Mediastinoscopy me ka biopsy

ʻO Mediastinoscopy me ka biopsy kahi hana e hoʻokomo ʻia ai kahi mea kukui (mediastinoscope) i kahi ākea ma ka umauma ma waena o nā akemāmā (mediastinum). Lawe ʻia ka ʻōpala (biopsy) mai nā ulu ulu a i ʻole nā ​​lymph node.

Hana ʻia kēia hana i ka haukapila. Hāʻawi ʻia ʻoe i ka anesthesia ākea i mea hiamoe ʻoe a ʻaʻole ʻeha. Hoʻokomo ʻia kahi paipu (endotracheal tube) i kou ihu a waha paha e kōkua iā ʻoe e hanu.

Hana ʻia kahi ʻoki liʻiliʻi ma luna pono o ka umauma. Hoʻokomo ʻia kahi mea i kapa ʻia he mediastinoscope ma o kēia ʻoki a hala mālie ʻia i ka hapa waena o ka pahu.

Lawe ʻia nā laikini kele i nā lymph node a puni nā alaloa. Lawe ʻia ka laulā a pani ʻia ka ʻokiʻoki me nā humuhumu.

E lawe pinepine ʻia kahi hihi umauma i ka hopena o ke kaʻina hana.

Lawe ʻia ke kaʻina hana ma kahi o 60 a 90 mau minuke.

Pono ʻoe e kau inoa i kahi palapala ʻae ʻikepili. ʻAʻole hiki iā ʻoe ke loaʻa ka meaʻai a wai paha no 8 mau hola ma mua o ka hoʻāʻo.

E hiamoe ʻoe i ke kaʻina hana. E loaʻa kahi palupalu ma ka pūnaewele o ke kaʻina hana ma hope. ʻEha paha kou ʻāʻī.

Hiki i ka hapa nui o ka poʻe ke haʻalele i ka haukapila i ke kakahiaka aʻe.

I ka hapanui o nā hihia, mākaukau ka hopena o ka biopsy ma 5 a 7 mau lā.

Hana ʻia kēia hana e nānā a laila biopsy lymph nodes a i ʻole nā ​​ulu ulu ʻē aʻe i mua o ka mediastinum, kokoke i ka paia o kou umauma.

• ʻO ke kumu maʻamau e ʻike inā ua pāhola ka maʻi ʻaʻai māmā (a i ʻole kekahi maʻi ʻaʻai ʻē aʻe) i kēia mau lymph node. Kāhea ʻia kēia.
• Hana ʻia kēia hana no kekahi mau maʻi (tuberculosis, sarcoidosis) a me nā maʻi autoimmune.

Biopsies o nā lymph node nāʻaʻaʻa he maʻamau a ʻaʻole hōʻike i nā hōʻailona o ke kanesa a i ʻole ka maʻi maʻi.

Hōʻike nā ʻike kūpono ʻole:

• Maʻi ʻo Hodgkin
• Kanesa maʻi ʻaʻai
• Lymphoma a i ʻole nā ​​tumors ʻē aʻe
• ʻO Sarcoidosis
• Ka hoʻolaha ʻana o ka maʻi mai kekahi ʻāpana o ke kino i kekahi ʻē aʻe
• Maʻi puʻu

Aia ka makaʻu o ka puncturing i ka esophagus, trachea, a i ʻole nā ​​kīʻaha koko. I kekahi mau hihia, hiki i kēia ke alakaʻi i ke kahe e hiki ke hoʻoweliweli i ke ola. No ka hoʻoponopono ʻana i ka ʻeha, pono e hoʻokaʻawale ʻia ka umauma a wehe ʻia ka umauma.

• Mediastinum

ʻO Cheng G-S, ʻo Varghese TK. Nā Tumors Mediastinal a me nā Cist. I: Broaddus VC, Mason RJ, Ernst JD, et al, eds. ʻO Murray & Nadel's Textbook of Respiratory Medicine. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Saunders; 2016: chap 83.

Putnam JB. Lū, pā umauma, pleura, a me mediastinum. I: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ʻO Sabiston Textbook of Surgery. 20 ouk. Piladelapia, PA: Elsevier; 2017: chap 57.