Hana hou i ka umauma: DIEP Flap

Anter

• ʻO wai ka moho no kahi kūkulu hou ʻana o DIAP flap?
• Āhea wau e kiʻi ai i kahi kūkulu hou ʻana o DIAP flap?
• He aha ka hana i ka hana hou ʻana o ka papa DIEP?
• He aha nā pōmaikaʻi o ke kūkulu hou ʻana o ka papa DIEP?
• Mālama i ka pono o ka mākala
• Hoʻohana i kāu kiko ponoʻī
• He aha nā pilikia e pili ana i ke kī ʻoihana DIEP?
• He aha ka hana ma hope o ke kūkulu hou ʻana o ka papa DIEP?
• Pehea e hoʻoholo ai inā loaʻa iā ʻoe kahi kūkulu hou o ka umauma

He aha ka DIEP kūkulu hou?

ʻO kahi pale hohonu o ke aʻa epigastric inferior artery perforator (DIEP) kahi hana i hana ʻia e hana hou i kahi umauma me ka hoʻohana ʻana i kāu kiko ponoʻī ma hope o ka mastectomy. ʻO kahi mastectomy kahi ʻoki e wehe i ka umauma, hana mau ʻia ma ke ʻano he ʻāpana o ka mālama ʻana i ka maʻi ʻaʻai umauma. Hiki i kahi kauka lāʻau ke hana i ke kīʻaha hou i ka wā a ma hope paha o kahi mastectomy.

ʻElua ala e hana ai i ka hana hou ʻana o ka umauma. ʻO kahi ala e hoʻohana ai i nā mea kūlohelohe i lawe ʻia mai kekahi ʻāpana o ke kino. ʻIke ʻia kēia ʻo ke kūkulu hou ʻana o autologous. ʻO kekahi ala e hoʻohana ai i nā implant umauma.

Aia he ʻano nui ʻelua o ke ʻoki hou ʻana o ka umauma autologous. Kapa ʻia lākou ʻo DIEP flap a me TRAM flap. Hoʻohana ka pale TRAM i kaʻiʻo, ʻili, a me ka momona mai kou ʻōpū o lalo e kūkulu i kahi umauma hou. ʻO ka DIEP flap kahi hana hou hou aʻe i hoʻomaʻemaʻe ʻia e hoʻohana ai i ka ʻili, momona, a me nā kīʻaha koko i lawe ʻia mai kou ʻōpū. Kū ʻo DIEP no ka “perforator artery epigastric inferior hohonu hohonu loa.” ʻAʻole like me kahi pale TRAM, mālama ka pale DIEP i nā mākala o ka ʻōpū a ʻae iā ʻoe e mālama i ka ikaika a me ka hana ma nā ʻūhū i kou ʻōpū. ʻO kēia ke alakaʻi aku nei i kahi hōʻemi ʻoi aku ka ʻeha a me ka wikiwiki.

Eia ka mea e pono ai ʻoe e ʻike e pili ana i ka hana o ke kūkulu hou ʻana, kāna mau pono a me nā pilikia, a me nā mea āu e manaʻo ai inā koho ʻoe i kahi pale DIEP.

ʻO wai ka moho no kahi kūkulu hou ʻana o DIAP flap?

ʻO kahi moho kūpono no kahi paʻi DIEP kekahi mea lawa pono i nā ʻōpū o ka ʻōpū ʻaʻole momona a ʻaʻole puhipaka. Inā ua loaʻa iā ʻoe kahi ʻōpū o ka ʻōpū ma mua, ʻaʻole paha ʻoe he moho no kahi kūkulu hou ʻana o DIAP flap.

Hiki i kēia mau mea ke hoʻokau iā ʻoe i ka makaʻu kiʻekiʻe no nā pilikia ma hope o ke kūkulu hou ʻana o DIEP. Hiki iā ʻoe a me kāu kauka ke kūkākūkā i nā koho ʻē aʻe inā ʻaʻole ʻoe he moho no ke kūkulu hou ʻana o DIEP.

Āhea wau e kiʻi ai i kahi kūkulu hou ʻana o DIAP flap?

Inā ʻoe he moho no ka DIEP flap, loaʻa paha iā ʻoe kahi ʻoki hou o ka umauma i ka manawa o kāu mastectomy a i ʻole mau mahina i mau makahiki ma hope.

ʻOi aku ka nui o nā wahine e ʻae e hana koke i ka hana hou ʻana o ka umauma. I kekahi mau hihia, pono ʻoe i kahi expander kikoʻī e hana i kahi no ka mea hou. ʻO kahi mea hoʻolaha mea ʻenehana kahi ʻano olakino a i ʻole mea hana i hoʻokomo ʻia e hoʻonui i nā mea a puni, e kōkua ana e hoʻomākaukau i kahi no ka ʻoki hou. E hoʻonui hoʻonui ʻia ia e hoʻolōʻihi i nā mākala a me ka ʻili umauma e hana i kahi no ka mea hana hou.

Inā pono ʻoe e hoʻohana i nā mea hoʻonui kino ma mua o ka hana hou ʻana o ke ʻoki hou, e hoʻopaneʻe ʻia ka pae hana hou. E hoʻokau kāu kauka lāʻau i ka mea hoʻolaha kino i ka manawa o ka mastectomy.

E hoʻopili ka Chemotherapy a me ka radiation i ka manawa o DIEP flap umauma hana hou. E kali ʻoe ʻehā a ʻeono pule ma hope o chemotherapy a ʻeono a 12 mau mahina ma hope o ka pāhawewe ʻana e hana hou i kāu DIEP.

He aha ka hana i ka hana hou ʻana o ka papa DIEP?

ʻO ke kūkulu hou ʻana o ka papa DIEP kahi hana nui i hana ʻia ma lalo o ka anesthesia ākea. E hoʻomaka kāu kaukoki ma ka hana ʻana i kahi ʻoki ma kou ʻōpū haʻahaʻa. A laila, e hoʻokuʻu lākou a hemo i ka pale o ka ʻili, momona, a me nā kīʻaha koko mai kou ʻōpū.

E hoʻoili ke kauka i ka pale i lawe ʻia i kou umauma e hana i kahi puʻu umauma. Inā ke kūkulu hou nei ʻoe i hoʻokahi umauma wale nō, e hoʻāʻo ana ka mea lōkōkō e hoʻohālikelike i ka nui a me ke ʻano o kou umauma ʻē aʻe e like me ka hiki. A laila e hoʻopili kāu kaukōkō i ke kō o ke kō i nā kīʻaha koko liʻiliʻi ma hope o ka umauma a ma lalo o ka lima. I kekahi mau hihia makemake ʻia e hāpai i ka umauma a hoʻēmi paha i ka umauma ʻē aʻe e kōkua e hōʻoia i ka symmetry o ka umauma.

Ma hope o ka hana ʻana o kāu kauka lāʻau i kaʻiʻo i loko o ka umauma hou a hoʻopili iā ia i ka lako o ke koko, e pani lākou i nā ʻokiʻoki i kou umauma hou a me kou ʻōpū me nā kuʻi. Hiki i ke kūkulu hou ʻana o ka pale DIEP a ʻewalu a 12 mau hola e hoʻopau ai. ʻO ka lōʻihi o ka manawa e pili ana i ka hoʻokō ʻana o kāu kauka lāʻau i ke kūkulu hou ʻana i ka manawa like me ka mastectomy a i ʻole ma hope o kahi ʻoki kaʻawale. Aia ia i ka hilinaʻi inā ʻoe e ʻoki ʻia ana ma hoʻokahi umauma a i ʻole ʻelua paha.

He aha nā pōmaikaʻi o ke kūkulu hou ʻana o ka papa DIEP?

Mālama i ka pono o ka mākala

ʻO nā ʻenehana kūkulu hou ʻana i nā umauma e hemo ai i nāʻiʻo o ka ʻōpū mai kou ʻōpū, e like me ka TRAM paʻa, hoʻonui i kou makaʻi i nā ʻōpū o ka ʻōpū a me ka hernia ʻO kahi hernia ke kipaku kahi mea ma waena o kahi nāwaliwali o ka mākala a i ʻole nā ​​mea i manaʻo ʻia e mālama iā ia i kahi.

ʻO ke kāpili kāpili DIEP, akā, ʻaʻole pili i ka mākala. ʻO kēia ka hopena i kahi manawa pōkole o ke ola ʻana a me ka liʻiliʻi o ka ʻeha ma hope o ke kaha ʻana. Ma muli o ka hoʻohana ʻole ʻia o nā mākala o ka ʻōpū ʻaʻole ʻoe e lilo ka ikaika o ka ʻōpū a me ka pono o nā mākala. ʻO ʻoe kekahi ma kahi haʻahaʻa haʻahaʻa o ka ulu ʻana i kahi hernia.

Hoʻohana i kāu kiko ponoʻī

E nānā hou aku kou umauma i hana hou ʻia no ka mea ua hana ʻia ia mai kāuʻiʻo ponoʻī. ʻAʻole nō ʻoe e hopohopo e pili ana i nā pilikia e hiki mai ana me nā implant ʻimi hoʻopunipuni.

He aha nā pilikia e pili ana i ke kī ʻoihana DIEP?

Hele mai nā ʻōpala āpau me ka makaʻu o ka maʻi, ke kahe ʻana o ke koko, a me nā hopena o ka anesthesia. ʻAʻole ʻokoʻa ka hana hou ʻana o ka umauma. Inā ʻoe e noʻonoʻo ana i kēia ʻoki kino, he mea nui ia e hana ʻia e kahi kauka lapaʻau nāna i hoʻomaʻamaʻa ākea a me ka ʻike i ka microsurgery.

Lumps: Hiki i ke kūkulu hou ʻana o ka pale umauma DIEP ke alakaʻi i nā puʻupuʻu momona. Hana ʻia kēia mau puʻupuʻu i nā ʻili maka i ʻike ʻia me ka momona momona. Hoʻolālā ke kino scar inā ʻaʻole lawa ka nui o ke koko i kekahi o nā momona i ka umauma. ʻAʻole ʻoluʻolu paha kēia mau puʻupuʻu a pono paha e hemo me ka lāʻau.

Kūkulu wai: Aia kekahi pilikia o ka wai a i ʻole ka hōʻiliʻili ʻana o ke koko ma hope o ke kahakaha ʻana i ka umauma hou. Inā kū kēia, hiki i ke kino ke ʻono maoli i ka wai. I nā manawa ʻē aʻe, pono e ninini ʻia ka wai.

Ka nalowale o ka naʻau: ʻAʻole loaʻa ka noʻonoʻo i ka umauma hou. Hiki i kekahi mau wahine ke loaʻa hou i kekahi mau manaʻo i ka manawa, akā nui ʻole.

Nā pilikia me ka lako o ke koko: Ma kahi o 1 i ka 10 mau kānaka i hana i kahi kūkulu hou ʻana o DIEP flap e ʻike i nā pale i loaʻa nā pilikia i ke kahe ʻana o ke koko i nā lā ʻelua ma hope o ka ʻoki ʻana. He kūlana olakino koʻikoʻi kēia a koi ʻia i ke ʻoki.

Hoʻowahāwahā ʻia nā kuki: Ma waho o 100 mau kānaka i loaʻa ka pale DIEP, ma kahi o 3 a 5 mau kānaka e hoʻomohala i ka hōʻole a i ʻole ka make ʻana o nā kiko. Kāhea ʻia kēia mea ʻo ka necrosisʻaʻaʻa, a ʻo ia hoʻi ʻaʻole i holo pono ka pale āpau. I kēia hihia, e neʻe kāu kauka i mua me ka hemo ʻana i nā ʻaʻa make. Inā hiki kēia hiki ke hoʻāʻo hou i ke kaha ma hope o ʻeono a 12 mau mahina.

Scars: ʻO ke kūkulu hou ʻana o ka papa DIEP i nā scars a puni kou umauma a me ka pihi ʻōpū. Aia paha ka ʻeha o ka ʻōpū ma lalo o kāu laina bikini, e moe ana mai ka hipbone a i ka hipbone. I kekahi manawa hiki i kēia mau makaʻu ke hoʻomohala i nā keloids, a i ʻole nāʻiʻo makaʻu i ulu nui ʻia.

He aha ka hana ma hope o ke kūkulu hou ʻana o ka papa DIEP?

E hoʻolōʻihi paha ʻoe i kekahi mau lā i ka haukapila ma hope o kēia ʻoki ʻana. E loaʻa ʻoe i kekahi mau paipu i kou umauma e hoʻokahe i nā wai. Lawe kāu kauka i nā kahawai ke iho ka nui o ka wai i kahi pae ʻae ʻia, ma waena o hoʻokahi pule a ʻelua paha.Hiki paha iā ʻoe ke hoʻomaka hou i nā hana maʻamau i loko o ʻeono a ʻumikūmālua pule.

Hiki iā ʻoe ke ʻoki kino e hoʻohui i kahi nipple a i ʻole areola i kāu umauma hou. E makemake ana kāu mea lapaʻau e hoʻokuʻu i kou umauma hou ma mua o ka hana hou ʻana i ka nipple a me ka areola. ʻAʻole paʻakikī kēia kīʻaha e like me ka hana hou ʻana o ka flap DIEP. Hiki i kāu kauka ke hana i kahi nipple a me nā areola e hoʻohana ana i kāu kino kino. ʻO kahi koho ʻē aʻe e loaʻa i kahi nipple a me nā tattoo areola ma kāu umauma hou. I kekahi mau hihia, hiki i kāu kauka lāʻau ke hana i kahi mastectomy-sparing mastectomy. I kēia hihia, e mālama ʻia kāu nipple ponoʻī.

Hiki i ke kīpoki DIEP flap ke hana i kahi kūlana i kapa ʻia ʻo ptal contradiatral ptosis, i ʻike ʻia hoʻi me ka umauma e iho ana. I ka mua a i ʻole ka lōʻihi o ka manawa, e hāʻule paha kou umauma kumu i kahi ala e hana ʻole ai ka umauma i hana hou ʻia. E hāʻawi kēia i kou umauma i kahi ʻano asymmetrical. Inā hoʻonāukiuki kēia iā ʻoe, e kamaʻilio i kāu kauka e pili ana i ka hoʻoponopono ʻana i kēia. Hiki ke hana i kēia i ka manawa like me kāu hana hou ʻana a ma hope paha me kahi ʻokiʻoki ʻē aʻe i ka umauma noncancerous.

Pehea e hoʻoholo ai inā loaʻa iā ʻoe kahi kūkulu hou o ka umauma

Ke hoʻoholo nei inā ʻaʻole e hana hou i ka umauma ma hope o ka mastectomy kahi koho pilikino loa. ʻOiai ʻaʻole pono ia he lāʻau lapaʻau, ʻike kekahi mau wahine ʻo ka loaʻa ʻana o ka hana hou ʻana i ka umauma e hoʻomaikaʻi i ko lākou olakino olakino a me ke ʻano o ke ola.

Nui a hewahewa nā koho kūkulu hou ʻana, a hele mai kēlā me kēia ʻano me kāna mau pono ponoʻī a me nā pilikia. E hoʻoholo ana nā ʻano mea like ʻole i ke ʻoki kūpono kūpono loa nāu. Aia kēia mau mea i:

• makemake pilikino
• nā pilikia olakino ʻē aʻe
• kou kaupaona a me ka nui o nā ʻōpū o ka ʻōpū a momona paha
• nā ʻōpū o ka ʻōpū ma mua
• kou olakino laulā

E hōʻoia e kūkākūkā i nā maikaʻi a me nā maikaʻi ʻole o nā koho āpau a me nā koho nonsurgical me kāu hui olakino ma mua o ka hoʻoholo ʻana.