Yintsholongwane yeKholoni (YeMithambo) Yintoni? Ziziphi Iimpawu Zayo? Yintoni Ebangela Oku?
IKholoni (Umhlathi) Umhlaza: Iimpawu, Izizathu, Uvavanyo kunye neendlela zonyango
Umhlaza wekoloni, sisifo esinzulu esivelayo kumhlathi omkhulu kunye nerektam, esichaphazela inxalenye ebalulekileyo yenkqubo yokugaya ukutya. Ngokuqhelekileyo, siqala xa iipolipu ezenzeka kumphezulu womhlathi ziguquka zibe ngumhlaza ngokuhamba kwexesha. Iimpawu zesifo, izizathu kunye nonyango zixhomekeke kwinqanaba lomhlaza kunye nempilo iyonke yomntu. Uvavanyo lwangethuba, njengakwezinye iintlobo zomhlaza, lubalulekile ekulweni nomhlaza wekoloni.
Yintoni Umhlaza weKoloni (Umhlathi)?
Umhlaza wekoloni, uvela kumhlathi omkhulu kwaye ungomnye weentlobo zomhlaza ezixhaphakileyo kwihlabathi liphela. Esi sifo siqhelekile kubantu abangaphezu kweminyaka engama-50, kodwa sinokuthi sivele nakubani na. Xa sithetha ngolwakhiwo lomhlathi omkhulu, umalunga ne-1.5–2 yeemitha ubude, kwaye unezahlulo ezimbini eziphambili: ikholoni kunye nerektam. Irektam yinxalenye yokugqibela yomhlathi omkhulu ekufutshane kakhulu nomphambili wesithuba sangasese, apho igcina inkunkuma yomzimba phambi kokuba ikhutshelwe ngaphandle. IKholoni ibhekisa kwinxalenye ebanzi yomhlathi omkhulu engaphambi kwerektam. Emva kokuba ukutya kudlule kumhlathi omncinci kungene kwikholoni, apha amanzi kunye neminerali zifunxwa, kwaye inkunkuma igcinwa kwirektam.
Umhlaza wekoloni, uqala kwiiseli ezikwisigqubuthelo sangaphakathi somhlathi omkhulu (umqolo we-mucosa).
Ubume beKholoni
Umhlaza uhlala uvela kwezi ndawo zilandelayo;
IKholoni yeSigmoid (inxalenye yokugqibela emilise u-S) : Yinxalenye yomhlathi omkhulu edibanisa kwirektam. Le yeyona ndawo ixhaphakileyo. Apha, inkunkuma iba lukhuni ngakumbi, ngoko ke iiseli zihlala ixesha elide zichaphazeleka yinkunkuma, nto leyo eyonyusa umngcipheko.
Irektam : Yeyona nxalenye ikufutshane nomphambili wesithuba sangasese. Umhlaza ophuhla kule ndawo ubizwa ngokuba umhlaza werektam, kodwa ngokuqhelekileyo kubhekiswa kuwo kunye nomhlaza wekoloni phantsi kwesihloko esithi “umhlaza wekolorektal”.
IKholoni ephumayo (ekunene): Yeyona ndawo yokuqala apho inkunkuma engamanzi evela kumhlathi omncinci ifika khona. Iitumor eziphuhla apha zihlala zibonakalisa iimpawu emva kwexesha, kuba inkunkuma iseyimanzana. Ngenxa yoko, umhlaza wekoloni ekunene uhlala ufumaneka kwinqanaba eliphambili.
IKholoni ethe tye (transverse) : Yinxalenye ethe tye edibanisa ikholoni yasekunene kunye nesekhohlo. Umhlaza unokuphuhla apha, kodwa akaxhaphakanga njengakwezinye iindawo.
IKholoni ehla (ekhohlo): Yinxalenye apho inkunkuma ihamba isiya kumphambili wesithuba sangasese. Iitumor apha zihlala zibonakalisa iimpawu ezifana nokubamba, ukuncipha kobubanzi benkunkuma, kunye nokopha kwangethuba.
Malunga ne-40–50% yeziganeko zenzeka kwikholoni ye-sigmoid kunye nerektam, malunga ne-20% kwikholoni ephumayo (ekunene), kwaye eseleyo kwikholoni ethe tye (transverse) kunye nehla (ekhohlo).
Yintoni Umhlaza weKolorektal?
Umhlaza wekolorektal ubandakanya umhlaza ophuhla kokubini kwikholoni kunye nerektam. Uvela kwinxalenye esezantsi yenkqubo yokugaya ukutya, xa iiseli zanda ngendlela engaqhelekanga. Ngokuqhelekileyo, uqala kwiipolipu ezilungileyo eziguquka zibe ngumhlaza ngokuhamba kwexesha. Xa umhlaza wekolorektal ufunyenwe kwangethuba, amathuba onyango anyuka kakhulu.
Zithini Iimpawu zoMhlaza weKoloni?
Umhlaza wekoloni amaxesha amaninzi awubangeli zinkxalabo zibonakalayo kwinqanaba lokuqala. Iimpawu ziqala ukubonakala xa itumor ikhula, kwaye zinokushwankathelwa ngolu hlobo:
Iintlungu zesisu okanye imijikelo
Ukunqaba kwexesha elide, ukubamba, okanye utshintsho kwindlela yokuphuma kwenkunkuma
Igazi kwinkunkuma okanye umbala omnyama (onjenge-tar) kwinkunkuma
Ukwehla kobunzima obungachazwanga
Ukudinwa okungapheliyo kunye nokungabi namandla
Ukudumba okanye imvakalelo yokugcwala esiswini
Ezi mpawu zinokubangelwa zezinye iingxaki zempilo. Ngenxa yoko, kubalulekile ukubonana nengcali yezempilo xa iingxaki zihlala ixesha elide okanye azinakuchazwa.
Izizathu kunye neMingcipheko yoMhlaza weKoloni
Nangona unobangela ochanekileyo womhlaza wekoloni ungaziwa ngokupheleleyo, imingcipheko ethile ichongiwe:
Ubudala: Umngcipheko uyanda kubantu abangaphezu kweminyaka engama-50.
Imbali yosapho: Umngcipheko uphezulu kubantu abanabazali, abantakwabo okanye abantwana abaye bafumana umhlaza wekoloni; kule meko, kuvavanyo lwangethuba luyacetyiswa.
Iipolipu: Iipolipu ezivelayo kudonga lomhlathi zinokuguquka zibe ngumhlaza ngokuhamba kwexesha, ngoko kubalulekile ukuba zifunyanwe kwaye ziphathwe.
Izifo ezifunyanwa ngokwemfuza: Ingakumbi i-Lynch syndrome (HNPCC) kunye nezinye iisifo ezidluliselwa ngemfuza zinokunyusa umngcipheko.
Izifo ezirhawulezayo zomhlathi: Izifo ezinjenge-Crohn kunye ne-ulcerative colitis zonyusa umngcipheko.
Indlela yokuphila: Ukutya okunesi-fiber esezantsi, amafutha aphezulu, ukutyeba kakhulu (obesity), ukungazilolonga, ukutshaya kunye nokusela utywala ngokugqithisileyo zonyusa umngcipheko.
Ezinye iimeko zempilo: Uhlobo lwesibini lwe-diabetes lonyusa umngcipheko womhlaza wekoloni.
Kufumanwa Njani Umhlaza weKoloni?
Namhlanje, iindlela ze-endoscopy zisebenza kakhulu ekuvavanyweni kwe-tumor zekholoni kunye nerektam. Ngekolonoskopi, indlela esemgangathweni, kunokwenzeka ukubona ngqo umphezulu wangaphakathi womhlathi kunye nokususa iipolipu ezisolisayo. Ukuqinisekisa uvavanyo, i-biopsy (ukuthatha isampuli yethishu enetyhefu ukuze ihlolwe) iyenziwa. Ukuvavanya umngcipheko we-tumor enkulu okanye ukusasazeka (metastasis), iindlela zokubonisa ezifana ne-computed tomography (CT) nazo zisetyenziswa. Uvavanyo lwegazi elifihliweyo kwinkunkuma luhlala lusetyenziswa njengesixhobo sokuhlola.
Amanqanaba oMhlaza weKoloni kunye neeMpawu ngokweNqanaba
Inqanaba 0 (Carcinoma in situ): Umhlaza usesephakathi kumphezulu wangaphakathi womhlathi, awukashukumi. Ngokuqhelekileyo akukho mpawu zibonakalayo.
Inqanaba 1: Umhlaza usezantsi kwiingqimba zangaphakathi zomhlathi. Iintlungu ezithambileyo zesisu, utshintsho kwindlela yokuphuma kwenkunkuma okanye igazi elincinci kwinkunkuma zinokubonakala.
Inqanaba 2: ITumor ingadlula udonga lomhlathi kodwa ayikasasazeki kwiindawo ze-lymph. Iintlungu zesisu, utshintsho olucacileyo kwindlela yokuphuma kwenkunkuma, ukwehla kobunzima kunye nokudumba kungavela.
Inqanaba 3: Umhlaza usasazeke kwiindawo ezikufutshane ze-lymph. Iintlungu zesisu, ukudinwa, ukungabi namdla wokutya kunye negazi kwinkunkuma zibonakala ngakumbi.
Inqanaba 4: Umhlaza usasazeke kwiindawo ezikude ezifana nesibindi okanye umphunga (metastasis). Ukudinwa okukhulu, iintlungu zesisu ezingapheliyo, ukuvaleka komhlathi kunye nokwehla kobunzima ngokukhawuleza kunokwenzeka.
Kutheni Uvela Umhlaza weKoloni?
Inkqubela yomhlaza wekoloni ngokuqhelekileyo iqala kwiipolipu ezilungileyo eziguquka zibe ngumhlaza ngokuhamba kwexesha. Utshintsho lweemfuza kwiiseli luyadlala indima; kodwa izinto zokusingqongileyo kunye nendlela yokuphila nazo zibalulekile. Nangona unobangela ochanekileyo ungenakuchazwa, ukuphepha imingcipheko kunye nokuthatha inxaxheba kwiinkqubo zokuhlola kunokunceda ekuthinteleni.
Kuthatha ixesha elingakanani ukuvela koMhlaza weKoloni?
Umhlaza wekoloni uhlala ukhula kancinci, kuthatha iminyaka emininzi. Ukuguquka kwepolipu ibe ngumhlaza kungathatha iminyaka eli-10–15. Ngenxa yoko, uvavanyo rhoqo lubalulekile, ngakumbi kwabo bakumngcipheko ophezulu.
Iindidi zoMhlaza weKoloni
Uninzi lweemhlaza zekholoni luhlobo lwe-adenocarcinoma; ezi tumor zivela kwiiseli zeegland ezigquma umphezulu wangaphakathi womhlathi. Kancinci, ezinye iintlobo ezifana ne-lymphoma, sarcoma, carcinoid okanye i-gastrointestinal stromal tumor (GIST) zinokufumaneka. Iindlela zovavanyo kunye nonyango ziyahluka ngokohlobo lwe-tumor.
Iindlela zonyango zoMhlaza weKoloni
Unyango luyilwa ngokweqanaba lesifo, imeko iyonke yomntu kunye neempawu ze-tumor. Kwinqanaba lokuqala, unyango lokuhlinzwa luhlala lwanele; injongo kukususa iipolipu kunye nethishu enomhlaza. Kwiimeko eziphambili, i-chemotherapy, ngamanye amaxesha i-radiotherapy, kunye nezinye iindlela ezifana nonyango olujolise kwithagethi okanye i-immunotherapy zinokongezwa. Ulandelelo kunye nonyango kufuneka lulawulwe liqela leengcali.
Utyando loMhlaza weKoloni
Utyando luyindlela ephambili kunyango lomhlaza wekoloni. Inkqubo esetyenziswayo ixhomekeke kwindawo yetumor kunye nokusasazeka kwayo; kwinqanaba lokuqala, kunokwaneleka ukususa ipolipu kuphela, kodwa kwiimeko eziphambili, i-partial colectomy (ukususwa kwenxalenye yekholoni kunye neendawo ezikufutshane ze-lymph) ingenziwa. Ubungakanani botyando kunye nexesha lokubuyela kwimeko yesiqhelo kuxhomekeke kwinqanaba lesifo kunye nezinto zomntu.
Imingcipheko enokwenzeka yoTyando loMhlaza weKoloni
Zonke iindlela zonyango zineengozi kunye neengxaki ezinokuthi zenzeke, njengoko kunjalo nakwiinkqubo zonyango lwekoloni yomhlaza. Ezi ziquka ukopha, ukwenzakala kwezitho zomzimba (umzekelo, iindlela zokuchama, ibhuleki, isilevu, isibindi, ipancreas okanye amathumbu), ukuvuleka kwezilonda zamathumbu, usulelo kwindawo yokuhlinzwa kunye nomonakalo weemithambo-luvo. Ezi ngozi zizama ukuncitshiswa ngokulandelwa komntu phambi nangemva kotyando. Izinto Ezingqwalaselwayo Emva Konyango Emva kotyando, isigulana sinokufumana iintlungu ezithambileyo ukuya kweziphakathi, ngamanye amaxesha usulelo okanye ukopha. Amayeza acetyiswa ngugqirha asetyenziswa kwiintlungu kwaye i-antibiotic zinokunikwa ukukhusela usulelo. Ukuxhasa ukuhamba kwegazi ngokuhamba (umzekelo, ukuhamba kwangoko kunye nemithambo) kunye nokusela amanzi ngokwaneleyo kubalulekile ekuthinteleni iingxaki. Kufuneka kulandelwe iingcebiso zikaGqirha kwaye kuqwalaselwe iziluleko zokutya ngexesha lokuphilisa. Inkqubo Yokuphilisa kunye Nexesha Lokuhlala Esibhedlele Emva kotyando lomhlaza wekoloni, umyinge wexesha lokuhlala esibhedlele ungaba ziintsuku ezi-5 ukuya kwezi-10. Emva kokukhutshwa esibhedlele, ukuphilisa kunokuthatha inyanga enye okanye ezimbini. Kule mihla, kubalulekile ukulandela iziluleko zokutya, ukusetyenziswa kwamayeza rhoqo kunye nokungaphoswa kweentlanganiso zokuhlola ukuze inkqubo ihambe kakuhle. Yintoni Enokwenziwa Ukuze Uthintele Umhlaza Wekoloni? Ukutya okutyebileyo kwi-fiber kunye nokulinganisela, ukufumana i-calcium eyaneleyo kunye ne-vitamin D, ukugcina ubunzima obusempilweni, ukwenza umthambo rhoqo, ukuphepha ukutshaya kunye nokusela utywala ngokugqithisileyo zizinto ezibalulekileyo zokuthintela. Ingakumbi emva kweminyaka engama-50, ukwenza uvavanyo rhoqo lunceda ekufumaneni isifo kwangoko kwaye kuphucula iziphumo zempilo. Ngubani Osemaphutheni Omhlaza Wekoloni? Kwihlabathi lonke, umhlaza wekoloni ufumaneka rhoqo kubantu abangaphezu kweminyaka engama-50. Kwabo banembali yomhlaza wekolorektal kusapho, kucetyiswa ukuba baqale uvavanyo rhoqo besebancinci. Ukutya okune-fiber ephantsi kunye neprotheyini ephezulu, ukuswela i-vitamin D kunye nezinye iingxaki zempilo ezifana neswekile, kuxelwe kwizifundo ezahlukeneyo ukuba zonyusa umngcipheko. Iintlungu zomhlaza wekoloni zihlala zivakala phi? Zinokuziva kwicala elisezantsi okanye elisecaleni lesisu, ngamanye amaxesha njengeentlungu zesisu ezisasazeke ngakumbi. Ngaba uvavanyo lwegazi efihlakeleyo kwindle luphawu lomhlaza wekoloni? Ukuphuma kwegazi efihlakeleyo kwindle kunokubonisa ukopha kumathumbu, kubandakanya nomhlaza wekoloni. Ukuqinisekiswa kwesifo kufuna uphando olungaphezulu. Ngaba umhlaza wekoloni unokufunyanwa kwi-ultrasound? I-ultrasound ayisoloko yanele ekufumaneni umhlaza ongaphakathi kumathumbu. Iindlela ezifana ne-colonoscopy kunye ne-CT zisebenza ngakumbi ekufumaneni. Ngaba utyando lomhlaza wekoloni luyingozi? Njengazo zonke iinkqubo zonyango, zikhona iingozi ezithile kodwa ezi zinokuncitshiswa ngamaqela anolwazi kunye nokulandela kakuhle. Umhlaza wekoloni (amathumbu) kufuneka uye kweliphi candelo? Amacandelo e-General Surgery kunye/okanye i-Gastroenterology ngamagcisa ekufuneka uye kuwo ukuze ufumane uvavanyo kunye nonyango. Utyando lomhlaza wekoloni luthatha ixesha elingakanani? Ixesha lonyango lixhomekeke kwindawo kunye nokusasazeka kwesifo, kodwa umyinge ungaba ziiyure ezi-2 ukuya kwezi-3. Ngaba umhlaza wekoloni unyangwa ngamayeza? Kwizigaba eziphambili, unyango ngamayeza afana ne-chemotherapy luyasebenza. Kodwa kwizinga lokuqala, indlela ephambili yonyango lutyando. Ngaba umhlaza wekoloni uyadluliselwa ngokwezakhelo? Kwabo banembali yomhlaza wekoloni kusapho, umngcipheko uphezulu ngenxa yokuthambekela kwezizalo, kodwa ayingabo bonke abagulayo abanezizalo. Ngaba umhlaza wekoloni unokuphinda ubuye? Ukulandela rhoqo emva konyango kubalulekile. Kwezinye iimeko, isifo sinokuphinda sibuye, ngoko kufuneka kulandelwe iingcebiso zikaGqirha. Ngaba umhlaza wekoloni kunye nomhlaza werektum ziyafana? Nangona umhlaza wekoloni kunye nomhlaza werektum benezinto ezifanayo, unyango kunye nendlela yokujongana nazo ziyahluka ngokwendawo. Zombini zibizwa ngokuba "umhlaza wekolorektal". Imithombo
I-World Health Organization (WHO) Ulwazi Lomhlaza Wekolorektal
https://www.who.int/news-room/fact-sheets/detail/colorectal-cancer
American Cancer Society Colorectal Cancer Guidelines
European Society for Medical Oncology (ESMO) Colorectal Cancer Clinical Practice Guidelines
Centers for Disease Control and Prevention (CDC) Colorectal Cancer Information
The Lancet, New England Journal of Medicine Uphando Olutsha NgeKolorektal Cancer
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