Ni iki cyitwa Adrenalectomy? Impamvu, Uburyo & Gukira

Adrenalectomy ni uburyo bwo kubaga bwo gukuraho imwe cyangwa byombi bya glande ya adrenal. Izi glande ntoya, zifite ishusho y'urukiramende ziba hejuru y'urugingo rwawe rw'impyiko kandi zikora imisemburo y'ingenzi ifasha kugenzura umuvuduko w'amaraso yawe, imikorere y'umubiri, n'uburyo usubiza ku ihungabana. Iyo izi glande zigaragaza ibibyimba cyangwa zigakora imisemburo myinshi cyane, kubaga birashobora kuba uburyo bwiza bwo kugarura ubuzima bwawe no gukumira ingorane.

Ni iki cyitwa adrenalectomy?

Adrenalectomy bisobanura gukuraho glande ya adrenal mu kubaga. Umuganga ushinzwe kubaga ashobora gukuraho glande imwe gusa (unilateral adrenalectomy) cyangwa glande zombi (bilateral adrenalectomy), bitewe n'uburwayi bwawe bwihariye. Ubu buryo bufasha kuvura indwara zitandukanye za adrenal zitashobora kuvurwa n'imiti gusa.

Glande yawe ya adrenal ingana n'igishishwa cy'igiti kandi ipima garama 4-5 kuri buri imwe. Zikora imisemburo y'ingenzi nka cortisol, aldosterone, na adrenaline ifasha umubiri wawe gukora neza. Iyo izi glande zirwaye cyangwa zikora cyane, kuzikuraho birashobora kurokora ubuzima.

Kuki adrenalectomy ikorwa?

Adrenalectomy iba ngombwa iyo glande yawe ya adrenal igaragaje ibibazo bikomeye byangiza ubuzima bwawe. Impamvu isanzwe ni ugukuraho ibibyimba, byaba ari ibifite kanseri cyangwa bitariho ariko bigatera umusaruro mwinshi w'imisemburo.

Dore indwara z'ingenzi zishobora gusaba iyi operasiyo:

• Udukozi twa adrenal: Udukoko twombi twa kanseri (adrenocortical carcinoma) n'utudokozi tudafite uburozi (adenomas) dutanga imisemburo myinshi cyane
• Pheochromocytoma: Udukozi dusohora adrenaline nyinshi cyane, bigatera umuvuduko mwinshi w'amaraso uteye akaga
• Cushing's syndrome: Iyo adrenal yawe itanga cortisol nyinshi cyane, bigatuma umubiri wiyongera ibiro, umuvuduko mwinshi w'amaraso, na diyabete
• Conn's syndrome: Gutanga aldosterone nyinshi cyane bitera umuvuduko mwinshi w'amaraso ukabije na potasiyumu nkeya
• Adrenal metastases: Iyo kanseri iva mu bindi bice by'umubiri wawe ikwirakwira mu ngingo za adrenal

Mu buryo butajegajega, abantu bamwe bakeneye adrenalectomy ya bilateral kubera indwara ikaze ya Cushing iyo izindi nshuti zananiwe. Muganga wawe azagereranya neza inyungu n'ibibazo mbere yo kugusaba iyi ntambwe ikomeye.

Ni iki gikorerwa adrenalectomy?

Umuganga wawe ushinzwe kubaga ashobora gukora adrenalectomy akoresheje uburyo butandukanye, hamwe no kubaga kwa laparoscopic (gukoresha uburyo butagira ingaruka nyinshi) ari bwo buryo bukoreshwa cyane uyu munsi. Guhitamo biterwa n'ubunini n'ahantu hakorerwa igikoko, ubuzima bwawe muri rusange, n'ubuhanga bw'umuganga wawe.

Ibi nibyo bikunda kuba mugihe cyo gukora ubu buryo:

1. Anesthesia: Uzasabwa anesthesia rusange kugirango uryame neza mugihe cyo kubaga
2. Gushyirwa ahantu: Umuganga wawe ushinzwe kubaga azagushyira kuruhande rwawe cyangwa ukubita hasi kugirango ugere ku ngingo za adrenal
3. Gukata: Hazakorwa ibikomere bito (laparoscopic) cyangwa igikomere kimwe kinini (kubaga gufunguye)
4. Gukuraho ingingo: Umuganga wawe ushinzwe kubaga atandukanya neza ingingo ya adrenal n'ibindi bice by'umubiri n'imitsi y'amaraso
5. Gufunga: Ibikomere bifungwa hamwe na sutures cyangwa colle y'ubuvuzi

Kubaga kwa laparoscopic bikoresha ibikomere bito 3-4 n'agakamera gato, bigatuma umuntu atagira ububabare bwinshi kandi agahita akira vuba. Kubaga bisanzwe bisaba igikomere kinini ariko bishobora kuba ngombwa iyo hari ibibyimba binini cyane cyangwa igihe hakekwa kanseri.

Uburyo bwose hamwe busanzwe bufata amasaha 1-4, bitewe n'uburyo ikibazo cyawe kimeze niba urugingo rumwe cyangwa byombi bikenera gukurwaho.

Ni gute witegura kubagwa adrenalectomy?

Kwitegura kubagwa adrenalectomy bikubiyemo intambwe nyinshi z'ingenzi kugirango ubone ko kubagwa kwawe kugenda neza kandi mu buryo bwizewe. Itsinda ryawe ry'ubuzima rizagufasha mu ntambwe zose, ariko ibi nibyo ushobora kwitega muri rusange mu byumweru bibanziriza uburyo bwawe.

Kwitegura kwawe birashoboka ko bizakubiyemo izi ntambwe z'ingenzi:

• Ibizamini mbere yo kubagwa: Ibizamini by'amaraso, ibizamini byerekana ishusho, n'ibizamini by'imikorere y'umutima kugirango hasuzumwe ubuzima bwawe muri rusange
• Guhindura imiti: Muganga wawe ashobora kugusaba imiti yo kugenzura umuvuduko w'amaraso cyangwa urugero rwa hormone mbere yo kubagwa
• Gutegura gusimbuza hormone: Niba urugingo rwombi rukurwaho, uzatangira kwiga kubyerekeye ubuvuzi bwo gusimbuza hormone ubuzima bwose
• Amabwiriza y'imirire: Uzakenera kwirinda kurya mu masaha 8-12 mbere yo kubagwa
• Isesengura ry'imiti: Imwe mu miti, cyane cyane iyo ituma amaraso ataguma, ishobora gukenera guhagarikwa by'agateganyo

Niba ufite pheochromocytoma, muganga wawe azagusaba imiti yihariye yitwa alpha-blockers mu byumweru byinshi mbere yo kubagwa. Izi zifasha kwirinda umuvuduko w'amaraso mwinshi mu gihe cyo kubagwa.

Kora uko ushoboye kugirango utegure umuntu uzakujyana mu rugo kandi agumane nawe umunsi umwe cyangwa ibiri nyuma yo kubagwa. Kugira ubufasha mu gihe cyo koroherwa bituma umuntu agira ihumure n'umutekano mwinshi.

Ni gute koroherwa nyuma ya adrenalectomy?

Kuzanzamuka nyuma yo kubagwa adrenalectomy biratandukana bitewe niba warabazwe na laparoscopic cyangwa kubagwa gusanzwe, ariko abantu benshi babaho neza cyane bafite ubuvuzi bukwiye n'ubwihangane. Umubiri wawe ukeneye igihe cyo gukira kubagwa no kumenyera impinduka zose za hormone.

Ibi nibyo ushobora kwitega mugihe cyo gukira:

• Kuguma mu bitaro: Iminsi 1-2 kubagwa na laparoscopic, iminsi 3-5 kubagwa gusanzwe
• Kugenzura ububabare: Imiti yandikwa na muganga yo kugabanya ububabare muminsi yambere, hanyuma ibindi byo kugura
• Kwirinda ibikorwa: Nta gukora ibintu biremereye (birenze ibiro 10) muminsi 2-4
• Kugaruka kukazi: Icyumweru 1-2 kubakora akazi ko kumeza, ibyumweru 4-6 kubakora akazi gakomeye
• Kuzanzamuka neza: Abantu benshi bumva bameze neza neza muminsi 6-8

Niba waravanyemo byombi bya adrenal glands, uzakenera gutangira imiti isimbura hormone ako kanya. Ibi bikubiyemo gufata imiti ya buri munsi kugirango isimbure hormone za adrenal glands zisanzwe zikora.

Itsinda ryabakubaze rizaguha amabwiriza arambuye yerekeye kwita ku gikomere, igihe cyo gusubukura ibikorwa bisanzwe, n'ibimenyetso byo kwitondera. Gukurikiza izi ngamba neza bifasha kugera ku musaruro mwiza.

Mbese ni izihe ngaruka n'ingorane za adrenalectomy?

Kimwe no kubagwa gukomeye, adrenalectomy ifite ingaruka zimwe, ariko ingorane zikomeye ntizisanzwe iyo zikorwa nabaganga bafite uburambe. Kumva izi ngaruka bifasha gufata ibyemezo bifitiye akamaro kubyerekeye ubuvuzi bwawe no kumenya icyo kwitondera mugihe cyo gukira.

Ingaruka zisanzwe zishobora kubaho mugihe cyo kubagwa icyo aricyo cyose zirimo:

• Ukuva amaraso: Nubwo bitaba kenshi, kuva amaraso menshi bishobora gusaba ko wongererwa amaraso
• Udukoko: Udukoko two mu gice cyabagirijwe tubaho mu buryo butarenze 5% by'ibihe
• Uduce tw'amaraso: Ibyago bigabanijwe no kwimuka hakiri kare no kunywa imiti igabanya amaraso niba bikenewe
• Uko umubiri witwara ku miti ituma umuntu atagira ubwenge: Biragoye ariko bishobora gutera ingorane zo guhumeka cyangwa ibimenyetso byo kwibasirwa n'umubiri

Ibyago byihariye bifitanye isano no gukuraho imitsi y'uruhu harimo kwangiza ibice byegereye nk'impyiko, umwijima, cyangwa urwagashya. Umuganga wawe yitwararika cyane kugira ngo arinde ibi bice, ariko ibyago birahari bitewe n'aho imitsi y'uruhu iherereye.

Niba ufite imitsi y'uruhu yakuweho ku mpande zombi, uzagira indwara yitwa adrenal insufficiency, isaba ko umuntu akomeza gufata imiti isimbura imisemburo ubuzima bwe bwose. Nubwo ibi byumvikana biteye ubwoba, abantu benshi babaho ubuzima busanzwe neza bafashwe neza n'imiti.

Ni ryari nkwiriye kubona umuganga nyuma yo gukuraho imitsi y'uruhu?

Ugomba guhita uvugana n'ikipe yawe y'ubuvuzi niba ubonye ibimenyetso bibangamiye nyuma yo gukuraho imitsi y'uruhu. Nubwo abantu benshi bakira neza, kumenya igihe cyo gushaka ubufasha bishobora gukumira ibibazo bito guhinduka ibibazo bikomeye.

Hamagara umuganga wawe ako kanya niba ubonye:

• Ibimenyetso byo kwibasirwa n'udukoko: umuriro uri hejuru ya 101°F, umutuku wiyongera cyangwa ubushyuhe buva ku gice cyabagirijwe, cyangwa amashyira ava mu gikomere
• Urubavu rukabije: Uburibwe burushaho kuba bubi aho gukira, cyangwa butagenzurwa n'imiti yategetswe
• Ingorane zo guhumeka: Guhumeka bigufi, kuribwa mu gituza, cyangwa inkorora ihoraho
• Ibibazo byo mu gifu: Isesemi ihoraho, kuruka, cyangwa kutabasha gukomeza kunywa amazi
• Ibimenyetso bya adrenal crisis: Intege nke zikabije, isereri, urujijo, cyangwa guta ubwenge (cyane cyane niba imitsi yombi yakuweho)

Uzajya ufite gahunda yo gusubira kwa muganga kugira ngo bagenzure uko urimo gukira n'uko imisemburo yawe ihagaze. Izo gahunda ni ingenzi kugira ngo barebe ko ukira neza kandi banahindure imiti niba bibaye ngombwa.

Niba warabazwe adrenalectomy ku mpande zombi, uzakenera kugenzurwa buri gihe ubuzima bwawe bwose kugira ngo barebe ko imiti ikoreshwa mu gusimbura imisemburo ikora neza.

Ibibazo bikunze kubazwa kuri adrenalectomy

Q1: Ese adrenalectomy ni nziza mu kuvura ibibyimba byo mu ngingo ya adrenal?

Yego, adrenalectomy ifatwa nk'uburyo bwiza bwo kuvura ibibyimba byinshi byo mu ngingo ya adrenal kandi ifite amateka meza y'umutekano iyo ikozwe n'abaganga babifitiye ubunararibonye. Iyo mirimo ikuraho neza ibibyimba bya kanseri n'ibitari kanseri bitera imisemburo myinshi.

Uko bikorwa bigenda neza cyane, abantu benshi bagira ibimenyetso byose bikira burundu mu byumweru bike cyangwa amezi nyuma yo kubagwa. Adrenalectomy ikorwa hakoreshejwe uburyo bwa laparoscopic ifite ibisubizo byiza cyane, hamwe n'umubare muto w'ingorane n'igihe gito cyo gukira ugereranije no kubagwa bisanzwe.

Q2: Ese gukuraho ingingo imwe ya adrenal bigira ingaruka ku misemburo yanjye?

Gukuraho ingingo imwe ya adrenal (unilateral adrenalectomy) mubisanzwe ntibitera ibibazo by'imisemburo by'igihe kirekire kuko ingingo yawe isigaye ishobora gukora imisemburo ihagije ku byo umubiri wawe ukeneye. Ingingo yawe ya adrenal isigaye akenshi ikura gato kugira ngo yishyure.

Ariko, umubiri wawe ushobora gukenera ibyumweru bike cyangwa amezi kugira ngo wimenyere neza. Muri iki gihe, ushobora kumva unaniwe cyangwa ufite ibimenyetso bike, ariko ibi mubisanzwe birakira uko ingingo yawe isigaye ifata imisemburo yose.

Q3: Ese nzakenera imiti isimbura imisemburo nyuma ya adrenalectomy?

Niba gusa ingingo imwe ya adrenal ikuweho, mubisanzwe ntuzakenera imiti isimbura imisemburo kuko ingingo yawe isigaye ishobora gukora imisemburo ihagije. Muganga wawe azagenzura urwego rw'imisemburo yawe kugira ngo arebe ko byose bikora neza.

Niba imitsi yombi y'imisemburo ikurwaho, uzakenera imiti yongera imisemburo ubuzima bwawe bwose, nk'urugero hydrocortisone na fludrocortisone. Nubwo ibi bisaba imiti ya buri munsi no gukurikiranwa buri gihe, abantu benshi bagira ubuzima bwiza cyane iyo bavuwe neza.

Q4: Bifata igihe kingana iki kugira ngo umuntu akire nyuma yo kubagwa adrenalectomy hakoreshejwe uburyo bwa laparoscopic?

Abantu benshi basubira mu bikorwa bisanzwe nyuma y'ibyumweru 2-4 nyuma yo kubagwa adrenalectomy hakoreshejwe uburyo bwa laparoscopic. Ushobora kumva umeze neza bihagije kugira ngo usubire ku kazi mu byumweru 1-2 niba ufite akazi ko mu biro, nubwo uzakenera kwirinda kuzamura ibintu biremereye mu gihe cy'ukwezi kumwe.

Kuzanzamuka neza, harimo gukira neza kw'imitsi yo imbere no gusubira mu bikorwa byose, mubisanzwe bifata ibyumweru 6-8. Ibyo gukata bito biva mu kubagwa hakoreshejwe uburyo bwa laparoscopic bikira vuba cyane kurusha icyo gukata kinini gisabwa mu kubagwa bisanzwe.

Q5: Ibimeme byo ku misemburo bishobora kugaruka nyuma ya adrenalectomy?

Icyago cyo kugaruka kw'ibimeme giterwa n'ubwoko bw'igimeme cyavanyweho. Ibimeme byiza (adenomas) ntibigaruka na rimwe nyuma yo kubivana byuzuye, kandi abantu benshi bafatwa nk'abakize.

Ibimeme bibi (adrenocortical carcinomas) bifite ibyago byinshi byo kugaruka, niyo mpamvu uzakenera gukurikiranwa buri gihe no gukoresha ibizamini by'amaraso. Nubwo hari ibimeme bikaze, abantu benshi baguma badafite kanseri imyaka myinshi cyangwa burundu nyuma yo kubagwa adrenalectomy neza.