udokotela wakho ekuncomile. Ungadinga i-acetaminophen (Tylenol) noma umuthi wezinhlungu kadokotela. UNGAYISHAYELI uma uphuza umuthi wezinhlungu we-narcotic.

Landela imiyalo kadokotela ohlinzayo ngokunakekela okusikwayo, okufaka:

• Gcina izindawo zokusika zihlanzekile, zomile, futhi zimbozwe ngamabhandishi (amabhandeshi). Uma ukusika kwakho kumbozwe nge-Dermabond (ibhandishi eliketshezi) ungahle ungadingi ukugqokwa.
• Geza izindawo ushintshe nokugqoka njengokuyalelwa.
• Buza udokotela wakho ohlinzayo lapho ungakwazi ukugeza noma ukugeza.

Qhubeka kancane nemisebenzi yakho ejwayelekile njengoba ukwazi.

Qhubeka nokuhambela okulandelayo nodokotela ohlinzayo. Kulezi zivakashi, udokotela ohlinzayo uzohlola ukusikeka abone ukuthi ukuhlinzwa kuphumelele yini.

Lokhu kuhlinzwa kungathuthukisa ikhwalithi yempilo kubantu abaningi. Akusebenzi kahle kubantu abanesithukuthezi esinzima kakhulu. Abanye abantu babona ukujuluka ezindaweni ezintsha emzimbeni, kepha lokhu kungazihambela kukodwa.

I-Sympathectomy - i-endoscopic thoracic; NJLL; Hyperhidrosis - endoscopic thoracic sympathectomy

• Ukunakekelwa kwesilonda sokuhlinzwa - kuvulekile

Iwebhusayithi ye-International Hyperhidrosis Society. I-Endoscopic thoracic sympathectomy. www.sweathelp.org/hyperhidrosis-treatment/ets-surgery.html. Kufinyelelwe ngo-Ephreli 3, 2019.

Izindlala JAA. I-Hyperhidrosis. Ku: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, abahleli. Ukwelashwa Kwezifo Zesikhumba: Amasu Wokwelashwa Okuphelele. Umhlaka 5. IPhiladelphia, PA: Elsevier; 2018: isahluko 109.

UMiller DL, uMiller MM. Ukwelashwa kokuhlinzwa kwe-hyperhidrosis. Ku: Sellke FW, del Nido PJ, Swanson SJ, ama-eds. Ukuhlinzwa kweSabiston neSpencer kwesifuba. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2016: isahluko 44.