Ama-radiosurgery we-stereotactic - iGamma Knife

I-stereosactic radiosurgery (i-SRS) iyindlela yokwelashwa kwemisebe egxila emandleni amakhulu amandla endaweni encane yomzimba.

Ngaphandle kwegama layo, i-radiosurgery empeleni akuyona inqubo yokuhlinzwa - akukho ukusika noma ukuthunga, kunalokho kuyindlela yokwelashwa ngemisebe.

Kusetshenziswa uhlelo olungaphezu kolulodwa ukwenza ama-radiosurgery. Lo mbhalo ukhuluma ngemisebe ye-Gamma Knife.

Uhlelo lwe-Gamma Knife radiosurgery lusetshenziselwa ukwelapha umdlavuza noma ukukhula emakhanda noma endaweni ephezulu yomgogodla. Emdlavuzeni noma ekukhuleni okuphansi komgogodla noma kwenye indawo emzimbeni, kungasetshenziswa olunye uhlelo lokuhlinza olugxile.

Ngaphambi kokwelashwa, ufakwa "uhlaka lwekhanda." Le yindilinga yensimbi esetshenziselwa ukukubeka kahle emshinini ukuze uthuthukise ukunemba nokukhomba ukukhomba. Uhlaka lunamathele ekhanda nasekhakhayini lakho. Inqubo yenziwa yi-neurosurgeon, kepha ayidingi ukusika noma ukuthunga.

• Usebenzisa i-anesthesia yendawo (njengodokotela wamazinyo ongayisebenzisa), amaphuzu amane afakwa esikhunjeni sesikhumba.
• Uhlaka lwekhanda lubekwe phezu kwekhanda lakho futhi kufakwe izikhonkwane ezine ezincane namahange. Ama-anchors aklanyelwe ukubamba uhlaka lwekhanda endaweni yawo, futhi luhamba ngokuqinile ngesikhumba luze luze ebusweni bogebhezi lwakho.
• Unikezwa isibulali sendawo futhi akufanele uzwe ubuhlungu, kunalokho ucindezelwa kuphela. Ngokuvamile unikezwa umuthi ozokusiza ukuphumule ngesikhathi senqubo efanelekayo.
• Uhlaka luzohlala lunamathiselwe kuyo yonke inqubo yokwelashwa, imvamisa amahora ambalwa, bese luzosuswa.

Ngemuva kokuthi ifreyimu linamathiselwe ekhanda lakho, kwenziwa ukuhlolwa kwe-imaging njenge-CT, i-MRI, noma i-angiogram. Izithombe zikhombisa indawo ngqo, usayizi, nokuma kwesimila sakho noma indawo enenkinga futhi kuvumela ukukhomba okunemba.

Ngemuva kokucabanga, uzolethwa egumbini lokuphumula ngenkathi odokotela nethimba le-physics belungisa uhlelo lwekhompyutha. Lokho kungathatha cishe imizuzu engama-45 kuya ehoreni. Okulandelayo, uzolethwa egumbini lokwelashwa.

Izinhlelo ezintsha ezingenasici zokubeka ikhanda ziyahlolwa.

Ngesikhathi sokwelashwa:

• Awudingi ukulala. Uzothola umuthi ozokusiza uphumule. Ukwelashwa uqobo akubangeli ubuhlungu.
• Ulele etafuleni elingena emshinini ohambisa imisebe.
• Uhlaka lwekhanda noma imaski yobuso ihambisana nomshini, onesigqoko sokuzivikela esinemigodi yokuletha imishayo emincane yemisebe ngqo kulitshe.
• Umshini ungahambisa ikhanda lakho kancane, ukuze imishayo yamandla ihanjiswe ezindaweni eziqonde ngqo ezidinga ukwelashwa.
• Abahlinzeki bezempilo bakwelinye igumbi. Bayakubona kumakhamera bakuzwe futhi bakhulume nawe ngemibhobho.

Ukulethwa kokwelashwa kuthatha noma yikuphi ukusuka emizuzwini engama-20 kuye emahoreni ama-2. Ungathola ukwelashwa okungaphezu kwesisodwa. Imvamisa, akudingeki izikhathi ezingaphezu kwezingu-5.

Ubhontshisi wemisebe egxile kakhulu kusetshenziswa uhlelo lweGamma Knife futhi kubhubhise indawo engajwayelekile. Lokhu kunciphisa ukulimala kwezicubu ezinempilo eziseduze. Le ndlela yokwelashwa imvamisa iyindlela yokuvula i-neurosurgery.

I-Gamma Knife radiosurgery ingasetshenziselwa ukwelapha lezi zinhlobo ezilandelayo zezicubu zobuchopho noma izicubu zomgogodla ongaphezulu:

• Umdlavuza osabalele (metastasized) uye ebuchosheni kusuka kwenye ingxenye yomzimba
• Isimila esikhula kancane senzwa exhuma indlebe ebuchosheni (i-acoustic neuroma)
• Izilonda zesikhumba
• Okunye ukukhula ebuchosheni noma emgogodleni (chordoma, meningioma)

IGamma Knife nayo isetshenziselwa ukwelapha ezinye izinkinga zobuchopho:

• Izinkinga zomkhumbi wegazi (i-arteriovenous malformation, i-arteriovenous fistula).
• Ezinye izinhlobo zesifo sokuwa.
• I-trigeminal neuralgia (ubuhlungu obukhulu bezinzwa zobuso).
• Ukudlidlizela okukhulu ngenxa yokundindizela okubalulekile noma isifo seParkinson.
• Kungasetshenziswa futhi njengokwelashwa okwengeziwe kwe- "adjuvant" ngemuva kokuthi umdlavuza ususwe ngokuhlinzwa ebuchosheni, ukusiza ukunciphisa ingozi yokuphindeka.

Ama-radiosurgery (noma yiluphi uhlobo lokwelashwa kwalolo daba), angalimaza izicubu ezungeze indawo elashwa. Uma kuqhathaniswa nezinye izinhlobo zemithi yokwelashwa ngemisebe, abanye bakholelwa ukuthi imisebe ye-Gamma Knife radiosurgery, ngoba ihlinzeka ngemithi yokukhomba, mancane amathuba okuthi ilimaze izicubu ezinempilo eziseduze.

Ngemuva kwemisebe ebuchosheni, ukuvuvukala kwendawo, okubizwa nge-edema, kungenzeka. Unganikezwa imithi ngaphambi nangemva kwenqubo yokwehlisa le ngozi, kepha kusengenzeka. Ukuvuvukala kuvame ukuphela ngaphandle kokwelashwa okuqhubekayo. Ezimweni ezingavamile, ukulaliswa esibhedlela nokuhlinzwa ngemisiko (ukuhlinzwa okuvulekile) kuyadingeka ukwelapha ukuvuvukala kobuchopho okubangelwa yimisebe.

Kunezimo ezingavamile zokuvuvukala okwenza iziguli zibe nezinkinga zokuphefumula, futhi kunemibiko yokufa kwabantu ngemuva kwemisebe ye-radiosurgery.

Ngenkathi lolu hlobo lwezokwelapha lungahlaseli kangako kunokuhlinzwa okuvulekile, lusengaba nezingozi. Khuluma nodokotela wakho mayelana nezingozi zokwelashwa ezingaba khona kanye nezingozi zokukhula kwesimila noma ukusabalala.

Amanxeba esikhumba nezindawo lapho kufakwe khona ifreyimu yekhanda esikhunjeni sakho kungenzeka kubomvu futhi kuzwele ngemuva kokwelashwa. Lokhu kufanele kudlule ngokuhamba kwesikhathi. Kungase kube khona ukulimaza.

Ngosuku olungaphambi kwenqubo yakho:

• UNGAYisebenzisi ukhilimu wezinwele noma isifutho sezinwele.
• UNGADLI noma uphuze noma yini phakathi kwamabili ngaphandle kokuthi utshelwe ngenye indlela ngudokotela wakho.

Usuku lwenqubo yakho:

• Gqoka izingubo zikanokusho.
• Letha imithi yakho ejwayelekile kadokotela esibhedlela.
• UNGAGQOKI ubucwebe, izimonyo, upholishi wezinzipho, noma iwigi noma okokuthaya izinwele.
• Uzocelwa ukuthi ususe amalensi wokuxhumana, izibuko zamehlo, namazinyo okufakelwa.
• Uzoshintsha ugqoke isibhedlela.
• Umugqa ofakwa ngaphakathi (IV) uzobekwa engalweni yakho ukuletha okokusebenza okuhlukile, imithi, noketshezi.

Imvamisa, ungaya ekhaya ngosuku olufanayo lokwelashwa. Hlela kusengaphambili ukuthi othile azokuhambisa ngemoto aye ekhaya, ngoba imithi oyinikezwayo ingakwenza ukozele. Ungabuyela emisebenzini yakho ejwayelekile ngosuku olulandelayo uma kungekho zinkinga, njengokuvuvukala. Uma unezinkinga, noma udokotela wakho ekholelwa ukuthi kuyadingeka, kungadingeka ukuthi uhlale esibhedlela ubusuku bonke ukuze ubhekwe.

Landela imiyalo oyinikezwe ngabahlengikazi bakho yokuthi ungazinakekela kanjani ekhaya.

Imiphumela ye-Gamma Knife radiosurgery ingathatha amasonto noma izinyanga ukubonwa. Isibikezelo sincike esimweni eselashwa. Umhlinzeki wakho uzoqapha inqubekelaphambili yakho esebenzisa ukuhlolwa kwe-imaging njenge-MRI ne-CT scan.

Ukwelashwa ngemisebe ye-stereotactic; Ama-radiosurgery we-stereotactic; I-SRT; SBRT; I-radiotherapy eqhekekile ehlukanisiwe; Ama-SRS; IGamma Knife; Imisebe ye-Gamma Knife; I-neurosugery engahlaseli; Isifo sokuwa - IGamma Knife

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UBrown PD, uJaeckle K, uBallman KV, et al. Umphumela we-radiosurgery wedwa vs i-radiosurgery enokwelashwa okuphelele kwemisebe yobuchopho ekusebenzeni kwengqondo ezigulini ezine-1 kuya ku-3 metastases yobuchopho: isilingo somtholampilo esingahleliwe. JAMA. 2016; 316 (4): 401-409. I-PMID: 27458945 pubmed.ncbi.nlm.nih.gov/27458945/.

UDewyer NA, Abdul-Aziz D, Welling DB. Ukwelashwa ngemisebe yezicubu ezinobungozi besisekelo se-cranial. Ku: IFlint PW, uFrancis HW, uHaughey BH, et al, eds. I-Cummings Otolaryngology: Ukuhlinzwa Kwekhanda Nentamo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2021: isahluko 181.

U-Lee CC, uDJ weSchlesinger, uShehan JP. Inqubo yamaRadiosurgery. Ku: Winn RH, ed. Ukuhlinzwa Kwe-Youmans neWinn Neurological. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2017: isahluko 264.