I-Laryngectomy

I-Laryngectomy ukuhlinzwa ukuze kususwe yonke noma ingxenye yomphimbo (ibhokisi lezwi).

I-Laryngectomy ukuhlinzwa okukhulu okwenziwa esibhedlela. Ngaphambi kokuhlinzwa uzothola i-anesthesia ejwayelekile. Uzobe ulele futhi ungenazinhlungu.

Ingqikithi ye-laryngectomy isusa wonke umphimbo. Ingxenye yepharynx yakho nayo ingakhishwa. I-pharynx yakho iyindinyana eboshwe ulwelwesi lwamafinyila phakathi kwamaphaseji akho acinene kanye nomphimbo.

• Udokotela ohlinzayo uzosika entanyeni yakho ukuvula indawo. Ukunakekelwa kuyathathwa ukulondolozwa kwemithambo yegazi emikhulu nezinye izakhiwo ezibalulekile.
• Umphimbo nezicubu ezizungezile zizosuswa. Ama-lymph node nawo angasuswa.
• Udokotela ohlinzayo uzobe esenza imbobo ku-trachea yakho nembobo phambi kwentamo yakho. I-trachea yakho izonamathiselwa kulo mgodi. Umgodi ubizwa ngestoma. Ngemuva kokuhlinzwa uzophefumula nge-stoma yakho. Awusoze wasuswa.
• Isigaxa sakho, imisipha, nesikhumba sakho kuzovalwa ngemithungo noma iziqeshana. Ungaba namashubhu avela esilondeni sakho isikhashana ngemuva kokuhlinzwa.

Udokotela ohlinzayo angenza ne-tracheoesophageal puncture (TEP).

• I-TEP imbobo encane ku-windpipe yakho (i-trachea) kanye neshubhu elihambisa ukudla kusuka emphinjeni kuya esiswini sakho (i-esophagus).
• Udokotela wakho ohlinzayo uzobeka ingxenye encane eyenziwe umuntu (okufakelwayo) kulokhu kuvulwa. Isitho sokufakelwa sizokuvumela ukuthi ukhulume ngemuva kokuthi ibhokisi lakho lezwi likhishiwe.

Kunokuhlinzwa okuningi okungahlaseli okususa ingxenye yomphimbo.

• Amagama ezinye zalezi zinqubo yi-endoscopic (noma i-resection transction), i-laryngectomy engaphelele, i-laryngectomy enezingqimba noma i-supraglottic, kanye ne-laryngectomy encane ye-supracricoid.
• Lezi zinqubo zingasebenza kwabanye abantu. Ukuhlinzwa onakho kuncike ekutheni umdlavuza wakho usabalale kangakanani nokuthi unhloboni yomdlavuza.

Ukuhlinzwa kungathatha amahora ama-5 kuye kwayi-9.

Imvamisa, i-laryngectomy yenziwa ukwelapha umdlavuza we-larynx. Kuyenziwa nokwelapha:

• Ukuhlukumezeka okukhulu, njengokulimala kwesibhamu noma okunye ukulimala.
• Ukulimala okukhulu komphimbo kusuka ekwelashweni ngemisebe. Lokhu kubizwa nge-radiation necrosis.

Izingozi zanoma yikuphi ukuhlinzwa yilezi:

• Ukungezwani komzimba nemithi
• Izinkinga zokuphefumula
• Izinkinga zenhliziyo
• Ukopha
• Ukutheleleka

Izingozi zalokhu kuhlinzwa yilezi:

• I-Hematoma (inqwaba yegazi ngaphandle kwemithambo yegazi)
• Ukutheleleka kwesilonda
• Ama-Fistula (ukuxhumana kwezicubu okwenzeka phakathi kwe-pharynx nesikhumba okungajwayelekile lapho)
• Ukuvulwa kwe-stoma kungaba kuncane kakhulu noma kuqine. Lokhu kubizwa ngokuthi yi-stomal stenosis.
• Ukuvuza uzungeze i-tracheoesophageal puncture (TEP) ne-prosthesis
• Ukulimala kwezinye izindawo zomhosha noma i-trachea
• Izinkinga ukugwinya nokudla
• Izinkinga ukukhuluma

Uzoba nokuvakashelwa nodokotela ngaphambi kokuhlinzwa. Ezinye zazo yilezi:

• Ukuhlolwa okuphelele komzimba nokuhlolwa kwegazi. Izifundo zokucabanga zingenziwa.
• Ukuvakashelwa kwengcweti yezinkulumo kanye nodokotela wokugwinya ukulungiselela izinguquko ngemuva kokuhlinzwa.
• Ukwelulekwa ngokudla okunempilo.
• Ukuyeka ukubhema - ukwelulekwa. Uma ubhema futhi awukayeki.

Njalo utshele umhlinzeki wakho wezokunakekelwa kwempilo:

• Uma ukhulelwe noma ungakhulelwa
• Imiphi imithi oyiphuzayo, ngisho nezidakamizwa, izithasiselo, noma amakhambi owathengile ngaphandle kwencwadi kadokotela
• Uma uphuze utshwala obuningi, uphuza iziphuzo ezingaphezu kwezingu-1 noma ezi-2 ngosuku

Phakathi nezinsuku ngaphambi kokuhlinzwa kwakho:

• Ungacelwa ukuthi uyeke ukuthatha i-aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), clopidogrel (Plavix), warfarin (Coumadin), kanye nanoma iziphi ezinye izidakamizwa ezenza kube nzima ngegazi lakho ukuminyana.
• Buza ukuthi imiphi imishanguzo okufanele usayiphuza ngosuku lokuhlinzwa kwakho.

Ngosuku lokuhlinzwa kwakho:

• Uzocelwa ukuthi ungaphuzi noma ungadli lutho ngemuva kwamabili ebusuku ngaphambi kokuhlinzwa kwakho.
• Thatha izidakamizwa umhlinzeki wakho akutshele ukuthi uziphuze ngesiphuzo esincane samanzi.
• Uzotshelwa ukuthi ufika nini esibhedlela.

Uzodinga ukuhlala esibhedlela izinsuku ezimbalwa ngemuva kokuhlinzwa.

Ngemuva kwenqubo, uzoba groggy futhi ngeke ukwazi ukukhuluma. Isifonyo se-oxygen sizoba se-stoma sakho. Kubalulekile ukugcina ikhanda lakho liphakeme, uphumule kakhulu, futhi uhambise imilenze yakho ngezikhathi ezithile ukuthuthukisa ukugeleza kwegazi. Ukugcina igazi lihamba kunciphisa ubungozi bokuthola igazi.

Ungasebenzisa ukucindezela okufudumele ukunciphisa izinhlungu eziseduze nokuqhekeka kwakho. Uzothola umuthi wezinhlungu.

Uzothola umsoco nge-IV (ishubhu elingena emthanjeni) nangokuphakelwa kwamashubhu. Ukondliwa kwamashubhu kunikezwa ngeshubhu elingena emakhaleni akho futhi lingene emphinjeni wakho (ithubhu yokondla).

Ungavunyelwa ukugwinya ukudla ngokushesha ezinsukwini ezimbili kuya kwezi-3 ngemuva kokuhlinzwa. Kodwa-ke, kuvame kakhulu ukulinda izinsuku ezingama-5 kuya kwezi-7 ngemuva kokuhlinzwa kwakho ukuze uqale ukudla ngomlomo wakho. Ungahle ube nesifundo sokugwinya, lapho kuthathwa khona i-x-ray ngenkathi uphuza okokuqhathanisa. Lokhu kwenziwa ukuqinisekisa ukuthi akukho ukuvuza ngaphambi kokuqala ukudla.

Ukukhipha kwakho kungasuswa ezinsukwini ezimbili kuya kwezi-3. Uzofundiswa ukuthi uyinakekela kanjani ithubhu yakho ye-laryngectomy ne-stoma. Uzofunda ukuthi ungageza kanjani ngokuphepha. Kufanele uqaphele ukuthi ungavumeli amanzi angene nge-stoma yakho.

Ukuvuselelwa kwenkulumo nesazi sokukhuluma kuzokusiza ufunde kabusha indlela yokukhuluma.

Uzodinga ukugwema ukuphakamisa okunzima noma umsebenzi onzima cishe amasonto ayisithupha. Ungaqala kancane imisebenzi yakho ejwayelekile, elula.

Landela umhlinzeki wakho njengoba utshelwe.

Amanxeba akho azothatha cishe amaviki amabili kuya kwamathathu ukuphola. Ungalindela ukululama okugcwele esikhathini esingangenyanga. Izikhathi eziningi, ukukhishwa komphimbo kuzokhipha wonke umdlavuza noma izinto ezilimele. Abantu bafunda ukushintsha indlela yabo yokuphila futhi baphile ngaphandle kwebhokisi lezwi labo. Ungadinga ezinye izindlela zokwelashwa, njenge-radiotherapy noma i-chemotherapy.

Qedela i-laryngectomy; I-laryngectomy engaphelele

• Izinkinga zokugwinya

ILorenz RR, Couch ME, iBurkey BB. Ikhanda nentamo. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ISabiston Incwadi Yokuhlinzwa. Umhla ka-20. IPhiladelphia, PA: Elsevier Saunders; 2017: isahluko 33.

Posner MR. Umdlavuza wekhanda nentamo. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-25. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 190.

URassekh H, Haughey BH. Ingqikithi yeLaryngectomy ne-laryngopharyngectomy. Ku: Flint PW, Haughey BH, Lund V, et al, ama-eds. I-Cummings Otolaryngology: Ukuhlinzwa Kwekhanda Nentamo. Umhlaka 6. IPhiladelphia, PA: Elsevier Saunders; 2015: isahluko 110.