Chisokonezo

Kachilombo ka cone (conization) ndi opareshoni yochotsa nyemba zosazolowereka kuchokera pachibelekeropo. Khomo lachiberekero ndilo gawo lotsika la chiberekero (chiberekero) lomwe limatsegukira kumtunda kwa nyini. Kusintha kosazolowereka m'maselo omwe ali pamwamba pa khomo pachibelekeropo kumatchedwa khomo lachiberekero dysplasia.

Njirayi imachitika mchipatala kapena m'malo opangira maopareshoni. Pa ndondomekoyi:

• Mupatsidwa mankhwala oletsa ululu (ogona komanso opanda ululu), kapena mankhwala okuthandizani kuti musangalale ndikumagona.
• Mudzagona patebulo ndikuyikapo mapazi anu mozungulira kuti muyimitse m'chiuno mwanu kuti muyesedwe. Wopereka zaumoyo adzaika chida (speculum) kumaliseche kwanu kuti awone bwino khomo lachiberekero.
• Tinthu tating'onoting'ono tating'onoting'ono tomwe timachotsedwa pachibelekeropo. Njirayi imatha kugwiritsidwa ntchito pogwiritsa ntchito waya wotenthedwa ndi magetsi (LEEP), scalpel (ozizira mpeni biopsy), kapena mtanda wa laser.
• Ngalande ya khomo lachiberekero pamwambapa imatha kupukutidwa kuti ichotse maselo kuti awunikenso. Uku kumatchedwa endocervical curettage (ECC).
• Chitsanzocho chimayesedwa pansi pa microscope ngati pali zizindikiro za khansa. Izi zimathanso kukhala chithandizo ngati wothandizirayo achotsa minofu yonse yamatenda.

Nthawi zambiri, mudzakwanitsa kupita kunyumba tsiku lomwelo motsatira ndondomekoyi.

Mutha kupemphedwa kuti musadye kapena kumwa kwa maola 6 mpaka 8 mayeso asanayesedwe.

Pambuyo pochita izi, mutha kukhala ndi zovuta zina kapena zosasangalatsa kwa pafupifupi sabata. Pewani izi kwa milungu 4 mpaka 6:

• Douching (douching sayenera kuchitidwa)
• Kugonana
• Kugwiritsa ntchito tampons

Kwa milungu iwiri kapena itatu mutatha kuchita izi, mutha kukhala ndi zotuluka:

• Magazi
• Kulemera
• Zachikasu

Cone biopsy yachitika kuti mupeze khansa ya pachibelekero kapena kusintha koyambirira komwe kumayambitsa khansa. Choyesera chachitsulo chimachitika ngati mayeso omwe amatchedwa colposcopy sangapeze chifukwa cha Pap smear yachilendo.

Cone biopsy itha kugwiritsidwanso ntchito pochiza:

• Mitundu yaying'ono mpaka yamphamvu yamasinthidwe achilendo (otchedwa CIN II kapena CIN III)
• Khansa yoyambirira ya khomo lachiberekero (gawo 0 kapena IA1)

Zotsatira zabwinobwino zimatanthawuza kuti mulibe ma cell omwe ali ndi khansa kapena khansa pachibelekeropo.

Nthawi zambiri, zotsatira zosazolowereka zimatanthauza kuti pamakhala ma cell okhazikika kapena khansa m'mimba mwa chiberekero. Kusintha kumeneku kumatchedwa khomo lachiberekero la intraepithelial neoplasia (CIN). Zosinthazo zagawidwa m'magulu atatu:

• CIN I - dysplasia wofatsa
• CIN II - dysplasia yodziwika bwino
• CIN III - dysplasia yoopsa ku carcinoma in situ

Zotsatira zachilendo zitha kukhalanso chifukwa cha khansa ya pachibelekero.

Zowopsa za biopsy ndizo:

• Magazi
• Chiberekero chosakwanira (chomwe chingayambitse kubereka msanga)
• Matenda
• Kutupa kwa khomo pachibelekeropo (komwe kumatha kubweretsa nthawi yopweteka, kubereka msanga, komanso kuvuta kutenga pakati)
• Kuwonongeka kwa chikhodzodzo kapena rectum

Kuphatikizira kwa khungu kumathandizanso kuti zikhale zovuta kuti omwe akukuthandizani azitha kutanthauzira zotsatira zachilendo za Pap smear mtsogolo.

Chiwopsezo - chulu; Kulumikizana kwa chiberekero; CKC; Khomo lachiberekero intraepithelial neoplasia - phirilo biopsy; CIN - chisokonezo cha kondomu; Khansa pachibelekeropo - biopsy cone; Khansa ya pachibelekero - chulu biopsy; Squamous intraepithelial lesion - cone biopsy; LSIL - chisokonezo cha cone; HSIL - chisokonezo cha cone; Kutsika kotsika kotsika; Mkulu amasankha chulucho biopsy; Carcinoma mu situ-kondomu biopsy; CIS - chisokonezo cha cone; ASCUS - kachipangizo kakang'ono; Maselo amtundu wa atypical - bie biopsy; AGUS - chisokonezo cha kondomu; Maselo osokoneza bongo - biopsy cone; Pap smear - cone biopsy; HPV - khunyu biopsy; Kachilombo ka papilloma kaumunthu - biopsy cone; Chiberekero - kachilombo kake; Colposcopy - khunyu biopsy

• Matupi achikazi oberekera
• Kuzizira kozizira kozizira
• Kuchotsa kozungulira kozizira

Cohen PA, Jhingran A, Oaknin A, Khansa ya khomo lachiberekero. Lancet. 2019; 393 (10167): 169-182 (Pamasamba) PMID: 30638582 pubed.ncbi.nlm.nih.gov/30638582/.

Salcedo MP, Baker ES, Schmeler KM. Intraepithelial neoplasia ya m'munsi maliseche (chiberekero, nyini, maliseche): etiology, kuwunika, kuzindikira, kuwongolera. Mu: Lobo RA, Gershenson DM, Lentz GM, Valea FA, olemba. Gynecology Yambiri. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2017: mutu 28.

Watson LA. Kulumikizana kwa chiberekero. Mu: Fowler GC, mkonzi. Njira za Pfenninger ndi Fowler Zoyang'anira Poyamba. Wolemba 4. Philadelphia, PA: Elsevier; 2020: chap 128.