Khansa ya Esophageal

Khansara yotupa ndi khansa yomwe imayamba m'mimba. Iyi ndiye chubu chomwe chakudya chimachokera pakamwa kupita m'mimba.

Khansa ya Esophageal siodziwika ku United States. Zimachitika nthawi zambiri mwa amuna azaka zopitilira 50.

Pali mitundu iwiri ikuluikulu ya khansa yam'matumbo; squamous cell carcinoma ndi adenocarcinoma. Mitundu iwiriyi imawoneka yosiyana ndi inzake pansi pa microscope.

Khansa ya squamous cell esophageal imalumikizidwa ndikusuta ndikumwa mowa kwambiri.

Adenocarcinoma ndi khansa yodziwika kwambiri ya khansa. Kukhala ndi khola la Barrett kumawonjezera chiopsezo cha khansa yamtunduwu. Matenda a acid Reflux (gastroesophageal Reflux matenda, kapena GERD) amatha kukhala Barrett esophagus. Zina mwaziwopsezo zimaphatikizapo kusuta, kukhala wamwamuna, kapena kunenepa kwambiri.

Zizindikiro zimatha kuphatikizira izi:

• Kusunthira kumbuyo kwa chakudya kudzera mum'mero ​​komanso pakamwa (kubwezeretsanso)
• Kupweteka pachifuwa kosagwirizana ndi kudya
• Zovuta kumeza zolimba kapena zakumwa
• Kutentha pa chifuwa
• Kusanza magazi
• Kuchepetsa thupi

Mayeso omwe amagwiritsidwa ntchito pothandiza kupeza khansa ya m'mimba atha kukhala:

• Mndandanda wa ma x-ray omwe adatengedwa kuti akafufuze m'mero ​​(barium swallow)
• Chifuwa cha MRI kapena thoracic CT (yomwe nthawi zambiri imagwiritsidwa ntchito kuthandizira kudziwa matendawo)
• Endoscopic ultrasound (yomwe nthawi zina imagwiritsidwa ntchito kudziwa gawo la matenda)
• Yesani kuti muwone ndikuchotsa zitsanzo zazitsulo zam'mero ​​(esophagogastroduodenoscopy, EGD)
• Kujambula kwa PET (nthawi zina kumakhala kofunikira pakudziwitsa gawo la matenda, komanso ngati opaleshoni ingatheke)

Kuyesa kwamagetsi kumatha kuwonetsa magazi pang'ono pachitopalayo.

EGD idzagwiritsidwa ntchito kupeza minofu kuchokera kumimba kuti ipeze khansa.

Khansara ikakhala pakhungu ndipo isafalikire, opareshoni idzachitika. Khansara ndi gawo, kapena zonse, zam'mero ​​zimachotsedwa. Kuchita opaleshoniyo kumatha kugwiritsidwa ntchito:

• Opaleshoni yotseguka, pomwe 1 kapena 2 yayikulu imapangidwa.
• Kuchita opaleshoni pang'ono, pomwe 2 mpaka 4 imapangidwa pang'ono m'mimba. Laparoscope yokhala ndi kamera yaying'ono imalowetsedwa m'mimba kudzera pachimodzi mwa izi.

Thandizo la radiation lingagwiritsidwenso ntchito m'malo mochita opareshoni nthawi zina pomwe khansa isafalikire kunja kwa kholingo.

Mwina chemotherapy, radiation, kapena zonse ziwiri zitha kugwiritsidwa ntchito pochepetsa chotupacho ndikupangitsa kuti opaleshoni ichite mosavuta.

Ngati munthuyo akudwala kwambiri kuti sangachite opaleshoni yayikulu kapena khansayo yafalikira ku ziwalo zina, chemotherapy kapena radiation ingagwiritsidwe ntchito kuthandiza kuchepetsa zizindikilo. Izi zimatchedwa mankhwala othandizira. Zikatero, matendawa samachiritsidwa.

Kuphatikiza pa kusintha kwa zakudya, mankhwala ena omwe angagwiritsidwe ntchito kuthandiza wodwalayo kumeza ndi awa:

• Kukulitsa (kukulitsa) kum'mero ​​pogwiritsa ntchito endoscope. Nthawi zina stent imayikidwa kuti imitseke.
• Phukusi lodyetsera m'mimba.
• Photodynamic therapy, momwe mankhwala apadera amalowetsedwa mu chotupacho ndikuwululidwa. Kuwala kumayambitsa mankhwala omwe amachititsa chotupacho.

Mutha kuchepetsa nkhawa zamankhwala ndikulowa nawo gulu lothandizira khansa. Kugawana ndi ena omwe akukumana nawo komanso omwe akukumana ndi mavuto kumatha kukuthandizani kuti musamve nokha

Khansara ikafalikira kunja kwa khosalo, opareshoni imathandizira mwayi wopulumuka.

Khansara ikafalikira kumadera ena amthupi, mankhwalawa samatheka. Chithandizochi chimawathandiza kuthetsa zizindikiro za matendawa.

Zovuta zingaphatikizepo:

• Chibayo
• Kuchepetsa thupi kwambiri chifukwa chosadya mokwanira

Itanani omwe akukuthandizani ngati zikukuvutani kumeza popanda chifukwa ndipo sizikhala bwino. Komanso itanani ngati muli ndi zizindikiro zina za khansa ya m'mimba.

Kuchepetsa chiopsezo cha khansa yam'mero:

• Osasuta.
• Malire kapena Musamamwe zakumwa zoledzeretsa.
• Fufuzani ndi dokotala ngati muli ndi GERD yoopsa.
• Pezani nthawi zonse ngati muli ndi Barrett esophagus.

Khansa - kum'mero

• Esophagectomy - kutulutsa
• Gastrostomy yodyetsa chubu - bolus
• Thumba lodyetsera la Jejunostomy

• Dongosolo m'mimba
• Kupewa kutentha kwa chifuwa
• Khansa ya Esophageal

Ku GY, Ilson DH. Khansa ya kum'mero. Mu: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, olemba. Chipatala cha Abeloff's Oncology. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2020: chap 71.

Tsamba la National Cancer Institute. Chithandizo cha khansa ya Esophageal (PDQ) - mtundu wa akatswiri azaumoyo. www.cancer.gov/types/esophageal/hp/esophageal-kuchiza-pdq. Idasinthidwa Novembala 12, 2019. Idapezeka pa Disembala 5, 2019.

Tsamba la National Comprehensive Cancer Network. Maupangiri azachipatala a NCCN mu oncology (malangizo a NCCN): khansa ya esophageal ndi esophagogastric. Mtundu 2.2019. www.nccn.org/professionals/physician_gls/pdf/esophageal.pdf. Idasinthidwa pa Meyi 29, 2019. Idapezeka pa Seputembara 4, 2019.