Pukhlini stravohodu dobroyakisnі - description. Cancer to stravohod - description, reasons, treatment of Osvita to stravohods ICD code 10

leiomyomy stravohodu... Two-thirds of the good-looking puffs of the stravohode store leiomyomy - puffs, which grow into the mucous membrane of the stravohode and do not get the mucous membrane before the process. symptoms... Likewise, leiomyomas reach 5 cm and larger sizes, in patients with dysphagia. Diagnostics .. Contrast roentgenologic doslidzhennya. At the stage of the stratohode, a defect resembling smooth edges and a change in mucous membrane appears. Promptly lykuvannya .. Right-sided thoracotomy and enucleation (viluschuvannya) of chickens from the wall of the intestine without shrinking of the mucous membrane in patients with the cliché manifestations of the chickens ..

Code for the international classification MKH-10 ailment:

• D13.0

Good poohlini, which grows in the education of the stravohod, - papilomy, lipomi, fibroloma and mixofibromia. symptoms: Dysphagia, growth and thinning. Diagnostics .. Contrast roentgenologic dosage to stravohodu .. Esophagoscope to diagnose and diagnose malignant new diagnostics. promptly lykuvannya.. esophagotomy, visible swelling and suturing of the esophagotic opening ..

ICD-10. D13.0 goodness new stravohodu

Polyp of the slunk is a new solution, as it appears over the surface of the mucous membrane of the given herbal organ. The symptomatology of some of them is not specific, and the diagnosis is not accelerated.

According to ICD 10, the growths in the empty slurry are carried up to the tenth glance of the morphology of similar new products. Insight є puffy-like good approval, as it may have a glandular structure, as it goes from the mucous membrane.

It is not safe to fall ill with the fact that there is no problem without severely reverberating symptoms. At an early stage, pathology rarely appears.

Yakshcho podbnі new solutions reach significant changes, є risik development of cramping pain syndrome in the area of ​​the abdomen, slunk bleeding, as well as the complicated process of evacuating the grub breast from the emptying of the slunk.

Some people see a little bit of a misunderstanding. The basis of diagnostics is based on endoscopic biopsies, fibrogastroscope, as well as roentgenography of the slunk empty.

Of course, there is a liking, tactics, as a rule, of a ma vichіkuvalny character, or it is immediately recognized as promptly involved.

Ethiology and classification

The human slunk is stored from three balls, external, internal and meat. For some reason, uncontrolled growth of the clitin in the inner sphere can be promoted. After settling on a naryst vidpovidak on food "scho take a drink in the shlunku".

description of pathology

Zvvychay such growths are good purchases of cells, which were established at the stage in the middle of the slurry. The name pathology rejected from the Greeks, "poli" means "bagato", "pus" means "leg". First of all, pour it into the slunk before you can stick it to a small amount, like a mushroom or a berry.

Pathology grows up to the end of the day. Yaksho є look at the polіpi in the slunker - how can you get sick? It’s a pity, it’s important to get rid of symptoms for symptoms.

Evidence of polіpіv can be supervised by actions inappropriate views, It is possible and bleeding, however, the most frequently occurring growths are vypadkovo. Vono can become in the process of improving the patient's growth at the time of getting sick.

Polypi according to ICD10

The international classification of ailments - ICD 10 - is a permanently evolving disease, a singular code is assigned to the skin. With this help, there is a cloud of ill health, for reasons, behind them, the brutalization of the client in medical pledge, Causes of lethal symptoms.

Before the transfer, the slurry polyp was introduced, the ICD 10 was wrought and described given pathology yak "polyp slunk and 12-gut". In the case of the shlunk polyp, the code is according to ICD 10 K31.7, the vyatka should become adenomatous polyp, which goes through the code D13.1.

Poli shlunka - not safe stench

Diagnostics of cancer stravohodu

cancer It is hostile to stravohid and to become a significant part of all pathologies of the organ, call it cancer stravohod. The main key signs of the pathology cycle are dysphagia (progressive failure of the act of co-operation) and the reduction of vagina.

Cancer is often sick with cancer, the frequency of sickness among all types of cancer becomes 5-7%. Code for MKH-10: cancer stravohodu (C15 evil new affirmation stravohod).

How to convert stravohid to cancer? The price of food for hvilyuє bagatokh people who run after their health. Find out the diagnostic methods, which allow the cancer to emerge.

Early diagnosis of cancer stravohodu

Possibilities of early diagnostics of cancer stravohodu obmezheni. The price is tied to this, that on this day there are dumb effective and reliable methods of diagnostics. People who are at the presence of the factories are guilty of being guilty and regularly examined for cancer diagnostics.

When Barrett's stranger is evident, who is overcrowded, the patient is guilty of once a week or so undergoes biopsy and endoscopy procedures;

If there is a dysplasia of the clitin, then the conduct of these conditions is guilty of being scrupulous. When dysplasia turns, a visible part is shown to the strainer to prevent the development of chubby. This tactic allows the diagnosis of cancer on the early stages If the forecast is ill-favored.

Early signs of cancer stravohodu

Sorry, swung key picture in case of cancer, the stravohodu beckon to try to in different stages becoming ill, which greatly accelerates the diagnosis of cancer. Sleepy symptoms, which can be spontaneous in cancer,:

• zagalnaya weakness, decrease in prasezdatnostі;
• pidvischena stomluvanst, drastic;
• temperature adjustment;
• anemia;
• Rizka vrata vagi.

Pouring into the slunker, symptoms and treatment

Likuvannya. Vibir to the method of treatment is to lay down in the stage of illness and localization of chickens.

Radical operations - extirpation of the stravohove along Osawa-Garlock, Lewis. For important, weakened ailments, the Dobromislov-Torek operation is to be seen.

In this hour, the show is expanded to the great combination of resection. To improve the resectability of the vicoriste before the operation exchange and chemotherapy.

The operation will be performed in 4-6 times. Promenade therapy as an independent method is indicated for lesions in the proximal part of the middle third, or for the upper third of the stratohole, and the ill-health of the viconati operation (for the sick person).

The total vignische dose should be approximately 60 Gy. Chemotherapy is practically not infused with the triviality of the life of ailments.

Forecast. For a radical surgical treatment 5 - the usual vision for all groups of ailments is 5-15%. In children who operated at the early stages of becoming ill (without visible defeat lymphatic universities), Tsey indicator is moving up to 30%.

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Cancer stravohodu - ailment lovers vipiti and smoke

Cancer is borrowed from a stravohod in the middle of all cancer patients, close to 5-7%. There is more to be found in the middle of the people in the middle and abducted period. It’s a pity, but it’s a pity to try to rejuvenate.

More severe to the whole pathology of the middle and lower ones to the stravohode. The most common cancer is squamous or adenocarcinoma.

Ethiology of cancer

Unambiguously, the reasons, scho to produce oncology, until the end, are not known for certain. Changes in mind to cancer stravohodu vizanі:

• ruinous food;
• traumatic ear mucilage stravohodu;
• recession;
• shkіdlivі calls;
• chronic fired up;
• spadkova smartness.

Until the ruin of the food, the malignant sludge, the greasy slime of the slurry, the products, the slime of the slurry, the products, the slime of the slurry, or the other the other potentially tease the slime of the element.

I tease slime chicken, alcohol, juvenile tyutyun. Chickens and lovers of vipiti have cancer of the stravohode winikє 100 times more often.

Negatively infused into the mucous membrane of the tract with a deficiency of vitamins A, B, C, and E, selenium, folic acid.

Rebirth into cancer can be chronic and ignited by the stravohode, virazki. Delivered carcinogenic to mucus stravohode shlunk juice, Zhovchy. The stench is thrown over here from the slunk in case of reflux esophagitis. injuries to stravohods good time, In addition, the descriptions of thermal and chemical ones can also be used for degenerated fabrics.

Cicatricial changes, polypia, cicatrices of pathology (Barrett's ailment, tylosis). Getting on the slime saw of metals (mish'yak, chromium) with a carcinogenic effect is introduced into the clinic until the malignant degeneration.

Delivered in a vzamozvyazok appear cancer zі spadkovіstyu.

The code for MKH 10 crayfish stravohodu in the fallowness from localization counts from C15 to C15. 9.

show cancer

It is not specific that they show themselves in the out-of-the-way skargs, as it is not to lead the wicked people to think about cancer. Periodically, the temperature rises to subfebrile numbers, there is a drink without special reasons, the appetite decreases, the ailment is worse. Deyaki, I mean, I will appear to be eddy to meat. Bezposredno symptoms, characteristic for cancer svitti stravohodu - the whole of the collapse of the disease (dysphagia). A lot of ailments can be traced to the destruction of the tilka zhorstkoi їzhі, because of the problem of the wickedness as well as the prodigious problem of rіdin.

Ailment is a definite sign of pain behind the sternum or in the interscapular region behind. A whole symptom is characteristic for a larger developmental stage, if during the process there are navkolishny stravochid nerves of the storm and organ.

Sposter on the overworld of dreaming

The voice grows quiet, hoarse. It is worth explaining the sprouting of chubby in the nerves, the gossip of the breast, and the paresis of the voices. Sickness to cough. Wine can be dry, torment, and can be wet, blood or pus. Tsey to talk about the sprouting of chubby in Legenevu fabric. It's a pity that close to 40% of the people who are sick are not allowed to speak of the nobility right up to the last stage. So ailment can develop 1 or 2 rock. Such a chubby can be seen as a wicked sorcerer in the presence of radiographic preliminaries in the breast cancer.

First Signs of Cancer Stravohodu

1. Dysphagia appears only toddy, if the chubby took up close to 70% of the education of the stravohod. Sometimes I think about the spasm of the shlunka, ale on every other day, dysphagia in case of cancer can be slow.
2. Even before you show the skarg for the destruction of the ailment, start to pay for the vidchuttya outside body with їzhі, even about seeing rubbish behind the breastbone.
3. Skargi on bіl represent only close to 30%. A handful of turbos only when you receive it, because of the interconnection with that when it’s received, it will become permanent.
4. Stravohidna blues. Vona polyagaє in vіdrizhtsі z'іїdenoі un-etched їzheyu.
5. Unacceptable putrid smell from the mouth. As a result of the obviousness of the transition to stravohody, it is necessary to get used to and accumulate before the transition.
6. Decrease of the vagi. Tse viclikano yak cancerous intoxications and decreased appetite, as well as those who are ill with ailments are seen through those who go through the process of wikklicing at new bil.

Gradation behind the steps

See 4 stages of crayfish in fallowness in terms of size and structure:

1. Up to 3 cm. Only slime marvels.
2. 3 - 5 cm. Diagnosis of metastasis from localization in lymphatic judgment.
3. 5 - 8 cm. Pukhlina sprouts all the stravohods. MAK metastases in lymphatic universities.
4. More than 8 cm

Signs of cancer to lie down on the yth step

• At 1 step, the patients do not see any visible failures, even the cancer can clearly appear on the endoscopy of the airway.
• With 2 degrees of ailment, it can be possible to break without visible manifestations, but in others there is already damage in the process of kovtannya.
• At 3 steps, all or even all the signs of cancer are already manifested - a decrease in vagi, a deterioration in kovtannya, bіl.
• At 4 steps, the sick person's camp is important. All signs of cancer turning. Rakova pukhlin can expand the bridle of the wall to the stravohode, and the opportunity to enlighten it.

Likuvannya and forecast

Hirurgical treatment of cancer ailments is ambiguous. From one side, the same radical surgery gives a divine chance to continue life. And on the other hand, the operation is folded, even more traumatic. The ailing one needs a little strength for a tricky period. And the sickness is especially sick and sick.

During the operation, the pathologic part of the travoduct is replaced by the tissue of the intestine. At a multitude of offenses, the light is offended: chest and cherevna. Tse great navantazhennya on organizm. Pislyaoperats_ynyy period is trivial, vimaga to the staff of patience, knowledge.

The operation is secondary only at 1 and 2 stages, spirally at 3 stages. The complexity of the operation grows to the fact that the order to grow the life itself is very important, as it is not the case that you cannot see it with the sprouting puffiness, but the edge is risky.

There is also a stagnation in exchange and chemotherapy.

To live on food with such a pathology cannot be accurately seen. On the colony of the whole term, they pour in the sick person, the patient's sickness, an hour of fermentation before the disease and the level of therapy, metastasis, germination in the inner organisms and the level of aggressiveness of the fluff. For averaged data, the 5-term term survives only 10-15% of all ailments.

A moody, friendly prognosis only in 1 - 2 stages.

Stage 3 is also characterized by the presence of diagnosed metastases. Pukhlina already drowned out all the resources of the stravohod and grew up in the middle organ. Vibir in the direction of the operative mobility with a stable patient's stance, as if allowing him to postpone the operation, a trivial period of operation, as well as, as it were, at the operation of the patient.

There will be a wide range of services involved. Part of the stravohodu, lymph vuzli can be seen. With a successful result of the operation and the period of operation, close to 10% of patients live for more than 5 years.

If it’s important that the suspicious organization is already feared with chubby, it’s not promptly involved. In such a way, only paliative symptomatic lykuvannya... Todi is the triviality of life in stock until the end of the day. As long as the love is not stagnant, then the forecast is even more unpleasant and living in the warehouse is 6-8 months. At the moment the first symptoms appear, the triviality of life becomes up to 5 years.

Progressing malignant approval of the stravohode, as well as crayfish chickens and localization, is not as smart as it gets. But if I look at it, the cancer of the localization process does not allow the nobility about itself, and it manifests itself with symptoms only at the end of the lower stage, the liking of the latter being already ineffective.

For operative treatment, chemotherapy and interchange therapy, the survival rate in patients with stage 1 becomes 90%, stage 2 - 50%, stage 3 - 10%.

Folk medicine.

to run people zasobi nada protirakovu diyu. Viriti їm chi nі - on the right dermal. Stagnate plantain grass, purity, m'yat, meadowsweet, cartilage and іnshі. You will be more rational to use herbs as a supplementary plant.

Cancer for stravohod is not virok. In case of a quick change, the forecast can be friendly.

More trochi novin:

bolzheludka.ru

Cancer stravohod

Cycle of treatment: part of the procedure for resection of the organ with evil new solutions.

tactics of addiction

non-drug treatment

Radical operation (resection or extirpation of the stravohode with regional lymphodissection) є the out-of-the-box standard in the treatment of patients with RESECTABLE cancer.

Palliative operations also play an important role in the system of providing additional assistance to the category of ailments, to prevent the loss of dysphagia as the most significant manifestation of illness.

In 80-90% of ailments, malignant swelling of the localization process is diagnosed in stages III-IV, in conjunction with only 10-15% of the ailments, it is possible that the disease is more radical and combined.

Pislyaoperative exchange therapy in SOD 50 Gy stagnates in the case of a non-radical appearance of plump or plump growth in the region when it is seen by a stravohode.

Promenade therapy, polychemotherapy and chemopromeneuverability increase in self-reliant meaning in cases of disabling unresectable carcinomas in the duct and in the presence of advanced metastases, as well as prevention of recurrent diseases.

Promeneva and chemopromeneva therapy as a self-contained method of treatment can be stagnant when localization of swelling in a shy viddili stravohodu.

Palliative operations (gastrostomy insertion, stenting of the gastrointestinal tract with stents)

surgical treatment

Hirurgical treatment is the main method for resectability of cancer to the travoductus with metastatic enemies of regional lymph nodes and without it.

Hirurgical treatment of transferring resection or extirpation to the trawler from the entrance to the regions of chicks larger than 5 cm and will be obligatory for the visibility of regional lymphodissection.

Vіk not є contraindicated until operative engagement.

Obligation of the operational involvement of the visitor begins the localization and the broadening of the fluffy battle, including:

Subtotal resection of the stravohode with the posterior mediastinal gastroesophagoplasty abdominal notothoracic access with the intra-pleural anastomosis;

Extirpation of the stravohode by thoracoabdominocervical access with posterior mediastinal gastroesophagoplasty or colonoesophagoplasty with anastomosis on the neck;

lower resection breastfeeding to the ventral duct and the proximal viddle of the slunk from the combined left-sided thoracophrenolaparotomic approach (Osawa-Garlok) with inferior thoracic swelling with / without transition to the cardiac part of the slunk. In case of severe intra-sternum to the stratohode, a visualization of the regional lymph node dissection is shown: the visualization of the regional medical and abdominal lymph nodes.

When combining extirpation of the trachea with resection of the trachea, head bronchi, aorta, and other vital structures, plastic can be added to the trachea to form an esophago- and gastrostomy.

Operatively, supervised by limphodissection, in the fallowness from the level of the display there is a standard two-zone (2S), expanded two-zone (2F) and three-zonal limphodissection.

Drug treatment(Only kosti, registered in the Republic of Kazakhstan, INN, courses or additional doses, from the values ​​of the form of the issue. Vkazuvati pharmacological groups, Pr: proton pump іngіbіtori. When explicit effective participation One sign, ale of chemistry form - vkazuvati all, pr: omeprazole, lansoprazole, rabeprazole. If the features are obvious, it is necessary to use: insulin pump, etc.)

If necessary, the registration should be done according to the steps: unavailable help, Outpatient, inpatient.

chemotherapy

Hіmіoterapіya held in skladі neoad'yuvantnoї hіmіopromenevoї terapії of the following operatsієyu in skladі chemoradiotherapy terapії abo samostіyno in razі vihіdnoї unresectable carcinomas stravohodu i at nayavnostі vіddalenih metastazіv and takozh protipokazan to hіrurgіchnogo lіkuvannya (at vіdsutnostі protipokazan to hіmіoterapії) i vіdmovі ailing od operative vtruchannya

monochemotherapy:

1. Paclitaxel 250 mg / m2, IV, 24-year infusion, 1st day. Kozhen 21 days. Colon stimulation factor is recommended.

2. Cisplatin 20 mg / m2, from the 1st to the 5th days, skin 3 times or 80 mg / m2, 1 p / 3 times.

3. Bleomycin 10-15 mg / m2, 2 times per day, up to a total dose of 200-300 mg.

4. Doxorubicin 40 mg / m2, 1st and 2nd days, skin 3 days.

5. Epirubicin 30 mg / m2, from the 1st to the 3rd days, skin 3 days.

6. Fluorouracil 500 mg / m2, from the 1st to the 5th day, skin 5 months.

7. Methotrexate * 40 mg / m2, dryness, trivial hour.

8. Vinorelbin * 25 mg / m2, dryness, trivial hour.

9. Mitomitsin * 20 mg / m2, 1 p / 4-6 times.

* Methotrexate, bleomycin, vinorelbin in mono-mode, often vicarious as a friend of the line of liking.

Combined chemotherapy:

1. Cisplatin 75-100 mg / m2, intravenously, on the 1st day. Fluorouracil 1000 mg / m2, trivial hour, intravenous infusion, from the 1st to the 5th day. Repeat course 1, 5, 8 and 11 types.

2. Irinotecan 65 mg / m Cisplatin 30 mg / m Repeat the course of skin 6 types.

3. Paclitaxel 180 mg / m2, 3-year infusion, 1st day. Cisplatin 60 mg / m2, 3-year infusion, 1st day. Repeat skin 2 conditions (maximum 6 courses) or paklitaxel 200 mg / m2, 24-year infusion, 1st day. Cisplatin 75 mg / m2, IV, 2nd day. Repeat skin 3 types *.

4. Carboplatin AUC 5, 1st day. Paklitaxel 150 mg / m2, 3-year infusion, 1st day. Skin 3 types.

5. Paclitaxel 175 mg / m2, 1st day. Cisplatin 20 mg / m2, day 1 to day 5. Fluorouracil 750 mg / m2, trivial hour, intravenous infusion, from the 1st to the 5th day. Skin 28 days. if necessary, on the primary prevention of colonization of the stimulating factor.

6. Docetaxel 75 mg / m2, 1st day. Cisplatin 75 mg / m2, 1st day. Skin 3 types.

7. Docetaxel 75 mg / m2, 1st day. Cisplatin 75 mg / m2, 1st day. Fluorouracil 750 mg / m2, trivial hour, intravenous infusion, from 1 to 5 days. Skin 3, if necessary, for the primary prevention of the colonial stimulating factor.

Інші vidi lіkuvannya

Promeneva and chemopromeneva therapy

Promeneva and chemopromenev therapy as an independent method cannot be overwhelmed before operative treatment. Increased visibility at stages I-II can be achieved with deprivation in 25-30% of patients with more resorption of fluff. On a positive note, the possibility of eliminating the risk of operational lethality and protecting stravohid. However, it means that post-radiation acceleration (esophagitis, virazka, stricture, fistula) develops in 30-40% of cases and, as a rule, it causes surgical treatment.

Exchange therapy technique

Distance exchange therapy is carried out according to the method of conventional (standard) or conformal optimization RID 1.8-2.0-2.5 Gy 5 fractions per week up to SOD 60-70 Gy in self-sustained mode, SOD 40-50 Gy in preoperative abnormal mode ... Vikoristovuєtsya bezperervny abo splitting course of exchange therapy. Optimization is carried out on gamma-therapeutic devices or liner prikoruvach.

The first period of time to be promoted either only from distance progression therapy, or (in case of altogether small primary swelling and the possibility of introducing endostatics) - for additional contact progression therapy, so as to promote the dosage of distance pre-treatment. The stagnation of a single exchange therapy allows a 2-fold increase in the frequency of repeated swelling resorption in some of the same distance exchange therapy.

The planning of the obsyag oprominennya includes the first puff plus 5 cm of normal fabrics up and down and down between the puffs and 2 cm laterally. Regional lymphatic universities of the first bar'єru (N1) will be rebuilt in the same dose as pukhlin.

With the localization of swelling in the lumpy appearance, the lumbar and upper thoracic segment and all adjacent lymph nodes, including the supraclavicular ones, appear.

In case of localization of swelling in the upper and / or middle thoracic formations, the entire thoracic segment is optimized to the level of diaphragms and medical lymph nodes.

In case of localization of swelling in the lower thoracic viddil, the thoracic and abdominal segments of the lower diaphragm, mediastinal and perigastric lymphatic nodes are increased.

The height of the fields is optimized from 11 to 22 cm, the width of the fields is to become 5-6 cm. In total, there are 4 fields of optimization.

Chemistry of treatment includes carrying out a distance exchange therapy with a total adhesion dose of up to 50 g without an interruption course (suboptimal dose) with a fraction of 1.8-2 g. On the ear and immediately after the completion of the exchange therapy, courses of polychemotherapy are carried out according to the scheme "cisplatin + 5-fluorouracil", for another, at intervals of 28 days, 1-2 courses of polychemotherapy are carried out.

Prototype indications prior to the remote exchange therapy є: - the appearance of any threat to the development of stratochid fistulas; - swelling with signs of bleeding; - germination of all trachea, head bronchi and aorta;

Decompensated fellow patients.

If there is a sickness in a surgical treatment, or if there is evidence of a contraindication before the operation of the indications, a course of one interchange therapy:

Stage I - distance exchange therapy in suboptimal doses of 50 Gy, 2 Gy, 5 times per day, with an uninterrupted course of 5 days.

Stage II - brachytherapy after 3 days of distance exchange therapy in 3 sessions of 5 Gy with an interval of 7 days. The point to the razrakhunku (pivot point) 1 cm towards the center of the radioactive dzherel.

In case of a planned paliative exchange therapy course for abnormal tumor stenosis, a single exchange therapy course can be started with brachytherapy sessions.

For the polishhennya efect, polychimotherapy is used:

Cisplatin 75 mg / m2, intravenously, on the 1st day;

Fluorouracil 1000 mg / m2 (750 mg / m2), internally; in the 1st, 2nd, 3rd, 4th days.

Zagalna scheme of the lіkuvannya:

Prototype indications before brachytherapy:

1. The length of the chubby along the strainer is more than 10 cm.

2. Evidence of distant metastases.

3. Expansion of swelling on the trachea and head bronchi.

4. Lokalizatsiya pochliny in shiynom vіddіlі stravohodu.

5. The sound of the stravohode is whirled, it is not easy to pass the endoscope through the yak.

Licuvannya to crayfish stravohode in fallowness due to the localization and stage of the fluffy process

prophylactic come in

Balanced vitamins and alcohol.

Hypovtaminozi A and B2, which are supervised by virazkovo-necrotic esophagitis; thermal, chemical, mechanical factors; kurinnya and malignant spirits; positive family history

Farther away: to follow the control over the ailments, there are three months of skin stretching out of the first rock and 6 months of the coming of the next 2 years.

Іndikatori efektivnostі lіkuvannya i BEZPEKA metodіv dіagnostiki i lіkuvannya described in protokolі (eg: vіdsutnіst Find our broken-winded ocherevini, vіdsutnіst pіslyaoperatsіynih uskladnen, іz zaznachennyam dіagnostichnih kriterіїv sposterezhennya for efektivnіstyu holding lіkuvalnih zahodіv - eg:.. Monіtoruvannya will rіvnya gemoglobіnu (plasma glucose krovі) i etc. - on weekends, once a week, etc.)

Zadovilny camp for thinking about the speed of the day and overcoming the wound, the appearance is a sign of an evil new solution.

With skin control, the viscosity is good: zagalny analiz blood, ultrasound dosage organs of the womb and the womb space.

Radiologic dosage of organs in the breast and radiopaque preliminaries is carried out 1 time in 6 months, pershі 3 months, in general - 1 time in 12 months.

In case of new indications, hospitalization of the sick is carried out and additional information about the endoscopy is carried out: endoscopy, computer tomography, biopsies of peripheral lymph nodes, radioisotopes of the patient, PET.

diseases.medelement.com

Diagnostics of cancer stravohodu

Oncological illnesses, which are hostile to stravochid and become a significant part of all pathological organisms, is called cancer stravohode. The main key signs of the pathology cycle are dysphagia (progressive failure of the act of co-operation) and the reduction of vagina.

Cancer is often sick with cancer, the frequency of sickness among all types of cancer becomes 5-7%. Code for MKH-10: cancer to the stravohod (C15 Malicious new to the stravohode).

How to convert stravohid to cancer? The price of food for hvilyuє bagatokh people who run after their health. Find out the diagnostic methods, which allow the cancer to emerge.

Early diagnosis of cancer stravohodu

Possibilities of early diagnostics of cancer stravohodu obmezheni. The price is tied to this, that on this day there are dumb effective and reliable methods of diagnostics. People who are at the presence of the factories are guilty of being guilty and regularly examined for cancer diagnostics.

When Barrett's stranger is evident, who is overcrowded, the patient is guilty of once a week or so undergoes biopsy and endoscopy procedures;

If there is a dysplasia of the clitin, then the conduct of these conditions is guilty of being scrupulous. When dysplasia turns, a visible part is shown to the strainer to prevent the development of chubby. This tactic allows diagnostics of cancer at the early stages, if the prognosis is sick.

Early signs of cancer stravohodu

Unfortunately, the clinical picture is twisted in case of cancer, the stravohode will be encouraged to try to prevent only at the lower stages of becoming ill, which will greatly accelerate the diagnosis of cancer. Sleepy symptoms, which can be spontaneous in cancer,:

• zagalnaya weakness, decrease in prasezdatnostі;
• pidvischena stomluvanst, drastic;
• temperature adjustment;
• anemia;
• Rizka vrata vagi.

The main symptom of cancer is dysphagia, which sometimes manifests itself in the appearance of lack of handiness in case of kovtannii їzhі, perhaps "sticking" їzhі to the walls of the stravohode. In the course of time, the symptoms will come up, and the failure of the passages is caused.

Another symptom, which is characteristic of the lower stages of cancer, the stravohode, bіl,, so і by itself. Most of the evidence can be periodical or permanent, and it is explained that the chick is growing, on the surface there are erosions and the development of esophagus.

As soon as I repair myself in the area between the shoulder blades, I can also get to know the fact that the chubby has gone beyond the boundary of the airway.

Often people take on such pains for showing osteochondrosis, for they have a heart disease and take care of all kinds of illnesses, and at the end of the hour, the swelling of their growth is not possible until the moment when people appear, there is no need for any additional help.

When the new establishment grows in dickheads(Bronchi or trachea) the patient develops a harsh, painful cough with blood, the temperature rises. As a result of the growth of swelling, internal bleeding and pericarditis may develop.

When metastases appear in remote organs, the most characteristic symptom is є strong beat.

Diagnostic dosage of cancer in case of adolescence

Krim key signs ailing, as you become inclined to appear at different stages, there are a number of instrumental and laboratory methods diagnostics of cancer stravohodu:

X-ray to the stravohode. It is carried out on the basis of X-ray contrast speeches, so as to the special sign of the uncomfortable stravohid. Most often, with the help of a vicorist suspension, the bar is passed through the stravohid and the slurry, which will remember the contours. On the sign you can see a defect in the storage, behind it you can see the appearance of chubby.

Pre-treatment of biological material discarded during biopsy. Visibility or appearance of crayfish cells and a type of chickpea.

EFGDS (esophagogastroduodenoscopy). It is carried out with the help of a special attachment - an endoscope. The procedure allows the assessment of the organs in the intestinal tract (including the intestinal tract) and to carry out early diagnosis of cancer, as well as to take material for a further microscopic examination.

The appearance of tumor markers in the blood. Seemingly, chickin chickens see special speeches, for which it is possible to see cancer. Tumor markers for cancer stravohode: TPA, SCC, CYFRA 21-1. Slide memory, how many tumor markers grow rapidly at the lower stages of cancer, in cob stage sickness їх appear less in 50% of people with ailments.

Bronchoscopia. Conducted for the designation of the upper dichny organs(Trachea, larynx, bronchi).

SPL. When it is reached, a special sensor is introduced into the empty space. With the help of an additional method, it is possible to assess the size of the chickens and the magnitude of the metastases in the pre-colonic lymph nodes.

Computer tomography. This is a highly effective method of diagnostics, for the help of which it is possible to infuse the puffin in sizes of 1 millimeter, as well as to detect the appearance of metastases.

Optical coherent endoscopic tomography. The price is quite a new method for diagnosing cancer of the stravohode. As a result, it is possible to see the structure of the tissue tissue on a glybin of up to 2 millimeters, allowing for more information to be carried out during a more secure and painful biopsy procedure.

Positron-emitting tomography. before the given doslіdzhennya a person who is ill to inject radioactive glucose, as I have the power to accumulate in crayfish cells... Then, with the help of a special scanner, you can use the signs, on which you can poke all the wrongs approved in sizes from 5 to 10 millimeters.

Analysis of blood in case of cancer in the early stages of illness is ineffective.

At the lower stages of the promoted by SHOE, Decreased number of eosinophils, zsuv leukocyte formulas, hypochromic anemia.

A gastroenterologist treats ailments to the stravohode and the slunk. Do you want to know a short gastroenterologist doctor in your place? Get up to speed with the rating of the list, which is based on the list of patients.

Viber is a place of residence.

The main methods of treating cancer stravohodu є:
* Hirurgic,.
* Promenevoi,.
* Combinations (one-to-one and surgical components),.
* Complex (this is a presentation of the surgical, exchange medicinal (chemotherapy) methods of treatment).
The low sensitivity of the chickens to dry chemical preparations, the palatial and short-hour effect of exchange therapy, to prevent surgery by the method of vibration in the case of cancer patients.
History wide sucking surgical method lіkuvannya crayfish stravohodu nіchu trocha more than 50 rockіv. The stagnation of surgical treatment, which was being streamed out in the daytime, high-quality methods of anesthesia, but often an hour of surgical intervention, and in the daytime of the modern method of plastic stage of surgery. Tse zumovilo trivale іsnuvannya double-step method of operational treatment. The first stage of the surgery was Dobromislov-Torek's operation (extirpation of the stravohode with overlays of the intestinal esophagostomy and gastrostomy), the other stage was plastic surgery of the stravohode according to one of the numerical fragmentation techniques. Practically all viddili were used for plastics. herbal tract: The small intestine and small intestine were used, the plastic methods were used with a slurry and slurry valves.
There was no longer any way to root the graft: pre-breast, retrosternal, in the box, which is distant to the tract, and it’s practically impossible to get stuck, methods of plastic surgery.
Visoka operative lethality, technical folding in hand, a large system of complex operations - all factors were divided into two groups of surgeries.
A large number of surgeries have become supporters of radical vision of the affected organ of any part in the case of non-started forms of disease and did not miss out on alternative therapy. Some surgeons and oncologists critically assessed the possibilities of surgical treatment of cancer in the stratohode, especially in high localizations, and introduced them to the methods of exchange therapy.
The high level of surgical technology, anesthesia, and optimal treatment tactics have increased the role of surgical treatment for cancer in the bloodstream.
Succinct principles of surgery for cancer stravohod:
* Maximum bake-free: the correct vibration of the prompt access and the exchange surgical engagement;
* Oncological adequacy: mobilization "go by the way" according to the principle of "go the judge to the affected organ", the correctness of the mobilization of the affected organ is due to the prevention of intraoperative disease, monophobic disease;
* Visoka funktsіonality: vibіr optimal method of plastics, technіchno simple form of antireflux anastomosis.
A predictive analysis of the efficiency of one-stage and difficult-to-use operations, showing the superiority of the first in terms of operational lethality (6.6%), completeness of treatment (98%) and long-term results (33% of 5-stage) survival.
When indicated, an indication before surgical treatment is necessary. In addition, it is too early for a cancer stravohode to bring to the destruction of the harvest and the distribution of all types of speech, prompt engagement.
In such a rank, the choice of the optimal method of treatment for a skin ailment for cancer is important to the most important staff. For a specific skin type, it is necessary to strictly determine the patient's stance, the degree of deterioration in the process, the broadening of the process, the technical flexibility of the operative surgery, and the maintenance of an adequate understanding of the operative look.
In this hour, there are two main methods of operational engagement:
* Vikorinennya to the travoduct with a plastic izoperistaltic slunk valve with extrapleural anastomosis on the sheath at the viglyad of transpleural visibility to the travoduct or extrapleural extirpation - transhiatal access. The method allows the date of the surgical inflow to the inflow of everything to the tract right up to the pharynx and to the resection of the oropharynx. Knowing the anastomosis in the shia posture pleural emptying However, there is a decrease in the risk of anastomosis inability, and it is not fatal. At the same hour, part of the cicatricial stenosis of the anastomosis. Slid pidcreslity, scho tractal method (without thoracotomy) resection to stravohod, obmezhene stasosuvannya with puffins great razmіrіv... It's a pity, most of the authors declare about the re-operation of operations with extended plump processes.
* Resection of the stravo-duct with a single-stage intrapleural plastic stravo-duct with a shlunk - an operation of the Lewis type. This is a practical way of introducing stenosis to the anastomosis, without providing the best functional results (during reflux esophagitis), protects the upper part of the intra-sternum due to the extra-sternum to be inaccessible for
In case of vikonanny operation in case of cancer, the intestinal tract is viscous;
The mortality rate for such types of operations is between 7-10%. Yak of the graft in the row of vypadkiv vikoristovuyut, crim of the shlunk, small intestine.
Chi did not lose its significance to the Torek-Dobromislov operation in terms of the possibility of a one-step stage of plastics (the camp of the ailing, technical specialties of the operation). In case of unprofitable breast cancer, it is necessary to use the patient to shunt a swollen stenosis with an overhead anastomosis.
In some unresectable chicks, a gastrostomy can be applied. Ailments on cancer stravohode with a gastrostomy can be added to exchange therapy.
The progression of cancer treatment to a stratovochus is to be found in a single method of treatment for patients with ailments, which are promptly detected through their apparent pathology (changes in heart disease, heart-vascular disease), dysfunctional systems and In a number of vypadkіv promenadelіkuvannya to wear with a bit of a palatial character (when conducted earlier laparotomy and gastrostomy).
Proliferation of ad hoc methods of oppression, allowing the harassment of grave ones key manifestations ailment in 35-40% of ailments.
By the method of optimization є stem in the region, the body should be optimized for a therapeutic dose of 60-70 Gy. Suddenly, in the area of ​​a hostile organ, the zone of lymphatic vascularization, a zone of possible metastases: paraesophageal lymphatic vascular, a zone of lymphatic vascular disease, arterial heart disease regions celiac stovbur, Supraclavicular regions. The classic method of optimization is 5 sessions of exchange therapy per day in a single sequential dose of 1.5-2Gy (classic fractional dose). In the case of other options, the fractional dose, which is given throughout the day, may change, as it may change and develop in the middle of the dose.
Methods of intracavitary optimization have emerged to be effective in treating cancer of the stravohode. Internal exchange therapy visit the AGAT VU equipment. At the same time, a thin probe with radioactive cobalt is introduced into the lumen of the trawler and stands on the equal footing. Dzherela viprominuvannya vstanovlyuyut 1 cm lower and higher between the puffs. We will be more friendly with the help of additional remote monitoring from internal road users.
combined and complex lykuvannya... The practice of oncologists in the field of education and the results of the treatment served as a drive for the development and storage of the combined method, as well as for one exchange therapy and operation. Nybilsh is justified combined treatment in ailments with localization of puffin in the middle thoracic viddili stravohodu.

lykuvannya

Ways of detecting cancer from the strand to vibrate fallowly from the stage of illness, growth and localization of chickens, as well as encouraging the patient (a lot of the will of more radical methods of therapy).

• General principle cancer therapy
  • Patients in stages 0, I, or IIa, have good results in surgical resection. Chemistry and radio therapy do not give significant results.
  • At stages IIb and III, the indicators of vizivanosti at vicious only surgical treatment are significantly degraded. The vision is to move in the presence of preoperative radioactive and chemotherapy to reduce the amount of chickens. At the patients who cannot carry out surgical treatment, The combination of radio and chemotherapy is not very large. Stagnation of radio therapy and chemotherapy okremo does not give a visible effect.
  • Patients with stage IV of the pathological process undergo only palatal therapy.

• Methods for treating cancer stravohodu
  • surgical treatment

    Operable ailments are not more than 30-35%.

    Subtotal esophagoectomy is carried out and the form of a piece stravohode is carried out.

    • Shown before surgical treatment
      • Вік less than 70 rockіv.
      • The amount of money for metastasis.

      There are less than 1/3 of such ailments in all diagnoses of cancer in the stravohode. Operational lethality is 10%.

    • Prototype shown before surgical treatment -
      • Metastases in lymphatic universities - N2 (fraught, shiyni or supraclavicular) or parenchymal organisms (pechinka, legeni).
      • Penetration in the adjoining organ (rotary laryngeal nerve, tracheobronchial tree, aorta, pericardium).
      • Important companions getting sick (for example, heart-damned sickness), You can create a threat to life in the course of the operation.
      • Before the operation, it is worthwhile to assess the function of the dysfunctional and heart-vascular systems. FEV1 less than 1.2 l and less than 40% wikidu fraction by the usual indications before the operation.
    • Esophagoectomy

      Resection of the stravohode (esophagoectomy) is the main method of treating cancer of the stravohode. In the present hour, one is stuck only in the capacity of a radical method of treatment and does not stagnate in the capacity of a paliative method, as for the treatment of dysphagia, it is without the help of other methods.

      Esophagoectomy can be carried out by a closed method for an additional access through the opening of the tract in case of transthoracic or thoracic growth (transhiatal esophagoectomy - Tkhe)) or through the transcranial or right thoracic access (transthoracic esophagotomy).

      The main change in Tkhe is the rate of growth of the breast, as you wake up to the new period and burn down the camp of the patients due to the weakened function of the organs of the environment.

      The message is visible to the stravohode, without interruption shlunkovo-intestinal tract take care of the auxiliary fabric of the slunk.

      Deyaki authorize vvazhayut, scho value Tkhe yak oncological surgery To reach the low, some part of the operation is carried out at the outskirts of the direct guard and at the same time there are fewer lymphatic universities, lower at the TTE. Tim is not less, a lot of retrospectives and two prospective reports have shown the visibility of the patients in the absence of the type of surgery being performed. The stage and hour of the operation are strongly influenced by the vision.

      • Transthoracic esophagotomy (TTE) technique.

        Patient's position: lying on the back on the operating table. An arterial catheter, a central venous catheter, a Foli catheter and a two-way endotracheal tube are inserted. Preoperative antibiotics are administered. To fight the upper middle rise. Pislya rounding up the emptying for metastases (if metastases appear, the operation does not go on further), the slunk is mobilized. The rights of the shlunkov and the rights of the shlunkov-oily artery are obtained, at that time, both the short shlunkov arteries and the liva shlunkov artery. Then the gastroesophageal opening to mobilize, the stray opening to grow. A pyloromyotomy is carried out, a Yunostomy is placed to prevent the feeding of a sick person in during the operational period... For suturing the abdominal access, the patient is moved to the lying position on the front of the boat, and the posterolateral development is carried out in the 5th mid-rib. There is an unpaired Vienna for securing a wide range of mobilization for the stravohod. The shlunka is carried out in the empty breast tissue and with a stretch of 5 cm below the gastroesophageal zone. There is an anastomosis between the stravohode and the slurry. Then the growth of the breast cancer can be sewn up.

      • The technique of carrying out transhiatal esophagotomy (Tkhe).

        The preoperative training is similar to that of TTE, with the exception of replacing a double-lumen endotracheal tube with a single-lumen tube. The shia is prepared in the quality of the operational field. The abdominal part of the operation, as well as in the case of TTE. Then on the left side it is possible to avoid the growth of the head of 6 cm. The internal jugular vein and the carotid artery are introduced laterally, stravochіdіlaєa behind the trachea. To improve the performance of the left rotary laryngeal nerve When retraction of the trachea, mechanical retractors do not get stuck. Then, for the resection of the proximal end of the drain and the thoracic part of the drain, the drain of the drain is carried out through rear middle to the level of the spared stravohod. Anastomosis is formed to the vivenny of the drainage tube on the surface of the sheath. Razrіzi zakryvayutsya.

      • Perevagi of minimally invasive techniques.

        The stagnation of laparoscopic and thoracoscopic techniques, revolutionized the treatment of good people with ailments, such as achalasia, and gastroesophageal reflux ailment. At the time of the opened surgery, the hour is less than in the hospital, and the hour of the operational renewal of food. The closest possible methodology will have a great role in the treatment of stravohid cancer, allowing the reduction of the number of rapidities on the side of the dysfunctional and heart-vascular systems.

      • Postoperative patient management
        • The average triviality of postoperative knowledge in hospitals is 9-14 days.
        • Nicholas during the operation of the patient should be carried out in the intensive therapy ward.
        • Patients are guilty but they should textubate at once and for the operation, ale piece ventilation lungs to be carried out in a secret way dichotomous systems... The collapse of the side of the dysfunctional (for example, atelectasis, pleural infection, pneumonia) and heart-vascular (broken heart rhythm) systems evolve in the first days of the operative period.
        • Patients are transferred from the intensive therapy ward in the surgical procedure, in the same way, as the main indicators of the activity of the mental and heart-vascular systems in the norm.
        • Harchuvannya for the help of jejunostomy to be repaired on the 1st day of the operation. More details: Likuvalne aficionados for operations on stravohods.
        • On the 6th day of the operation, an additional delay will be carried out with a change in the capacity of the welders.
        • Yaksho porushen is dumb, the patient needs to go orally.
        • As soon as the seams fail, the drainage pipes get stuck on the ground, and the harnessing goes for the help of the jejunostomy to quiet feast, as long as the seamstresses do not wake up.
      • postoperative acceleration

        Approximately 40% of the patients are diagnosed with storage.

        • Folding from the side of the dichal system (15-20%) includes atelectasis, pleural infection and pneumonia.
        • Folding from the side heart-vascular system(15-20%) include heart arrhythmias and myocardial infarction.
        • Septic delayed (10%) include wound infection, lack of anastomoses, and pneumonia.
        • When stricture is formed, anastomosis can be dilated (in 20% of cases).
        • Mortality rates are due to the functional camp of the patient, as well as the admissibility of the operative surgeon and the surgical team. An indicator of the highest level of esophageal surgery for cancer of the stravohode є intraoperative mortality is less than 5%. For rіdkіsnymi vinyats, such a rіven can only be reached in the great surgical centers.
        • As a result of the lack of seams, it can develop into a breast emptying, which can lead to the development of sepsis and death.
      • Further outpatient care of patients

        Patients will look around with a surgeon after 2 and 4 months of surgery and after 6 months through the skin by an oncologist.

        Most of the patients turn around to their own level of activity in a stretch of 2 months.

        Patients undergo screening procedures with additional endoscopy computer tomography shije, breast cells and black emptying with an interval of 6 months for a stretch of 3 rockets, and at the same time it is shy.

    • Palliative surgical treatment

      Palliatively lіkuvannya are directed to the lower step of the obstruction to the stratospin for securing the possibility of oral intake. Manifest obstructions to the stravohode can be significant, supervising the dreaming and turning aspirations.

      Manual dilatation therapy (buzhuvannya), installation of a probe, radioactive therapy, laser photocoagulation and photodynamic therapy are stagnant. For some people, the installation of jejunostomy is required. Losing a dilatation to a stravohode is trivial to make no more than a few days. For the sake of the passage of the airway, it is more efficient to use the metal stents. Deyakі models with plastic pokritam zastosovovat for closing the tracheopathic fistula, and on deyakіy modifications of the design of the transfer valve for preventing reflux in times, as if the stent is installed close to the NSS.

      Endoscopic laser therapy can be used for palatal treatment of dysphagia. At the same time, a channel is burned in the fabric of the chubby with the mark of renewal of prowess. Can be repeated every time you need it.

      When photodynamic therapy is carried out, photophrine II, Porfimer Sodium and Efir deematoporphyrin (DHE) are stagnated, which are soaked by tissue and act as a photosensitizer. If the laser projection is straight to the chubby, there will be no fluffy radicals, so you will be able to burn the chubby clitini. Patients, who are photodynamic therapy, are responsible for a unique number of straight sleepy exchanges for 6 years of sleep, as the child is sensitized to sleepy exchanges.

      In case of rozpovsyudzhenny cancer, X-ray therapy is ineffective, with localized cancer, it is normal to change dysphagia. However, the Danish method of treatment is characterized by a large number of side effects and a lot of stagnation.

  • Surgical methods of treatment

    Surgical methods of treatment lead to stagnation in patients with carcinoma of the ductus, in others it is contraindicated to surgical treatment.

    Meta therapy is the price of reducing the manifestation of dysphagia and renewing the ability to eat.

    It is not possible to name a single most beautiful method of paliative therapy, suitable in any situation. In most patients, it is necessary to establish a number of palatial methods for training the prosperity of the stravohod (div. paliative lykuvannya). The most common method of palatal therapy is guilty of being taken for a skin patient individually, depending on the characteristics of the swelling, the patient's transfer, and individual features, which appear as a medicine.

    • chemotherapy

      Chemotherapy is an independent method of therapy. Only an insignificant number of patients can reach a small and a short hour of food. There have not been any changes in the preparation of chemotherapy drugs.

      Laser therapy for dysphagia improvement in 70% of patients. For education, it is necessary to repeat the course of the course.

      Intubation behind the help of a dull metal stent, which is introduced endoscopically, before fluorographic control. The whole method allows the child to educate the trachea in the case of an open country and especially brown in the presence of a tracheopathic fistula.

      Photodynamic therapy is an even more promising non-surgical method of therapy. Photosensitive drugs are meant, as they are vibrating adsorbed by malignant tissue changes. Then the area is given to a direct light inflow, the drop of the photosensitizer on the radicals is observed, without the need for a medium amount of fluff. Vicious Effects photodynamic therapy - the formation of strictures in the stravohode in 34% of patients.