Dukurikije amakuru y’ingenzi yatanzwe n’Ikigo Mpuzamahanga Gishinzwe Ubushakashatsi ku Kanseri (IARC) cy’Umuryango Mpuzamahanga wita ku Buzima (OMS), kanseri y’ibihaha yabaye imwe mu ndwara mbi zikomeye cyane, kandi gukumira no kuvura kanseri y’ibihaha byabaye ikintu cy’ingenzi mu gukumira no kuvura kanseri.
Dukurikije imibare y’ibarurishamibare ifatika, gusa ku birebana20% by'abarwayi ba kanseri y'ibihaha itari iy'uturemangingo duto bashobora kubagwa nezaAbenshi mu barwayi ba kanseri y'ibihaha bamaze kugera muriibyiciro by'iterambereiyo bapimwe, kandi bashobora kubona inyungu nkeya mu kuvura hakoreshejwe imirasire n'imiti gakondo. Uko iterambere rikomeje n'iterambere rya siyansi y'ubuvuzi, hagaragayeubuvuzi bwo kuvura indwarank'uburyo bwo gusimbura kubagwa byazanye icyizere gishya ku barwayi ba kanseri y'ibihaha.
1. Ni ibihe bintu uzi ku bijyanye no kuvura kanseri y'ibihaha hakoreshejwe uburyo bwa ablative?
Uburyo bwo kuvura kanseri y'ibihaha bugizwe ahanini n'uburyo bwo kuvura kanseri y'ibihahagukuraho imiyoboro ya microwave no gukuraho imiyoboro ya radiyoIhame ryo kuvura rikubiyemo gushyiramo electrode ikoresha uburyo bwa "ablative", izwi kandi nka“iperereza,”mu kibyimba cyo mu bihaha. Electrode ishobora guterakugenda vubautwuma nk'iyoni cyangwa molekile z'amazi ziri muri iki kibyimba, bigatanga ubushyuhe buterwa no gukururana, bigaterakwangirika ku buryo budasubirwaho nko kwangirika kw'uturemangingo tw'ikibyimba.Muri icyo gihe, umuvuduko wo kohereza ubushyuhe ugabanuka cyane mu bice bisanzwe by'ibihaha bikikije, bigatuma ubushyuhe buri mu kibyimba bugumana"Ingaruka zo gukingira ubushyuhe."Uburyo bwo kuvura indwara ya kanseri bushobora kwica ikibyimba neza mu gihekurengera cyane ingingo zisanzwe z'ibihaha.
Ubuvuzi bwa Ablative burangwa n'uburyo bwabwogusubiramo, kutagira ububabare buhagije bw'umurwayi, gukomereka guke, no gukira vuba,kandi byamenyekanye cyane kandi bikoreshwa mu buvuzi. Ariko, ukurikije ko ubuvuzi bwo kuvura indwara zikomoka ku matungo bukubiyemo amasomo menshi nka radiology, oncology, radiology interventional, na shami y’umubiri mu kubaga, bisaba ubuhanga bwo kubaga ku rwego rwo hejuru n’ubuhanga busesuye butangwa n’umuganga ubaga.
Uyu munsi, twifuza kubagezaho inzobere izwi cyane mu bijyanye no kuvura indwara zitandukanye,Dr. Liu Chen, umaze imyaka myinshi akora muri urwo rwego kandi akaba yiyemeje gukora ubushakashatsi ku buhinduzi bw’indwara no gukwirakwiza uburyo bwo gusuzuma no kuvura indwara zitagaragara cyane nko gusuzuma kanseri y’ibibyimba bigoye kandi bifite ibyago byinshi, gukuraho ubushyuhe, no gutera utunyangingo tw’ibinyabutabire.Dr. Liu azwi nk' “intwari ku isonga ry’urushinge” kandi yagize uruhare mu gushyiraho ubwumvikane bw’impuguke n’amabwiriza ku buryo butandukanye bwo kuvura kanseri y’ibihaha mu Bushinwa. Yatangije igitekerezo cyo gucunga neza kanseri y’ibihaha anashyiraho uburyo busanzwe bwo kubaga kugira ngo anonosore gufata ibyemezo byo kuvura kanseri y’ibihaha mu buryo bwo kuvura kanseri y’ibihaha mu ntangiriro, ateza imbere iterambere rusange ry’uburyo bwo gusuzuma no kuvura kanseri y’ibihaha mu Bushinwa.
“Intwari ku isonga ry'urushinge” – Dogiteri Liu Chen
Yibanda ku gupima no kuvura ibibyimba mu buryo buciriritse binyuze mu gupima indwara.
1. Gukuraho mikoroonde/Radiofrequency
2. Uburyo bwo gusuzuma hakoreshejwe icyuma gipima uturemangingo (percutaneous biopsy)
3. Gutera uduce duto tw’imirasire
4. Uburyo bwo kuvura ububabare buterwa n'ingaruka
2. Intego n'ibimenyetso by'ubuvuzi bwo kuvura kanseri y'ibihaha
"Ubwumvikane bw'inzobere ku kuvura indwara zo mu bihaha ziterwa no kwandura indwara"(icapisho rya 2014) rigabanya uburyo bwo kuvura kanseri y'ibihaha mu byiciro bibiri: uburyo bwo kuvura no kuvura indwara ziterwa n'udukoko.
Gukuraho indwara zo kuvuraigamije gukuraho burundu ibibyimba byo mu gace k'ikibyimba kandi ishobora kuvura.Kanseri y'ibihaha yo mu cyiciro cya mbere ni ikimenyetso cy'ubuvuzi bwo kuvura indwara zo mu bihaha,cyane cyane ku barwayi bafite imikorere mibi y’umutima n’ibihaha, abageze mu za bukuru, abadashobora kwihanganira kubagwa, kwanga kubagwa, cyangwa abafite ikibyimba kimwe cyongeye kugaruka nyuma yo kuvurwa hakoreshejwe imirasire, ndetse na bamwe mu barwayi bafite ibisebe byinshi bya kanseri y’ibihaha bakeneye gukomeza imikorere y’ibihaha.
Gukuraho ibyuma bigabanya ububabareigamijekugabanya cyane ikibyimba cy’ibanze ku barwayi ba kanseri y’ibihaha iri ku rwego rwo hejuru, kugabanya umutwaro w’ikibyimba, kugabanya ibimenyetso biterwa n’ikibyimba, no kunoza ubuzima bw’umurwayi.Ku barwayi ba kanseri y'ibihaha iri ku rwego rwo hejuru, ibibyimba bifite umurambararo ntarengwa wa cm 5 cyangwa bafite ibibyimba byinshi bashobora kuvurwa hakoreshejwe uburyo bwinshi bwo gupima urushinge, uburyo bwinshi, cyangwa uburyo bwinshi bwo kuvura, cyangwa bagahuzwa n'ubundi buryo bwo kuvura kugira ngo bakomeze kubaho. Ku ndwara z'ibihaha zifata ibihaha mu gihe cya nyuma, niba uburyo bwo kugenzura ibibyimba byo hanze y'ibihaha ari bwiza kandi hakaba hari ibibyimba bike gusa bisigaye mu bihaha, uburyo bwo kuvura bushobora gufasha mu kugenzura indwara no kunoza ubuzima bw'umurwayi.
3. Ibyiza byo kuvura indwara zo mu mutwe
Kubagwa bidakunze kugaragara, gukira vuba: Ubuvuzi bwo kuvura hakoreshejwe uburyo bwa Ablative bufatwa nk'uburyo bwo kubaga bugabanya ubukana bw'indwara. Urushinge rw'amashanyarazi rukoreshwa muri electrode ya Ablative rukunze kuba rufite umurambararo wamm 1-2, bigatuma habaho gukata uduce duto two kubaga tungana n'umwobo w'urushinge. Ubu buryo butanga ibyiza nkoihungabana rike, ububabare buke, no gukira vuba.
Igihe gito cyo kubagwa, uburambe bwiza:Ubuvuzi busanzwe bukorwa hakoreshejwe ikinya cyangwa bugashyirwa hamwe n'imitsi igabanya ububabare mu mitsi, bigatuma badakenera gukoresha endotracheal intubation. Abarwayi baba basinziriye gake kandi bashobora gukangurwa byoroshye no gukangura buhoro. Hari abarwayi bashobora kumva ko kubagwa byarangiye nyuma yogusinzira vuba.
Uburyo bwo gusuzuma indwara icyarimwe kugira ngo hamenyekane neza:Mu gihe cyo kuvura indwara yo mu bwoko bwa abrasion, igikoresho cya “coaxial guide” cyangwa “synchronous puncture” gishobora gukoreshwa kugira ngo hamenyekane uburyo bwo gupima igisebe.gusuzuma indwara no gupima imiterere y'uturemangingogutanga amakuru y'ingirakamaro ku byemezo by'ubuvuzi bikurikira.
Uburyo bushobora gusubirwamo: Ubushakashatsi bwinshi bwakozwe n'amasoko yo mu gihugu no mu mahanga bwagaragaje ko igipimo cyo kugenzura abarwayi ba kanseri y'ibihaha mu gihe cyo hambere bavurwa hakoreshejwe uburyo bwo kuvura indwara ya “ablative therapy” kingana n'icyo kubagwa cyangwa kuvurwa hakoreshejwe imirasire ya stereotactic. Mu gihe indwara ya “ablative therapy” isubira inyuma, uburyo bwo kuvura indwara ya “ablative therapy” bukoreshwa mu buryo bwa “ablative therapy”.bishobora gusubirwamo inshuro nyinshikugira ngo bongere bagarure ubushobozi bwo kugenzura indwara mu gihekongera ubuzima bw'umurwayi.
Gukora cyangwa kongera imikorere y'ubudahangarwa bw'umubiri: Ubuvuzi bwa Ablative bugamijekwica uturemangingo twa kanseri mu mubiri, kandi rimwe na rimwe, bishobora gutuma ubudahangarwa bw'umubiri bw'umurwayi bukora neza cyangwa bukarushaho kwiyongera, bigatuma aho ibibyimba bitavuwe mu bindi bice by'umubiri bigaragaza ko byasubiye inyuma. Byongeye kandi, uburyo bwo kuvura bushobora guhuzwa n'imiti ikoreshwa mu buryo bw'umubiri kugira ngo hakorweingaruka zo guhuza ibikorwa.
Uburyo bwo kuvura hakoreshejwe uburyo bwa Ablative bukwiriye cyane cyane abarwayi badashobora kwihanganira kubagwa cyangwa gusinziriza indwara bitewe n'indwaraimikorere mibi y'umutima n'ibihaha, gusaza, cyangwa indwara nyinshi zishingiye kuNi uburyo bwiza bwo kuvura abarwayi bafiteudusimba twinshi two mu cyiciro cya mbere (nk'udusimba twinshi two mu kirahuri cyo hasi).
Igihe cyo kohereza: Kanama-23-2023