Wopanga prostatectomy

Radical prostatectomy (kuchotsa Prostate) ndikuchita opareshoni yochotsa prostate gland yonse ndi minofu ina yozungulira. Zachitika kuti athetse khansa ya prostate.

Pali mitundu 4 yayikulu kapena maluso a opaleshoni ya prostatectomy. Njirazi zimatenga pafupifupi 2 mpaka 4 maola:

• Kubwezeretsa - Dokotala wanu azidula kuyambira pansi pamimba panu lomwe limafikira ku fupa lanu. Kuchita opaleshoniyi kumatenga mphindi 90 mpaka maola 4.
• Laparoscopic - Dokotalayo amadula kangapo m'malo modula kamodzi. Zida zazitali, zopyapyala zimayikidwa mkati modula. Dokotalayo amaika chubu chochepa kwambiri chokhala ndi kanema (laparoscope) mkati mwazochekerako. Izi zimathandiza dokotalayo kuti aone mkati mwa mimba yanu pamene mukuchita izi.
• Opaleshoni ya robotic - Nthawi zina, opaleshoni ya laparoscopic imachitika pogwiritsa ntchito makina a robotic. Dokotalayo amasuntha zida ndi kamera pogwiritsa ntchito manja a robotic atakhala pamalo oyang'anira pafupi ndi tebulo logwirira ntchito. Si chipatala chilichonse chomwe chimapereka ma robotic.
• Zowonjezera - Dokotala wanu amadzicheka pakhungu pakati pa anus ndi m'munsi mwa scrotum (perineum). Kudulidwa ndikocheperako poyerekeza ndi njira ya retropubic. Opaleshoni yotereyi nthawi zambiri imatenga nthawi yocheperako ndipo imayambitsa kuchepa kwamagazi. Komabe, zimakhala zovuta kuti dokotalayo asasokoneze mitsempha yozungulira prostate kapena kuchotsa ma lymph node omwe ali pafupi ndi njirayi.

Pazinthu izi, mutha kukhala ndi anesthesia kuti mugone komanso kumva kupweteka. Kapenanso, mudzalandira mankhwala kuti muchepetse theka la thupi lanu (msana kapena epidural anesthesia).

• Dokotalayo amachotsa prostate gland m'minyewa yoyandikana nayo. Mimbulu yam'mimba, matumba awiri ang'onoang'ono odzaza madzi pafupi ndi prostate, amachotsedwanso.
• Dokotalayo asamalira kuti asawonongeke pang'ono pamitsempha ndi mitsempha yamagazi.
• Dokotalayo amalumikiza mtsemphawo ndi mbali ina ya chikhodzodzo yotchedwa chikhodzodzo khosi. Mkodzo ndi chubu chomwe chimanyamula mkodzo kuchokera mu chikhodzodzo kudzera mu mbolo.
• Dokotala wanu amathanso kuchotsa ma lymph node m'mimba mwake kuti awone ngati ali ndi khansa.
• Kutulutsa, kotchedwa kudaila kwa Jackson-Pratt, kumatha kusiyidwa m'mimba mwanu kuti muthe madzi owonjezera mutachitidwa opaleshoni.
• Chubu (catheter) chimatsalira mu urethra ndi chikhodzodzo kuti muthe mkodzo. Izi zidzakhala m'malo kwa masiku angapo mpaka masabata angapo.

Radate prostatectomy imachitika nthawi zambiri khansa isanafalikire kupitirira prostate gland. Izi zimatchedwa kuti khansa ya prostate.

Dokotala wanu angakulimbikitseni chithandizo chimodzi chifukwa cha zomwe mukudziwa za mtundu wanu wa khansa komanso zomwe zimawopsa. Kapenanso, dokotala wanu akhoza kuyankhula nanu za mankhwala ena omwe atha kukhala abwino khansa yanu. Mankhwalawa atha kugwiritsidwa ntchito m'malo mochita opareshoni kapena atachitidwa opaleshoni.

Zinthu zofunika kuziganizira posankha mtundu wa maopaleshoni zimaphatikizapo zaka zanu ndi mavuto ena azachipatala. Kuchita opaleshoniyi kumachitika nthawi zambiri kwa amuna athanzi omwe amayembekezeka kukhala zaka 10 kapena kupitilira apo.

Kuopsa kwa njirayi ndi:

• Mavuto owongolera mkodzo (kusadziletsa kwamikodzo)
• Mavuto okonzekera (kusowa mphamvu)
• Kuvulala kwa rectum
• Urethral okhwima (kumangika kwa kutsegula kwamikodzo chifukwa chofiyira)

Mutha kuchezeredwa kangapo ndi omwe amakuthandizani pa zaumoyo. Muyesedwa mthupi mokwanira ndipo mutha kukhala ndi mayeso ena. Wothandizira anu adzaonetsetsa kuti mavuto azachipatala monga matenda ashuga, kuthamanga kwa magazi, komanso mavuto amtima kapena mapapo akuyendetsedwa.

Ngati mumasuta, muyenera kusiya milungu ingapo musanachite opareshoni. Wopereka wanu atha kuthandiza.

Nthawi zonse muuzeni omwe akukuthandizani mankhwala, mavitamini, ndi zina zowonjezera zomwe mumamwa, ngakhale zomwe mwagula popanda mankhwala.

Pakati pa masabata musanachite opaleshoni yanu:

• Mutha kufunsidwa kuti musiye kumwa aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), vitamini E, clopidogrel (Plavix), warfarin (Coumadin), ndi zina zilizonse zowononga magazi kapena mankhwala omwe amalepheretsa magazi anu kuvala.
• Funsani mankhwala omwe muyenera kumwa patsiku la opareshoni yanu.
• Pa tsiku lisanachitike opaleshoni yanu, imwani zakumwa zomveka bwino zokha.
• Nthawi zina, mungapemphedwe ndi omwe amakupatsani kuti mutenge mankhwala ofewetsa mankhwala ofewetsa tuvi tolimba tsiku lomwelo musanachite opareshoni. Izi zidzatsuka zomwe zili mkati mwanu.

Patsiku la opareshoni yanu:

• Musadye kapena kumwa chilichonse pakati pausiku usiku musanachite opareshoni.
• Tengani mankhwala omwe adauzidwa kuti mumwe pang'ono pokha madzi.
• Mudzauzidwa nthawi yobwera kuchipatala. Onetsetsani kuti mwafika nthawi.

Konzani nyumba yanu mukadzafika kunyumba pambuyo pa opaleshoni.

Anthu ambiri amakhala mchipatala kwa masiku 1 kapena 4. Pambuyo pa opaleshoni ya laparoscopic kapena robotic, mutha kupita kwanu tsiku lotsatira.

Mungafunike kugona mpaka m'mawa mutachita opaleshoni. Mudzalimbikitsidwa kuti muziyenda mozungulira pambuyo pake.

Namwino wanu amakuthandizani kusintha malo ogona ndikuwonetsani zolimbitsa thupi kuti magazi aziyenda. Muphunziranso kukhosomola kapena kupuma kwambiri kuti muteteze chibayo. Muyenera kuchita izi maola 1 kapena 2 aliwonse. Mungafunike kugwiritsa ntchito chida chopumira kuti mapapu anu aziwoneka bwino.

Pambuyo pa opaleshoni yanu, mutha:

• Valani masitonkeni apadera m'miyendo mwanu kuti magazi asagundane.
• Landirani mankhwala opweteka m'mitsempha mwanu kapena kumwa mapiritsi opweteka.
• Muzimva kupuma pachikhodzodzo.
• Mukhale ndi katole ya Foley m'chikhodzodzo chanu mukamabwerera kwanu.

Kuchita opaleshoniyo kuyenera kuchotsa maselo onse a khansa. Komabe, mudzayang'aniridwa mosamala kuti khansa isabwererenso. Muyenera kuyesedwa pafupipafupi, kuphatikiza kuyesa magazi a prostate enieni a antigen (PSA).

Kutengera zotsatira za kudwala ndi zotsatira za mayeso a PSA atachotsa prostate, omwe amakupatsani mwayiwo akhoza kukambirana nanu za mankhwala a radiation kapena mankhwala.

Prostatectomy - kwakukulu; Radical retropubic prostatectomy; Wopanda perineal prostatectomy; Laparoscopic kwakukulu prostatectomy; LRP; Laparoscopic prostatectomy; RALP; Chifuwa cha lymphadenectomy; Khansa ya prostate - prostatectomy; Kuchotsa prostate - kwakukulu

• Chitetezo cha bafa cha akulu
• Kusamalira catheter wokhala
• Zochita za Kegel - kudzisamalira
• Prostate brachytherapy - kutulutsa
• Radical prostatectomy - kutulutsa
• Chisamaliro cha catheter cha Suprapubic
• Chisamaliro cha bala la opaleshoni - chotseguka
• Zamgululi incontinence - kudzikonda chisamaliro
• Matumba otulutsa mkodzo
• Mukakhala ndi nseru ndi kusanza
• Mukakhala ndi vuto la kukodza mkodzo

Bill-Axelson A, Holmberg L, Garmo H, ndi al. Radical prostatectomy kapena kukhala tcheru kudikirira khansa yoyambirira ya prostate. N Engl J Med. 2014; 370 (10): 932-942. PMID: 24597866 www.ncbi.nlm.nih.gov/pubmed/24597866. (Adasankhidwa)

Ellison JS, He C, Wood DP. Ntchito yoyambira mkodzo ndi ntchito zogonana zimaneneratu za kuchira pambuyo pa chaka chimodzi kuchokera ku prostatectomy. J Urol. 2013; 190 (4): 1233-1238. PMID: 23608677 www.ncbi.nlm.nih.gov/pubmed/23608677.

Tsamba la National Cancer Institute. Chithandizo cha khansa ya Prostate (PDQ) - mtundu wa akatswiri azaumoyo. www.cancer.gov/types/prostate/hp/prostate-kuchiza-pdq. Idasinthidwa pa Januware 29, 2020. Idapezeka pa February 20, 2020.

Kuthanso MJ, Koyama T, Fan KH, et al. Zotsatira zanthawi yayitali mutalandira chithandizo cha khansa yapafupi ya prostate. N Engl J Med. 2013; 368 (5): 436-445. PMID: 23363497 www.ncbi.nlm.nih.gov/pubmed/23363497.

Schaeffer EM, Partin AW, Lepor H. Tsegulani kwambiri prostatectomy. Mu: Wein AJ, Kavoussi LR, Partin AW, Peters CA, olemba. Urology wa Campbell-Walsh. 11th ed. Philadelphia, PA: Elsevier; 2016: chap 114.

Su LM, Gilbert SM, Smith JA. Laparoscopic and robotic-assisted laparoscopic radate prostatectomy ndi pelvic lymphadenectomy. Mu: Wein AJ, Kavoussi LR, Partin AW, Peters CA, olemba. Urology wa Campbell-Walsh. 11th ed. Philadelphia, PA: Elsevier; 2016: chap 115.