Yini i-Nephrectomy? Inhloso, Inqubo & Ukululama

I-nephrectomy ukususwa ngokuhlinzwa kwesinye noma womabili amaphaphu. Le nqubo iba yimpoqo lapho iphaphu lonakele kakhulu, ligula, noma libeka engozini yezempilo engakwazi ukulawulwa ngeminye imithi. Ngenkathi umcabango wokususwa kwephaphu ungase uzizwe ukhathaza, abantu abaningi baphila impilo egcwele, enempilo ngephaphu elilodwa, futhi izindlela zokuhlinza zesimanje zenze le nqubo yaphepha futhi yasebenza ngempumelelo kunangaphambili.

Yini i-nephrectomy?

I-Nephrectomy yinqubo yokuhlinzwa lapho odokotela besusa khona konke noma ingxenye yephaphu emzimbeni wakho. Udokotela ohlinzayo wenza le ncomo lapho iphaphu lonakala kakhulu ukuthi lingasebenzi kahle noma lapho ukulishiya endaweni kungalimaza impilo yakho yonke.

Kunezinhlobo eziningana zezinqubo ze-nephrectomy, ngayinye eyenzelwe izidingo zakho ezithile zezokwelapha. I-partial nephrectomy isusa kuphela ingxenye egulayo yephaphu, igcina inyama enempilo ngangokunokwenzeka. I-nephrectomy elula isusa lonke iphaphu, kuyilapho i-radical nephrectomy isusa iphaphu kanye nezicubu ezizungezile, okuhlanganisa i-adrenal gland kanye nama-lymph nodes aseduze.

Izindaba ezinhle ukuthi ungaphila impilo ejwayelekile ngokuphelele ngephaphu elilodwa elinempilo. Iphaphu lakho elisele lizothatha kancane kancane umsebenzi wamaphaphu womabili, nakuba le nqubo ithatha isikhathi futhi umzimba wakho udinga ukusekelwa ngesikhathi sokulungiswa.

Kungani kwenziwa i-nephrectomy?

Odokotela batusa i-nephrectomy lapho ukugcina iphaphu kungabangela umonakalo omkhulu kunokuwususa. Lesi sinqumo asenziwa kalula, futhi ithimba lakho lezokwelapha lizohlola zonke ezinye izinketho zokwelapha kuqala.

Izizathu ezivame kakhulu ze-nephrectomy zihlanganisa umdlavuza wezinso, ukulimala okukhulu kwezinso ngenxa yokulimala, kanye nesifo sezinso esingapheli esiqhubeke ngaphandle kokwelashwa. Ngezinye izikhathi, abantu bakhetha ukunikela ngephaphu ukusiza omunye umuntu, okubizwa ngokuthi i-living donor nephrectomy.

Ake sibheke izimo ezithile ezingaholela kulolu hlelo:

• Umdlavuza wezinso ongazange usabalale kwamanye amalungu omzimba
• Amathambo ezinso amakhulu avimba ukugeleza komchamo ngokuphindaphindiwe
• Isifo sezinso se-polycystic esibangela ubuhlungu nezinkinga
• Umonakalo wezinso ngenxa yegazi eliphezulu noma isifo sikashukela
• Izifo ezinzima ezinso ezingaphenduli ekwelashweni
• Ukwelashwa kwezinso ngenxa yezingozi noma ukulimala
• Izinso ezingasebenzi ezandisa ingozi yokutheleleka

Ezimweni ezingavamile, i-nephrectomy ingase idingeke ngezimo zofuzo njenge-Wilms tumor ezinganeni noma ukukhubazeka okukhulu okuthinta ukuthuthukiswa kwezinso. Udokotela wakho uzohlola ngokucophelela isimo sakho esithile futhi axoxe ngesizathu sokuthi i-nephrectomy iyona ndlela engcono kakhulu yezempilo yakho.

Yini inqubo ye-nephrectomy?

Inqubo ye-nephrectomy ngokuvamile ithatha amahora angu-2 kuya kwangu-4, kuye ngobunzima becala lakho. Udokotela ohlinzayo uzokhetha indlela engcono kakhulu yokuhlinza ngokusekelwe esimweni sakho, impilo yonke, nesizathu senqubo.

Ama-nephrectomies amaningi namuhla enziwa kusetshenziswa izindlela ezingahlaseli kakhulu ezibizwa ngokuthi ukuhlinzwa kwe-laparoscopic. Udokotela ohlinzayo wenza ukusikeka okuncane emzimbeni wakho futhi usebenzisa ikhamera encane namathuluzi akhethekile ukususa izinso. Le ndlela ibangela ubuhlungu obuncane, izibazi ezincane, nokululama okusheshayo uma kuqhathaniswa nokuhlinzwa okuvulekile kwendabuko.

Ngesikhathi senqubo, uzobe uphansi ngaphansi kwe-anesthesia ejwayelekile, ngakho ngeke uzizwe lutho. Udokotela ohlinzayo uzoxhuma ngokucophelela izinso emithanjeni yegazi kanye ne-ureter (ithumbu elithwala umchamo emathunjini akho) ngaphambi kokuyisusa. Ithimba lokuhlinza liqapha izimpawu zakho ezibalulekile kuyo yonke inqubo.

Kwezinye izimo, udokotela ohlinzayo angase adinge ukusebenzisa ukuhlinzwa okuvulekile, okubandakanya ukusika okukhulu. Le ndlela ngezinye izikhathi iyadingeka kuma-tumor amakhulu kakhulu, izicubu eziningi ezivela ekuhlinzweni kwangaphambilini, noma izimo zezokwelapha eziyinkimbinkimbi ezenza ukuhlinzwa kwe-laparoscopic kube yingozi kakhulu.

Ungalungiselela kanjani i-nephrectomy yakho?

Ukulungiselela i-nephrectomy kuhilela izinyathelo eziningana ezibalulekile ezisiza ukuqinisekisa umphumela ongcono kakhulu. Ithimba lakho lezokwelapha lizokuqondisa esinyathelweni ngasinye, kodwa ukuqonda okulindelekile kungakusiza ukuthi uzizwe uqiniseka futhi ulungile.

Ukulungiselela kwakho kuzoqala emasontweni ngaphambi kokuhlinzwa ngezivivinyo ezihlukahlukene nokuhlolwa kwezokwelapha. Lezi zivivinyo zisiza udokotela ohlinzayo ukuthi aqonde impilo yakho yonke futhi ahlele indlela ephephe kakhulu yenqubo yakho.

Nakhu ongakulindela ngesikhathi sokulungiselela kwakho:

• Ukuhlolwa kwegazi ukuhlola ukusebenza kwezinso nempilo yonke
• Izifundo zokucabanga njenge-CT scans noma i-MRIs ukwenza imephu ye-anatomy yakho
• Izivivinyo zomsebenzi wenhliziyo namaphaphu ukuqinisekisa ukuthi ulungele ukuhlinzwa
• Ukwethula nodokotela wakho we-anesthesiologist ukuze nixoxe ngokuphatha ubuhlungu
• Ukulungiswa kwemithi, ikakhulukazi ama-blood thinners
• Ukuvinjelwa kokudla kuqala ngobusuku obandulela ukuhlinzwa
• Ukuhlelwa kokunakekelwa ngemuva kokuhlinzwa nokuthuthwa

Udokotela wakho uzohlinzeka ngemiyalelo ethile mayelana nokudla, ukuphuza, nokuthatha imithi ngaphambi kokuhlinzwa. Ukulandela lezi ziqondiso ngqo kusiza ukuvimbela izinkinga futhi kuqinisekisa ukuthi ukuhlinzwa kwakho kuqhubeka njengoba kuhleliwe.

Ungawafunda kanjani imiphumela yakho ye-nephrectomy?

Ukuqonda imiphumela yakho ye-nephrectomy kuhilela ukubheka kokubili umphumela wokuhlinzwa osheshayo kanye nemiphumela yesikhathi eside empilweni yakho. Udokotela wakho ohlinzayo uzochaza abakutholile ngesikhathi senqubo nokuthi kusho ukuthini ngekusasa lakho.

Uma i-nephrectomy yakho yenziwe ukwelapha umdlavuza, ithimba lakho labahlinzi lizohlola izicubu zezinso ezisusiwe ngaphansi kwe-microscope. Lokhu kuhlaziywa, okubizwa ngokuthi umbiko we-pathology, kunikeza imininingwane enemininingwane ngohlobo nesigaba somdlavuza, okusiza ukunquma ukuthi ngabe udinga ukwelashwa okwengeziwe.

Umbiko we-pathology ngokuvamile uhlanganisa imininingwane ngosayizi we-tumor, izinga (ukuthi amaseli omdlavuza abukeka enjani), nokuthi umdlavuza usabalale yini ezicutshini eziseduze. Udokotela wakho uzochaza lezi zinto ngamagama alula futhi axoxe ngalokho okushiwo yikho ngokuqagela kwakho kanye nohlelo lokwelashwa.

Nge-nephrectomies engeyona umdlavuza, ukugxila kushintshela ekutheni izinso zakho ezisele zisebenza kahle kangakanani kanye nentuthuko yakho yokululama iyonke. Ithimba lakho lezokwelapha lizogada ukusebenza kwezinso zakho ngokuhlolwa kwegazi okuvamile futhi liqinisekise ukuthi umzimba wakho uzivumela kahle ukuba nezinso eyodwa.

Ungayithuthukisa kanjani ukululama kwakho ngemuva kwe-nephrectomy?

Ukwelulama ngemuva kwe-nephrectomy kuyinqubo kancane kancane edinga ukubekezela nokuzibophezela ekulandeleni isiqondiso sethimba lakho lezokwelapha. Abantu abaningi bangalindela ukubuyela emisebenzini ejwayelekile phakathi kwamasonto angu-4 kuya kwangu-6, nakuba wonke umuntu ephola ngejubane lakhe.

Ukwelulama kwakho ngokushesha kuzogxila ekuphatheni ubuhlungu, ekuvikeleni izinkinga, nasekuvumeleni umzimba wakho ukuba uphole. Cishe uzohlala esibhedlela izinsuku eziyi-1 kuya kwezi-3 ngemuva kokuhlinzwa kwe-laparoscopic, noma izinsuku eziyi-3 kuya kwezi-5 ngemuva kokuhlinzwa okuvulekile.

Nakhu okuyinhloko kokululama okuphumelelayo:

• Ukuphuza imithi yokubamba ubuhlungu njengoba kuqondiswe
• Ukwandisa kancane kancane umsebenzi womzimba uqala ngokuhamba okufushane
• Ukugwema ukuphakamisa okunzima amasonto angu-4 kuya kwangu-6
• Ukugcina ukusikeka kokuhlinzwa kuhlanzekile futhi komile
• Ukuya kuwo wonke ama-aphoyintimenti okulandelayo
• Uhlala unamanzi futhi udla ukudla okunomsoco
• Ukuqapha izimpawu zezinkinga ezinjengomkhuhlane noma ubuhlungu obukhulu

Izinso zakho ezisele zizoqala kancane kancane ukuthatha umsebenzi wazo zombili izinso, inqubo ethatha izinyanga eziningana. Ngesikhathi lesi, kubalulekile ukuvikela impilo yezinso zakho ngokuhlala unamanzi, udle ukudla okunempilo, futhi ugweme imithi engase ilimaze izinso zakho.

Yini umphumela ongcono kakhulu ngemuva kwe-nephrectomy?

Umphumela ongcono kakhulu ngemuva kwe-nephrectomy ukuphola okuphelele ngaphandle kwezinkinga kanye nokujwayela ngempumelelo impilo ngesinso esisodwa. Abantu abaningi bafinyelela le nhloso futhi baqhubeke nokuphila impilo ejwayelekile, enempilo.

Impumelelo ngemuva kwe-nephrectomy isho izinto ezahlukene ngokuya ngokuthi kungani ube nale nqubo. Uma ubenomdlavuza, impumelelo ihlanganisa ukususwa okuphelele komdlavuza ngaphandle kwesidingo sokwelashwa okwengeziwe. Ezinye izimo, impumelelo isho ukukhululeka ezimpawini kanye nokuthuthukiswa kwekhwalithi yempilo.

Impumelelo yesikhathi eside ihlanganisa ukugcina impilo enhle yezinso ngokukhetha indlela yokuphila kanye nokunakekelwa kwezempilo okuvamile. Isinso sakho esisele singakwazi ukuphatha umsebenzi wazo zombili izinso, kodwa kubalulekile ukusivikela ekulimaleni ngokudla okufanele, ukuthatha amanzi, nokugwema izinto ezingase zilimaze ukusebenza kwezinso.

Abantu abaningi babuyela kuyo yonke imisebenzi yabo ejwayelekile, okuhlanganisa umsebenzi, ukuzivocavoca, nezinto abazithandayo, ezinyangeni ezimbalwa ngemuva kokuhlinzwa. Ngokunakekelwa okufanele, isinso sakho esisele kufanele sikusebenzele kahle iminyaka eminingi ezayo.

Yiziphi izici eziyingozi zezinkinga ze-nephrectomy?

Ukuqonda izici eziyingozi zezinkinga ze-nephrectomy kukusiza wena nethimba lakho lezokwelapha ukuthi nithathe izinyathelo zokunciphisa izinkinga ezingaba khona. Ngenkathi i-nephrectomy ngokuvamile iphephile, izici ezithile zingakhuphula amathuba okuba nezinkinga.

Ubudala nesimo sempilo esiphelele kuyizici ezibalulekile ezithonya ingozi yakho. Abantu abadala kanye nabantu abanezimo zempilo eziningi bangase babhekane nezingozi eziphakeme, kodwa lokhu akusho ukuthi ukuhlinzwa akuphephile - kusho nje ukuthi ithimba lakho lezokwelapha lizothatha izinyathelo zokuphepha ezengeziwe.

Nawa amafektri ayinhloko okufanele uwazi:

• Ubudala obukhulu (ngaphezu kweminyaka engama-70)
• Isifo senhliziyo noma samaphaphu
• Isifo sikashukela noma umfutho wegazi ophezulu
• Ukukhuluphala ngokweqile
• Ukuhlinzwa kwesisu kwangaphambilini
• Ukubhema noma ukusebenzisa utshwala ngokweqile
• Izinkinga zokujiya kwegazi
• Isifo sezinso esingamahlalakhona esinsweni esisele

Ukuba nezici eziyingozi akusho ukuthi nakanjani uzoba nezinkinga - kumane kusho ukuthi ithimba lakho lezokwelapha lizokuqapha ngokucophelela futhi lithathe izinyathelo ezengeziwe zokukugcina uphephile. Abantu abaningi abanezici eziyingozi eziningi banokuhlinzwa kwezinso okuphumelelayo ngaphandle kwezinkinga.

Ingabe kungcono ukuba nokuhlinzwa kwezinso okuyingxenye noma okuphelele?

Ukukhetha phakathi kokuhlinzwa kwezinso okuyingxenye nokuphelele kuncike esimweni sakho sezokwelapha esithile nokuthi yini ephephe kakhulu empilweni yakho yesikhathi eside. Uma kungenzeka, odokotela bahlinza ngohlobo lokuhlinzwa kwezinso okuyingxenye ngoba kugcina umsebenzi wezinso.

Ukuhlinzwa kwezinso okuyingxenye kuvame ukuba yindlela engcono kakhulu yezimila ezincane zezinso, izinhlobo ezithile zesifo sezinso, noma uma unesinso esisodwa esisebenzayo kuphela. Le ndlela isusa kuphela ingxenye enesifo ngenkathi igcina inyama yezinso enempilo ngangokunokwenzeka.

Ukuhlinzwa kwezinso okuphelele kuba ngcono uma lonke izinso ligula, uma izimila zikhulu kakhulu ukuthi zingasuswa ngengxenye, noma uma izinso zibeka ingozi yezempilo engakwazi ukulawulwa nganoma iyiphi enye indlela. Udokotela ohlinzayo uzohlola ngokucophelela isimo sakho futhi ancome indlela enikeza ibhalansi engcono kakhulu yokuphepha nokusebenza kahle.

Isinqumo sibuye sicabangele umsebenzi wakho wonke wezinso nokuthi ngabe inyama yakho yezinso esele izokwanela yini ukugcina impilo yakho. Ithimba lakho lezokwelapha lizoxoxa ngalezi zinto nawe futhi lichaze ukuthi kungani lincoma indlela ethile.

Ziyini izinkinga ezingaba khona zokuhlinzwa kwezinso?

Noma i-nephrectomy ngokuvamile iphephile, njenganoma yikuphi ukuhlinzwa, ingaba nezinkinga. Ukuqonda lezi zinto ezingenzeka kukusiza ukuthi uqaphele izimpawu zokuxwayisa futhi ufune usizo ngokushesha uma kudingeka.

Izinkinga eziningi zincane futhi ziyaxazululeka ngokwelashwa okufanele. Izinkinga ezinzima azivamile, ikakhulukazi uma ukuhlinzwa kwenziwa odokotela abanolwazi ezikhungweni zezokwelapha ezinempahla.

Nazi izinkinga ezingenzeka okufanele uziqaphele:

• Ukuphuma igazi ngesikhathi noma ngemva kokuhlinzwa
• Ukutheleleka endaweni yokuhlinzwa
• Amaqhubu egazi emilenzeni noma emaphashini
• Ukwenzakala kwezitho eziseduze ngesikhathi sokuhlinzwa
• I-Hernia endaweni yokusika
• Ubuhlungu obungapheli noma ukuba ndikindiki
• Ushintsho ekusebenzeni kwezinso esinsweni esisele

Izinkinga ezingavamile kodwa ezinzima zingabandakanya ukuphuma igazi okukhulu okudinga ukumpontshwa kwegazi, umkhuhlane wamaphaphu, noma ukwehluleka kwezinso esinsweni esisele. Ithimba lakho lezokwelapha lizokuqapha ngokucophelela ngezinkinga ezinjalo futhi lithathe isinyathelo ngokushesha uma zenzeka.

Iningi labantu lithola ukwelulama ku-nephrectomy ngaphandle kwezinkinga ezinkulu. Udokotela ohlinzayo uzoxoxa ngezici zakho eziyingozi futhi achaze ukuthi yiziphi izinyathelo abazithathayo ukunciphisa izinkinga ezingenzeka.

Kufanele ngibone nini udokotela ngemva kwe-nephrectomy?

Kufanele uthinte udokotela wakho ngokushesha uma uhlangabezana nanoma yiziphi izimpawu ezikhathazayo ngemva kwe-nephrectomy. Ngenkathi ukungakhululeki okuthile kujwayelekile ngesikhathi sokululama, izimpawu ezithile zingase zibonise izinkinga ezidinga ukunakekelwa kwezokwelapha okusheshayo.

Ithimba lakho lezokwelapha lizohlela ama-aphoyintimenti okulandelayo njalo ukuze liqaphe ukululama kwakho futhi lihlole ukusebenza kwezinso zakho. Lawa ma-aphoyintimenti abalulekile ekubambeni izinkinga ezingenzeka kusenesikhathi nasekuqinisekiseni impilo yakho yesikhathi eside.

Xhumana nodokotela wakho ngokushesha uma uhlangabezana:

• Umkhuhlane ongaphezu kuka-101°F (38.3°C)
• Ubuhlungu obukhulu noma obuqhubekayo
• Ukuphuma kwegazi eliningi noma uketshezi oluvela ezindaweni zokuhlinzwa
• Izimpawu zokutheleleka njengobubomvu, ukufudumala, noma amanyela
• Ukuphefumula kanzima noma ubuhlungu besifuba
• Ukuvuvukala komlenze noma ubuhlungu
• Isicanucanu nokuhlanza okungami
• Ushintsho emikhubeni yokuchama

Ukuqapha isikhathi eside kubaluleke ngokufanayo. Uzodinga ukuhlolwa njalo ukuze uqaphe ukusebenza kwezinso zakho, umfutho wegazi, nempilo yakho yonke. Lokhu kuhlolwa kusiza ekuqinisekiseni ukuthi isinso sakho esisele sihlala sinempilo futhi sibambe noma yiziphi izinkinga ngaphambi kokuba zibe zimbi.

Imibuzo evame ukubuzwa mayelana ne-nephrectomy

Q.1 Ingabe i-nephrectomy ilungele umdlavuza wezinso?

Yebo, i-nephrectomy ivame ukuba yindlela yokwelapha esebenza kahle kakhulu umdlavuza wezinso, ikakhulukazi lapho umdlavuza ukhawulelwe esinso. Ukususwa ngokuhlinzwa kunikeza ithuba elingcono kakhulu lokuphulukiswa ezimweni eziningi zomdlavuza wezinso.

Uhlobo lwe-nephrectomy luncike ngosayizi nendawo yethumba. I-nephrectomy engaphelele ithandwa ngamathumba amancane, kuyilapho imidlavaza emikhulu noma enolaka ingase idinge ukususwa okuphelele kwesinso. Udokotela wakho we-oncologist uzosebenza nodokotela ohlinzayo ukunquma indlela engcono kakhulu yesimo sakho esithile.

Q.2 Ingabe ukuba nesinso esisodwa kubangela izinkinga zempilo?

Abantu abaningi abanesinso esisodwa baphila impilo ejwayelekile, enempilo ngaphandle kwezinkinga ezinkulu zempilo. Isinso sakho esisele sizothatha umsebenzi wazo zombili izinso kancane kancane futhi singakwazi ukusingatha lo msebenzi owengeziwe ngempumelelo.

Noma kunjalo, kubalulekile ukuvikela isinso sakho esisele ngokukhetha indlela yokuphila enempilo. Lokhu kufaka phakathi ukuhlala unamanzi, ukudla ukudla okunomsoco, ukuzivocavoca njalo, nokugwema izinto ezingase zilimaze ukusebenza kwezinso. Ukuhlolwa kwezokwelapha njalo kusiza ekuqapheni impilo yakho yezinso ngokuhamba kwesikhathi.

Q.3 Kuthatha isikhathi esingakanani ukululama ku-nephrectomy?

Isikhathi sokululama siyahluka ngokuya ngohlobo lokuhlinzwa kanye nempilo yakho yonke. Abantu abaningi bangakwazi ukubuyela emisebenzini elula phakathi kwamasonto angu-1 kuya kwangu-2 futhi baqhubeke nemisebenzi ejwayelekile phakathi kwamasonto angu-4 kuya kwangu-6 ngemva kwe-laparoscopic nephrectomy.

Ukuhlinzwa okuvulekile ngokuvamile kudinga isikhathi eside sokululama, ngokuvamile amasonto angu-6 kuya kwangu-8 ngaphambi kokubuyela emisebenzini ephelele. Udokotela ohlinzayo uzohlinzeka ngemihlahlandlela ethile esekelwe kunqubo yakho kanye nentuthuko yokuphola. Kubalulekile ukungasheshi ukululama kwakho futhi ulandele yonke imiyalelo ngemva kokuhlinzwa ngokucophelela.

Q.4 Ngingakwazi yini ukuzivocavoca ngemva kwe-nephrectomy?

Yebo, nakanjani ungaqeqesha ngemva kwe-nephrectomy, futhi umsebenzi womzimba ovamile empeleni unenzuzo empilweni yakho yonke kanye nokusebenza kwezinso. Nokho, kuzodingeka uqale kancane kancane futhi ukhuphule kancane izinga lakho lomsebenzi njengoba uphola.

Qala ngokuhamba kancane ngokushesha nje lapho udokotela wakho ekugunyaza, ngokuvamile kungakapheli izinsuku ezimbalwa ngemva kokuhlinzwa. Gwema ukuphakamisa izinto ezisindayo nemisebenzi enamandla aphezulu amasonto angu-4 kuya kwangu-6. Uma usululame ngokugcwele, ngokuvamile ungaqhubeka nayo yonke imisebenzi yakho oyithandayo, okuhlanganisa ezemidlalo nokuzivocavoca ejimini.

Q.5 Ingabe izinso zami ezisele zizokhula ngemva kwe-nephrectomy?

Yebo, izinso zakho ezisele zizokhula kancane kancane ngosayizi futhi zisebenze ukuze zikhokhele izinso ezisusiwe. Le nqubo, ebizwa ngokuthi i-compensatory hypertrophy, ijwayelekile ngokuphelele futhi inempilo.

Izinso zakho zingase zikhule ngosayizi ngamaphesenti angama-20 kuya kwangama-40 ezinyangeni ezimbalwa njengoba zizivumela ukusingatha umsebenzi owengeziwe. Lokhu kwandiswa kuyisibonakaliso sokuthi izinso zakho ziphumelela ekuthathweni komsebenzi wazo zombili izinso futhi akuyona imbangela yokukhathazeka.