Endoscopic thoracic sympathectomy

Endoscopic thoracic sympathectomy (ETS) ndi opaleshoni yochiza thukuta lolemera kwambiri kuposa zachilendo. Matendawa amatchedwa hyperhidrosis. Nthawi zambiri opaleshoniyi imagwiritsidwa ntchito pochiza thukuta m'manja kapena pankhope. Mitsempha yachifundo imayang'anira thukuta. Opaleshoniyi imadula mitsempha iyi mpaka mbali ina ya thupi yomwe imatuluka thukuta kwambiri.

Mukalandira opaleshoni musanachite opaleshoni. Izi zidzakupangitsani inu kugona ndi kumva ululu.

Kuchita opaleshoniyi kumachitika motere:

• Dokotalayo amapanga mabala awiri kapena atatu odulidwa pansi pa mkono umodzi mbali yomwe kumatuluka thukuta kwambiri.
• Mapapu anu mbali iyi ndi otupa (kugwa) kuti mpweya usalowe mkati ndi kutuluka mkati mwa opaleshoni. Izi zimapatsa dotolo mpata wambiri kuti agwire ntchito.
• Kamera yaying'ono yotchedwa endoscope imalowetsedwa kudzera m'modzi mwa mabala anu pachifuwa. Kanema wochokera pakamera amawonetsedwa pa chowunika m'chipinda chogwiritsira ntchito. Dokotalayo amawona polojekitiyo pochita opaleshoniyo.
• Zida zina zazing'ono zimalowetsedwa kudzera pakucheka kwina.
• Pogwiritsa ntchito zida izi, dokotalayo amapeza misempha yomwe imayendetsa thukuta m'dera lamavuto. Izi zimadulidwa, kudula, kapena kuwonongedwa.
• Mapapu anu mbali iyi ali ndi mpweya.
• Zocheka zimatsekedwa ndi ulusi (sutures).
• Phukusi laling'ono lamadzi limatha kutsalira pachifuwa chanu kwa tsiku limodzi kapena apo.

Pambuyo pochita izi mbali imodzi ya thupi lanu, dokotalayo akhoza kuchita chimodzimodzi mbali inayo. Kuchita opaleshoni kumatenga pafupifupi 1 mpaka 3 maola.

Kuchita opaleshoniyi kumachitidwa mwa anthu omwe manja awo amatuluka thukuta kwambiri kuposa zachilendo. Itha kugwiritsidwanso ntchito kuthana ndi thukuta kwambiri pankhope. Amagwiritsidwa ntchito pokhapokha ngati mankhwala ena ochepetsa thukuta sanagwire ntchito.

Zowopsa za ochititsa dzanzi ndi opaleshoni yonse ndi izi:

• Thupi lawo siligwirizana ndi mankhwala
• Mavuto opumira
• Kukhetsa magazi, magazi kuundana, kapena matenda

Zowopsa za njirayi ndi:

• Kutolera magazi pachifuwa (hemothorax)
• Kutolera mpweya m'chifuwa (pneumothorax)
• Kuwonongeka kwa mitsempha kapena mitsempha
• Matenda a Horner (kuchepa kwa thukuta la nkhope ndi zikope zothothoka)
• Kuchuluka kapena thukuta latsopano
• Kuchuluka thukuta m'malo ena amthupi (kutuluka thukuta)
• Kuchedwa kwa kugunda kwa mtima
• Chibayo

Uzani dokotala wanu kapena wothandizira zaumoyo:

• Ngati muli ndi pakati kapena mutha kukhala ndi pakati
• Ndi mankhwala ati, mavitamini, zitsamba, ndi zina zowonjezera zomwe mukugwiritsa ntchito, ngakhale zomwe mwagula popanda mankhwala

M'masiku asanachitike opareshoni:

• Mutha kufunsidwa kuti musiye kumwa mankhwala ochepetsa magazi. Zina mwa izi ndi aspirin, ibuprofen (Advil, Motrin), ndi warfarin (Coumadin).
• Funsani dokotala wanu wa zachipatala mankhwala omwe muyenera kumamwa patsiku la opareshoni yanu.
• Ngati mumasuta, yesetsani kusiya. Funsani omwe akukuthandizani kuti akuthandizeni kusiya. Kusuta kumawonjezera ngozi yamavuto monga kuchira pang'onopang'ono.

Patsiku la opareshoni yanu:

• Tsatirani malangizo okhudza nthawi yosiya kudya ndi kumwa.
• Tengani mankhwala omwe dokotala wanu wakuuzani kuti mumamwe pang'ono.
• Fikani kuchipatala nthawi yake.

Anthu ambiri amakhala mchipatala usiku umodzi ndikupita kwawo tsiku lotsatira. Mutha kukhala ndi ululu kwa sabata limodzi kapena awiri. Tengani mankhwala opweteka monga adokotala anu adalangizira. Mungafunike acetaminophen (Tylenol) kapena mankhwala opweteka. MUSAMAYENDETSE ngati mukumwa mankhwala opweteka.

Tsatirani malangizo a dokotalayo okhudza kusamalira zomwe zadulazo, kuphatikizapo:

• Sungani malo obowolera aukhondo, owuma, okutidwa ndi zokutira (bandeji). Ngati incision yanu ili ndi Dermabond (bandage yamadzi) simudzafunika kuvala kulikonse.
• Sambani malowa ndikusintha mavalidwe malinga ndi malangizo.
• Funsani dokotala wanu wa opaleshoni mukamasamba kapena kusamba.

Pang'onopang'ono pitirizani ntchito zanu zonse momwe mungathere.

Pitirizani ulendo wotsatira ndi dokotalayo. Pa maulendo amenewa, dokotalayo amayang'ana momwe zidutsazo zakhalira ndikuwona ngati opaleshoniyi idachita bwino.

Kuchita opaleshoniyi kumatha kukonza moyo wa anthu ambiri. Sizigwiranso ntchito kwa anthu omwe ali ndi thukuta lolemera kwambiri. Anthu ena amawona thukuta m'malo atsopano pathupi, koma izi zimatha zokha.

Sympathectomy - endoscopic thoracic; Achichepere; Hyperhidrosis - endoscopic thoracic sympathectomy

• Chisamaliro cha bala la opaleshoni - chotseguka

Webusaiti ya International Hyperhidrosis Society. Endoscopic thoracic sympathectomy. www.sweathelp.org/hyperhidrosis-treatments/ets-surgery.html. Idapezeka pa Epulo 3, 2019.

Zoyenda JAA. Matenda a Hyperhidrosis. Mu: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, olemba. Kuchiza kwa Matenda a Khungu: Njira Zambiri Zakuchiritsira. 5th ed. Philadelphia, PA: Elsevier; 2018: mutu 109.

[Adasankhidwa] Miller DL, Miller MM. Chithandizo cha opaleshoni cha hyperhidrosis. Mu: Sellke FW, del Nido PJ, Swanson SJ, olemba. Opaleshoni ya Sabiston ndi Spencer pachifuwa. 9th ed. Philadelphia, PA: Elsevier; 2016: chap 44.