ʻO Mediastinoscopy kahi hana e hiki ai iā ʻoe ke nānā pono i loko o ka mediastinum, ka ʻāpana o ka pahu ma waena o nā māmā ʻelua, mai kahi ʻoki liʻiliʻi i ka ʻāʻī, me ka ʻole e wehe i ka iwi ʻaoʻao. ʻAe ʻia e lawe ʻia nā biopsies.

ʻO Mediastinoscopy kahi endoscopy o ka mediastinum. Hāʻawi ia i ka nānā pono ʻana i nā mea i loaʻa ma waena o nā māmā ʻelua, i ka puʻuwai, i nā bronchi nui ʻelua, i ka timus, i ka trachea a me nā esophagus, nā kīʻaha koko nui , a me nā mea ʻē aʻe) a me kahi helu o nā lymph node. 

ʻO ka hapa nui o ka mediastinoscopy e pili ana i nā lymph node. ʻOiai, hiki i nā x-ray, scans a me MRI ke hōʻike ua loaʻa iā lākou ka leo, akā ʻaʻole lākou e ʻae iā mākou e ʻike inā ʻo kēia adenomegaly ma muli o kahi pathology hoʻoulu a i ʻole kahi tumo. E hoʻoholo, pono ʻoe e hele a ʻike, a maliʻa paha e lawe i hoʻokahi a i ʻole mau lymph node e kālailai ʻia i ka hale hana. ʻO ka mea maʻamau, hoʻohana ʻia ka mediastinoscopy e nānā i ka nui o ka manaʻo kānalua i hōʻike ʻia i kahi hōʻike kiʻi i ka mediastinum a, inā pono, e hana i kahi biopsy.

Ma mua o ka wehe ʻana i ka iwi ʻaoʻao no kēia nānā ʻike, hoʻohana ka mediastinoscopy i kahi hulina i kapa ʻia he mediastinoscope. Hoʻokomo ʻia kēia hollow tube me nā olonā opio a ma o kahi e hiki ai ke hoʻokuʻu ʻia i nā mea hana ʻoki liʻiliʻi, i loko o ka thorax ma o ke kuhi ʻana o kekahi mau kenimika i hana ʻia ma ke kumu o ka ʻāʻī.

ʻO kēia kaʻina hana ʻokiʻoki wale nō diagnostic. Paipai ʻia ma hope o nā ʻano kiʻi kiʻi olakino maʻamau (x-ray, CT scan, MRI) ke hōʻike ʻia kēia mau mea i ka nui o ke ʻano kānalua i ka mediastinum. ʻAe ʻia: 

e noho aliʻi ma ke ʻano o nā leona. Hiki ke pehu nā lymph node i ka mediastinum i ka pane ʻana i kahi maʻi e like me ka tuberculosis a i ʻole sarcoidosis, akā e hoʻopili ʻia e ka lymphoma (maʻi ʻaʻai o ka ʻōnaehana lymphatic) a i ʻole nā ​​metastases mai nā maʻi ʻē aʻe (o ka akemāmā, ka umauma a i ʻole esophagus i ke 'ano wae);

e lawe i nā laʻana o nā aʻa a i ʻole nā ​​lymph node, i ka manawa o ke kanalua e pili ana i ka hōʻino o kahi tumo a i ʻole e wehewehe i ka ʻike. ʻO kēia mau biopsies, i kālailai ʻia i loko o ke keʻena hoʻokolohua, e hiki ai ke hoʻokumu i ke ʻano tumo, kona pae evolutionary a me kona hoʻolōʻihi ʻia ʻana.

e hāhai i ka hoʻomohala ʻana o kekahi mau maʻi ʻaʻai akū, aia ma ka ʻaoʻao o waho o kēia mea, no laila ʻike ʻia mai ka mediastinum.

ʻOi aku ka nui hou aku, ua hoʻololi ʻia ka mediastinoscopy e nā ʻano hana diagnostic hou liʻiliʻi, ʻoi aku ka liʻiliʻi Pākuʻi PET, ka mea e hiki ai, ma ka hoʻohui ʻana i ka injection o kahi huahana radioactive me kahi scanner, e hōʻoia i kekahi mau maʻi ʻaʻai a i ʻole e ʻimi i nā metastases; a me / a i ʻole ultrasound-alakaʻi transbronchial biopsy, e pili ana i ka hele ʻana i kahi nila liʻiliʻi ma ka waha a laila ka bronchi e kuʻi i kahi pona lymph aia ma kēlā ʻaoʻao o ka paia bronchial. ʻO kēia ʻenehana hope loa, ka mea koi ʻole i kahi ʻokiʻoki, ʻae ʻia i kēia manawa e ka hoʻomohala ʻana o kabronchoscopy ultrasound (hoʻohana i kahi endoscope palupalu loa, hoʻokomo ʻia me kahi ʻimi ultrasound liʻiliʻi ma kona hopena). Akā ʻaʻole hiki ke hoʻololi i ka mediastinoscopy e kēia mau ʻenehana i nā manawa āpau. Ke hilinaʻi nui nei ia i ka wahi o ka leona. 

Pēlā nō, ʻaʻole pili ka mediastinoscopy i nā kūlana āpau. Inā ʻaʻole hiki ke kiʻi ʻia nā liona biopsy i kēia ala (no ka mea aia lākou ma ka lobe pulmonary luna, ʻo kahi laʻana), pono i ka mea ʻokiʻoki e koho i kahi hana ʻē aʻe: ʻo ka mediastinotomy, ʻo ia ka ʻōlelo o ka wehe ʻana o ka mediastinum, aiʻole ka thoracoscopy, endoscopy o ka thorax i kēia manawa ke hele nei ma waena o nā ʻoki liʻiliʻi ma waena o nā iwi ʻaoʻao.

ʻOiai he hōʻike hōʻoia ia, ʻo ka mediastinoscopy kahi hana ʻoki. No laila e hana ʻia e kahi kauka, ma ka hale keaka hana, a koi ʻia i ka haukapila ʻekolu a ʻehā mau lā paha.

Ma hope o ka anesthesia laulā, hana ʻia kahi ʻoki liʻiliʻi ma ke kumu o ka ʻāʻī, i ka notch ma luna o ka umauma. Hoʻokomo ʻia ka mediastinoscope, kahi puʻupuʻu paʻa paʻa lōʻihi me kahi ʻōnaehana, ma o kēia ʻoki a iho i lalo i ka mediastinum, ma hope o ka trachea. Hiki i ke kaukipoki ke nānā pono i nā meaola ma laila. Inā pono, hoʻolauna ʻo ia i nā mea hana ʻē aʻe ma o ka endoscope e hana i kahi biopsy, no ka loiloi i ka hale hana. I ka manawa e hemo ai ka mea kani, pani ʻia ka ʻokiʻoki me ke suture ʻāpiki a i ʻole ke kāwiliolaola.

Hoʻokahi hola paha ka lōʻihi o kēia hōʻike. Hoʻonohonoho ʻia ka hoʻokuʻu ʻana mai ka haukapila no ka lā ʻelua a i ʻole ʻelua, i ka manawa e māʻona ai nā kaukō lapaʻau ʻaʻohe pilikia.

ʻO ka ʻike ʻike a me ka mōʻaukala i hāʻawi ʻia e mediastinoscopy hiki i ka mea hiki ke hoʻonohonoho i ka papahana hoʻōla. Aia kēia i ka maʻi maʻi i kuhikuhi ʻia. 

I ka hanana o ka maʻi ʻaʻai, he nui nā koho lapaʻau ʻana, a kaukaʻi ʻia i ke ʻano o ka tumo, kona pae a me kona hoʻolōʻihi ʻia: ʻoki (wehe ʻana i ka tumo, ka hoʻoneʻe ʻana i kahi ʻāpana o ka akemā, a pēlā aku), chemotherapy, radiotherapy, immunotherapy a i ʻole kahi hui o kekahi o kēia mau koho.

I ka hanana o ka metastasis, ʻo ka lapaʻau kahi ʻāpana o ka papa hana no ka tumo mua.

Inā he mumū a maʻi maʻi paha ia, e nānā a mālama ʻia ke kumu kūpono.

Kākaʻikahi nā pilikia mai kēia hoʻokolokolo ʻana. E like me nā hana, aia kahi haʻahaʻa o ka hopena i ka anesthesia, ke kahe ʻana o ke koko a me ka palu, ka maʻi a me nā pilikia hoʻōla. Aia kekahi pilikia nui o ka hōʻino ʻana i ka esophagus a i ʻole pneumothorax (ʻeha i nā māmā e hoʻoheheʻe ai ka ea i loko o ka lua pleura).

Hiki ke hoʻonāukiuki ʻia ke aʻalolo laryngeal, e hoʻonāukiuki i nā kaula o ka manawa, a laila hoʻololi i ka leo a i ʻole ke kani ʻana, a hiki i kekahi mau pule.

ʻIke ʻia ka ʻeha i nā lā mua ma hope o ka hana. Akā hana i nā painkillers i kuhikuhi ʻia. Hiki ke hoʻomaka hou nā hana maʻamau i nā wikiwiki. ʻO ka ʻili liʻiliʻi, mae wale ia i loko o ʻelua a ʻekolu paha mahina.