He aha ka Adrenalectomy? Ke Kumu, ke Kaʻina Hana & Hoʻōla

ʻO ka adrenalectomy kahi hana ʻoki e wehe i hoʻokahi a i ʻole nā ​​ʻelua o kāu ʻōpū adrenal. Aia kēia mau ʻōpū liʻiliʻi, ʻano huinakolu ma luna o kēlā me kēia puʻupaʻa a hana i nā hormones nui e kōkua i ka hoʻoponopono ʻana i kou koko, ka metabolism, a me ka pane ʻana i ke kaumaha. Ke ulu nā ʻōpū i nā maʻi a i ʻole e hana nui i nā hormones, ʻo ka ʻoki ʻana paha ke ala maikaʻi loa e hoʻihoʻi i kou olakino a pale i nā pilikia.

He aha ka adrenalectomy?

ʻO ka adrenalectomy ke ʻano o ka wehe ʻana i nā ʻōpū adrenal. Hiki i kāu kauka lapaʻau ke wehe i hoʻokahi ʻōpū (unilateral adrenalectomy) a i ʻole nā ​​ʻōpū ʻelua (bilateral adrenalectomy), ma muli o kou maʻi kikoʻī. Kōkua ke kaʻina hana i ka mālama ʻana i nā maʻi adrenal like ʻole ʻaʻole hiki ke mālama ʻia me ka lāʻau lapaʻau wale nō.

Ma kahi o ka nui o ka walnut kou ʻōpū adrenal a kaupaona ma kahi o 4-5 grams kēlā me kēia. Hana lākou i nā hormones nui e like me ka cortisol, aldosterone, a me ka adrenaline e mālama pono i kou kino. Ke maʻi a hana nui paha kēia mau ʻōpū, hiki i ka wehe ʻana iā lākou ke hoʻopakele i ke ola.

No ke aha e hana ʻia ai ka adrenalectomy?

He mea pono ka Adrenalectomy ke loaʻa i kou ʻōpū adrenal nā pilikia koʻikoʻi e hoʻoweliweli i kou olakino. ʻO ke kumu maʻamau ka wehe ʻana i nā maʻi, inā he maʻi ʻaʻai a i ʻole he maʻi maʻi akā ke hana nei i ka hana nui o ka hormone.

Eia nā kūlana nui e koi ai i kēia ʻoki:

• Nā ʻōpū adrenal: ʻO nā ʻōpū maʻi (adrenocortical carcinoma) a me nā ʻōpū maikaʻi (adenomas) e hana ana i nā hormones nui
• Pheochromocytoma: Nā ʻōpū e hoʻokuʻu ana i ka adrenaline nui, e hoʻoulu ana i nā piʻi koko kiʻekiʻe weliweli
• Cushing's syndrome: Ke hana nui nā adrenal i ka cortisol, e alakaʻi ana i ka loaʻa ʻana o ke kaumaha, ke koko kiʻekiʻe, a me ka maʻi diabetes
• Conn's syndrome: ʻO ka hana nui ʻana o ka aldosterone e hoʻoulu ana i ke koko kiʻekiʻe a me ka potassium haʻahaʻa
• Adrenal metastases: Ke laha ka maʻi mai nā ʻāpana ʻē aʻe o kou kino i nā adrenal glands

ʻAʻole maʻamau, pono kekahi poʻe i ka adrenalectomy bilateral no ka maʻi ʻo Cushing koʻikoʻi i ka wā i hāʻule ai nā lāʻau lapaʻau ʻē aʻe. E noʻonoʻo pono kāu kauka i nā pōmaikaʻi e kūʻē i nā pilikia ma mua o ka ʻōlelo ʻana i kēia hana nui.

He aha ke kaʻina hana no ka adrenalectomy?

Hiki i kāu kauka lapaʻau ke hana i ka adrenalectomy me ka hoʻohana ʻana i nā ala like ʻole, me ka laparoscopic (minimally invasive) ʻokiʻoki ʻo ia ke ʻano maʻamau i kēia lā. Aia ke koho i ka nui a me kahi o kāu ʻōpū, kou olakino holoʻokoʻa, a me ka ʻike o kāu kauka lapaʻau.

Eia ka mea e hana maʻamau i ka wā o ke kaʻina hana:

1. Anesthesia: E loaʻa iā ʻoe ka anesthesia maʻamau no laila e hiamoe loa ʻoe i ka wā o ke ʻokiʻoki
2. Kūlana: E hoʻonoho kāu kauka lapaʻau iā ʻoe ma kou ʻaoʻao a i ʻole ke alo i lalo e komo i nā adrenal glands
3. ʻIkiʻoki: E hana ʻia nā ʻokiʻoki liʻiliʻi (laparoscopic) a i ʻole hoʻokahi ʻokiʻoki nui (open surgery)
4. Wehe ʻana i ka gland: Hoʻokaʻawale pono kāu kauka lapaʻau i ka adrenal gland mai nā ʻiʻo a me nā kīʻaha koko a puni
5. Panina: Ua pani ʻia nā ʻokiʻoki me nā sutures a i ʻole ke kāpili ʻokiʻoki

Hoʻohana ka ʻoki laparoscopic i 3-4 mau ʻoki liʻiliʻi a me kahi kamera liʻiliʻi, e hopena ana i ka ʻeha liʻiliʻi a me ka hoʻōla wikiwiki. Pono ka ʻoki hāmama i kahi ʻoki nui aʻe akā pono paha no nā ʻōpū nui loa a i ʻole ke manaʻo ʻia ka maʻi kanesa.

ʻO ka hana holoʻokoʻa e lawe maʻamau i 1-4 mau hola, ma muli o ke paʻakikī o kāu hihia a inā pono e wehe ʻia hoʻokahi a i ʻole nā ​​ʻelua kelena.

Pehea e hoʻomākaukau ai no kāu adrenalectomy?

ʻO ka hoʻomākaukau ʻana no ka adrenalectomy e pili ana i kekahi mau ʻanuʻu nui e hōʻoia i ka maʻalahi a me ka palekana o kāu ʻoki. E alakaʻi kāu hui mālama ola iā ʻoe ma kēlā me kēia ʻanuʻu, akā eia ka mea āu e manaʻo ai i nā pule e alakaʻi ana i kāu hana.

E pili ana kāu hoʻomākaukau ʻana i kēia mau ʻanuʻu nui:

• Nā hoʻokolohua ma mua o ka hana: Nā hoʻokolohua koko, nā kiʻi kiʻi, a me nā hoʻokolohua hana puʻuwai e loiloi i kou olakino holoʻokoʻa
• Nā hoʻoponopono lāʻau: Hiki i kāu kauka ke kuhikuhi i nā lāʻau lapaʻau e kāohi i ke koko a i ʻole nā ​​pae hormone ma mua o ke ʻoki
• Hoʻolālā pani hormone: Inā e wehe ʻia nā kelena ʻelua, e hoʻomaka ʻoe e aʻo e pili ana i ka lāʻau lapaʻau pani hormone ola
• Nā alakaʻi meaʻai: Pono ʻoe e hoʻokē ʻai no 8-12 mau hola ma mua o ke ʻoki
• Nānā lāʻau: Pono e hoʻōki ʻia kekahi mau lāʻau lapaʻau, ʻoi aku ka lahilahi o ke koko, no kekahi manawa

Inā loaʻa iā ʻoe kahi pheochromocytoma, e kuhikuhi kāu kauka i nā lāʻau lapaʻau kūikawā i kapa ʻia he alpha-blockers no kekahi mau pule ma mua o ke ʻoki. Kōkua kēia mau mea i ka pale ʻana i nā piʻi koko weliweli i ka wā o ke kaʻina hana.

E hōʻoia e hoʻonohonoho i kekahi e hoʻokele iā ʻoe i ka home a noho pū me ʻoe no ka lā mua a i ʻole ʻelua ma hope o ke ʻoki. ʻO ka loaʻa ʻana o ke kākoʻo i ka wā o kou ola hou ʻana e hana i kahi ʻokoʻa nui i kou hōʻoluʻolu a me kou palekana.

Pehea ka hoʻōla ʻana ma hope o ka adrenalectomy?

He ʻokoʻa ka hoʻōla ʻana mai ka adrenalectomy ma muli o ke ʻano o ke ʻoki āu i loaʻa ai, inā he laparoscopic a i ʻole he ʻoki hāmama, akā hana maikaʻi ka hapa nui o nā kānaka me ka mālama pono a me ke ahonui. Pono kou kino i ka manawa e hoʻōla ai mai ke ʻoki a hoʻoponopono i nā loli hormonal.

Eia kāu mea e manaʻo ai i ka wā o kou hoʻōla ʻana:

• Noho ma ka haukapila: 1-2 mau lā no ke ʻoki laparoscopic, 3-5 mau lā no ke ʻoki hāmama
• Hoʻokele ʻeha: Nā lāʻau lapaʻau ʻeha i kuhikuhi ʻia no ka pule mua, a laila nā koho ma luna o ka pāʻani
• Nā palena hana: ʻAʻole hāpai i nā mea kaumaha (ma luna o 10 paona) no 2-4 mau pule
• Hoʻi i ka hana: 1-2 mau pule no nā hana pākaukau, 4-6 mau pule no nā hana kino
• Hoʻōla piha: Manaʻo ka hapa nui o nā kānaka i ka maʻamau i loko o 6-8 mau pule

Inā ua wehe ʻia nā ʻōpū adrenal ʻelua, pono ʻoe e hoʻomaka i ka lāʻau lapaʻau hormone pani koke. Aia kēia i ka lawe ʻana i nā lāʻau lapaʻau i kēlā me kēia lā e pani i nā hormones a kou mau ʻōpū adrenal e hana maʻamau ai.

E hāʻawi kāu hui ʻoki i nā ʻōlelo kikoʻī e pili ana i ka mālama ʻana i ka ʻeha, i ka wā e hoʻomaka ai i nā hana maʻamau, a me nā hōʻailona hōʻailona e nānā ai. ʻO ka hahai ʻana i kēia mau alakaʻi me ka akahele e kōkua i ka hōʻoia ʻana i ka hopena maikaʻi loa.

He aha nā pilikia a me nā pilikia o ka adrenalectomy?

E like me nā ʻoki nui ʻē aʻe, lawe ka adrenalectomy i kekahi mau pilikia, akā ʻaʻole maʻamau nā pilikia koʻikoʻi ke hana ʻia e nā kauka lapaʻau i ʻike ʻia. ʻO ka hoʻomaopopo ʻana i kēia mau pilikia e kōkua iā ʻoe e hana i nā hoʻoholo i ʻike ʻia e pili ana i kāu mālama ʻana a ʻike i ka mea e nānā ai i ka wā o ka hoʻōla.

ʻO nā pilikia maʻamau e hiki ke hana me kekahi ʻoki:

• Ke kahe ʻana o ke koko: ʻOiai he mea maʻamau ʻole, hiki i ke kahe nui ʻana o ke koko ke koi i ka hoʻoili ʻana i ke koko
• Maʻi: Loaʻa nā maʻi ma ke kahua o ka ʻoki ʻana ma lalo o 5% o nā hihia
• Nā koko koko: Hoʻemi ʻia ka pilikia me ka neʻe mua ʻana a me nā mea lahilahi koko inā pono
• Nā hopena anesthesia: He mea maʻamau ʻole akā hiki ke komo i nā pilikia hanu a i ʻole nā hopena maʻi

ʻO nā pilikia kikoʻī e pili ana i ka adrenalectomy e komo pū ana me ka pōʻino i nā ʻōkana kokoke e like me ka puʻupaʻa, ke akepaʻa, a i ʻole ka spleen. Mālama nui kāu kauka lapaʻau e pale i kēia mau mea, akā aia ka pilikia ma muli o kahi o nā adrenal glands.

Inā loaʻa iā ʻoe ka adrenalectomy bilateral, e hoʻomohala ʻoe i kahi maʻi i kapa ʻia ʻo adrenal insufficiency, e koi ana i ka lāʻau lapaʻau hoʻololi hormone i ke ola. ʻOiai he mea weliweli kēia, nui ka poʻe e ola ana i nā ola maʻamau me ka mālama ʻana i ka lāʻau lapaʻau kūpono.

I ka manawa hea wau e ʻike ai i ke kauka ma hope o ka adrenalectomy?

Pono ʻoe e hoʻokaʻaʻike koke i kāu hui mālama ola inā ʻike ʻoe i nā hōʻailona e pili ana ma hope o kāu adrenalectomy. ʻOiai e ola maʻalahi ka hapa nui o nā kānaka, ʻo ka ʻike ʻana i ka wā e ʻimi ai i ke kōkua hiki ke pale i nā pilikia liʻiliʻi mai ka lilo ʻana i nā pilikia koʻikoʻi.

E kelepona koke i kāu kauka inā ʻike ʻoe:

• Nā hōʻailona o ka maʻi: ʻO ke kuni ma luna o 101°F, ka hoʻonui ʻana i ka ʻulaʻula a i ʻole ka mahana a puni nā ʻokiʻoki, a i ʻole ka hoʻokahe ʻana o ka ʻōpala
• ʻEha nui: ʻO ka ʻeha e ʻoi aku ka ʻino ma mua o ka maikaʻi, a i ʻole ʻaʻole i mālama ʻia e nā lāʻau lapaʻau i kuhikuhi ʻia
• Nā pilikia hanu: ʻO ka pōkole o ka hanu, ka ʻeha o ka umauma, a i ʻole ka ʻū mau
• Nā pilikia digestive: ʻO ka nausea mau, ka luaʻi ʻana, a i ʻole ka hiki ʻole ke mālama i nā wai i lalo
• Nā hōʻailona pilikia adrenal: ʻO ka nāwaliwali nui, ka ʻūlū, ka huikau, a i ʻole ka hāʻule ʻana (ʻoi aku ka nui inā ua wehe ʻia nā ʻōpū ʻelua)

E loaʻa iā ʻoe nā manawa hālāwai e mālama ai i kou ola a me nā pae hormone. He mea nui kēia mau hālāwai no ka hōʻoia ʻana e mau ana kou ola ʻana ma ke ala a me ka hoʻoponopono ʻana i nā lāʻau lapaʻau inā pono.

Inā ua loaʻa iā ʻoe ka adrenalectomy bilateral, pono ʻoe e mālama mau i ke koena o kou ola e hōʻoia i ka hana pono ʻana o kāu lāʻau lapaʻau hormone.

Nā nīnau i nīnau pinepine ʻia e pili ana i ka adrenalectomy

Q1: He palekana anei ka adrenalectomy no ka mālama ʻana i nā maʻi adrenal?

ʻAe, ua manaʻo ʻia ka adrenalectomy ke ʻano maʻamau no ka mālama ʻana i ka hapa nui o nā maʻi adrenal a he moʻolelo palekana maikaʻi loa i ka wā e hana ʻia e nā kauka lapaʻau i ʻike ʻia. Hoʻopau maikaʻi ke kaʻina hana i nā maʻi maʻi a me nā maʻi maikaʻi ʻole e hana ana i ka hana nui o ka hormone.

He kiʻekiʻe loa nā helu holomua, me ka hapa nui o nā kānaka e ʻike ana i ka hoʻoponopono piha ʻana o kā lākou mau hōʻailona i loko o nā pule a i ʻole nā mahina ma hope o ke ʻoki ʻana. He hopena maikaʻi loa ka adrenalectomy laparoscopic, me nā helu pilikia haʻahaʻa a me nā manawa hoʻōla wikiwiki i hoʻohālikelike ʻia me ke ʻoki ʻana.

Q2: Hoʻopilikia anei ka wehe ʻana i hoʻokahi ʻāpana adrenal i koʻu pae hormone?

ʻO ka wehe ʻana i hoʻokahi ʻāpana adrenal (unilateral adrenalectomy) ʻaʻole ia e hana i nā pilikia hormone lōʻihi no ka mea hiki i kāu ʻāpana i koe ke hana i nā hormones lawa no nā pono o kou kino. ʻO ka pinepine, ulu iki ka ʻāpana adrenal i koe e uku.

Eia naʻe, pono paha i kou kino i kekahi mau pule a i ʻole mau mahina e hoʻoponopono piha. I kēia manawa, hiki iā ʻoe ke ʻike i kekahi luhi a i ʻole nā hōʻailona maʻalahi, akā hoʻoponopono maʻamau kēia mau mea i ka wā e lawe ai kāu ʻāpana i koe i ka hana hormone piha.

Q3: Pono anei iaʻu ka lāʻau lapaʻau hormone ma hope o ka adrenalectomy?

Inā hoʻoneʻe ʻia hoʻokahi ʻāpana adrenal, ʻaʻole pono ʻoe i ka lāʻau lapaʻau hormone no ka mea hiki i kāu ʻāpana i koe ke hana i nā hormones kūpono. E nānā kāu kauka i kāu pae hormone e hōʻoia i ka hana pono ʻana o nā mea a pau.

Inā wehe ʻia nā ʻōpū adrenal ʻelua, pono ʻoe i ka lāʻau lapaʻau hormone no ke ola me nā lāʻau lapaʻau e like me ka hydrocortisone a me ka fludrocortisone. ʻOiai e koi ana kēia i ka lāʻau lapaʻau i kēlā me kēia lā a me ka nānā mau ʻana, mālama ka hapa nui o nā kānaka i ke ola maikaʻi loa me ka mālama kūpono.

Q4: Pehea ka lōʻihi o ka hoʻōla ʻana mai ka adrenalectomy laparoscopic?

Hoʻi ka hapa nui o nā kānaka i nā hana maʻamau i loko o 2-4 mau pule ma hope o ka adrenalectomy laparoscopic. E manaʻo paha ʻoe e maikaʻi e hoʻi i ka hana i loko o 1-2 mau pule inā he hana pākaukau kāu, akā pono ʻoe e pale i ka hāpai ʻana i nā mea kaumaha no hoʻokahi mahina.

ʻO ka hoʻōla piha ʻana, me ka hoʻōla piha ʻana o nā ʻiʻo o loko a me ka hoʻi ʻana i nā hana a pau, e lawe maʻamau i 6-8 mau pule. Hoʻōla wikiwiki nā ʻoki liʻiliʻi mai ke ʻoki laparoscopic ma mua o ka ʻoki nui e pono ai no ke ʻoki hāmama.

Q5: Hiki i nā ʻōpū adrenal ke hoʻi mai ma hope o ka adrenalectomy?

Aia ka manawa o ka hoʻi hou ʻana o ka ʻōpū i ke ʻano o ka ʻōpū i wehe ʻia. ʻAʻole loa e hoʻi hou nā ʻōpū maikaʻi (adenomas) ma hope o ka wehe ʻana, a ua manaʻo ʻia ka hapa nui o nā kānaka ua ola.

Loaʻa i nā ʻōpū ʻino (adrenocortical carcinomas) ka pilikia kiʻekiʻe o ka hoʻi hou ʻana, ʻo ia ke kumu e pono ai ʻoe i nā scans a me nā hoʻokolohua koko. ʻOiai me nā ʻōpū ʻino, nui ka poʻe e noho ana me ka maʻi ʻaʻai no nā makahiki a i ʻole mau loa ma hope o ka adrenalectomy kūleʻa.