Mediastinoscopy yokhala ndi biopsy

Mediastinoscopy yokhala ndi biopsy ndi njira yomwe chida chowunikira (mediastinoscope) chimayikidwa mchifuwa pakati pa mapapo (mediastinum). Manja amatengedwa (biopsy) kuchokera pachimake chilichonse chosazolowereka kapena ma lymph node.

Njirayi imachitika mchipatala. Mudzapatsidwa mankhwala oletsa ululu kuti mugone ndipo musamve kuwawa kulikonse. Chubu (endotracheal chubu) chimayikidwa m'mphuno kapena mkamwa kuti chikuthandizeni kupuma.

Kudulidwa kocheperako kumapangidwa pamwamba pa mafupa okhaokha. Chida chotchedwa mediastinoscope chimalowetsedwa kudzera podula ndikudutsa bwino mkatikati mwa chifuwa.

Zitsanzo zamatenda zimatengedwa ndi ma lymph node ozungulira njira zampweya. Kukula kumachotsedwa ndipo kudula kwa opaleshoni kumatsekedwa ndi ulusi.

X-ray ya chifuwa nthawi zambiri imatengedwa kumapeto kwa ndondomekoyi.

Njirayi imatenga pafupifupi mphindi 60 mpaka 90.

Muyenera kusaina chikalata chovomerezeka. Simudzatha kukhala ndi chakudya kapena madzi kwa maola 8 mayeso asanayesedwe.

Mudzakhala mukugona panthawiyi. Padzakhala kukoma mtima pamalowo pochita izi pambuyo pake. Mutha kukhala ndi zilonda zapakhosi.

Anthu ambiri amatha kuchoka mchipatala m'mawa mwake.

Nthaŵi zambiri, zotsatira za biopsy zimakhala zokonzeka masiku asanu kapena asanu ndi awiri.

Njirayi imachitika poyang'ana kenako kenako biopsy lymph node kapena zophuka zina zilizonse zomwe zili kutsogolo kwa mediastinum, pafupi ndi khoma lanu pachifuwa.

• Chifukwa chodziwika kwambiri ndikuwona ngati khansa ya m'mapapo (kapena khansa ina) yafalikira ku ma lymph node. Izi zimatchedwa staging.
• Njirayi imathandizidwanso ndimatenda ena (chifuwa chachikulu, sarcoidosis) ndimatenda amthupi.

Ma biopsies a lymph node tishu ndi abwinobwino ndipo sawonetsa zizindikiro za khansa kapena matenda.

Zotsatira zachilendo zitha kuwonetsa:

• Matenda a Hodgkin
• Khansa ya m'mapapo
• Lymphoma kapena zotupa zina
• Sarcoidosis
• Kufalikira kwa matenda kuchokera mthupi limodzi kupita ku linzake
• Matenda a chifuwa chachikulu

Pali chiopsezo choboola kummero, trachea, kapena mitsempha yamagazi. Nthawi zina, izi zimatha kubweretsa magazi omwe angaike pangozi moyo. Pofuna kukonza zovulalazi, chifuwa cha bere chimayenera kugawanika ndikufunyulula chifuwa.

• Mediastinum

Cheng GS, Varghese TK. Zotupa zapakati ndi zotupa. Mu: Broaddus VC, Mason RJ, Ernst JD, et al, olemba. Buku la Murray & Nadel la Mankhwala Opuma. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier Saunders; 2016: chap 83.

Putnam JB. Mapapu, khoma pachifuwa, pleura, ndi mediastinum. Mu: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Buku Lopanga Opaleshoni. Wolemba 20th. Philadelphia, PA: Elsevier; 2017: mutu 57.