mohs shastrachikitsa

mohs shastrachikitsa, shastrachikitsa oka saadhaarana shastravaidyudu, frederic ii. chae abhivruddhi cheyabadindi. mose, anedi suukshmadarshini dwara niyantrinchabade shastrachikitsa, idhi saadhaarana mariyu arudaina charma cancerlaku chikitsa cheyadaaniki upayoginchabadutundi. shastrachikitsa samayamlo, kanajaalam yokka prati tolagimpu tarvaata mariyu roogi vechi unnappudu, kanajaalam cancer kanaala kosam pareekshinchabadutundi. aaa pareeksha adanapu kanajaala tolagimpu nirnayaanni nirdesistundi. mohs shastrachikitsa anedi gaddakattina vibhaga hystologyni upayoginchi charma cancer (puurti chuttukolata paridheeya mariyu lothaina anchu anchanaa-ccpdma) tolaginchetappudu puurti anchu niyantrananu pondadaaniki bangaaru praamaanika paddhati. sii. sii. pii. dii. emm. eah ledhaa mohs shastrachikitsa anedi chaalaa irukaina shastrachikitsa margine mariyu adhika nivaarana retutho charma cancernu tolaginchadaaniki anumatistundi.
chaalaa adhyayanalu perkonna mohs shastrachikitsato nayam chese raetu 97 saatam mariyu 99.8% madhya praathamika besal-sell carcinoma, atyanta saadhaarana rakam charma cancer. squamous sell carcinoma kosam kooda mose vidhananni upayogistaaru, conny takkuva nivaarana retutho. punaraavruta besal-sell cancer mohs shastrachikitsato takkuva nivaarana retunu kaligi untundi, idhi 94 saatam paridhiloo untundi. idhi melanoma-inn-situ (shastrachikitsakudipai aadharapadi 77 saatam nundi 98 saatam varaku nayam chese raetu), mariyu konni rakaala melanoma (nayam chese raetu 52 saatam) tolagimpuloo upayoginchabadindi.
mohs shastrachikitsaku itara soochanalalo dermatophybrosarcoma proteuberance, caratocanthoma, spindle sell tumours, sebasius carcinomas, microsystic adnexal carcinoma, merkel sell carcinoma, puggets rommu vyaadhi, etypical fibroxanthoma mariyu leomyosarcoma unnaayi. mohs prakriya micrographicga niyantrinchabadutundi kabatti, idhi cancer kanajaalaanni khachitamaina tolagimpunu andistundi, ayithe aarogyakaramaina kanajaalam tappinchabadutundi. shastrachikitsa tolagimpu mariyu pratyeka hystopathological vislaeshanha kharchunu parigananaloki teesukunnappudu, itara shastrachikitsa paddhatula kante mohs shastrachikitsa kooda ekkuva kharchutho kuudukunnadi kaavacchu. ayithe, kanajaala samrakshana atyanta praamukhyata kaligina (mukham, meda, chetulu, diguva kaallu, paadaalu, jananendriyaalu) shareera nirmaana praantaalalo charma cancerla chikitsa kosam mohs shastrachikitsanu ketayinchali.
upayoginchandi.
mohs shastrachikitsanu saadhaaranamgaa thala mariyu medapai upayogistaaru, ikkada daani upayogam saadhaarana kanajaalaanni samrakshistundi mariyu punaraavrutamayye pramaadaanni taggistundi. eee kaaranaala valla, chetulu, paadaalu, cheelamandalu, todalu, urugujjulu ledhaa jananendriyaalapai charma cancerlaku kooda dheenini pariganistaaru. oka centimeter kante takkuva parimaanamlo unna saralamaina, melanoma kaani charma cancer kosam trunk ledhaa antya bhagalapai mose shastrachikitsanu upayoginchakudadu. sariiramlooni eee bhagalapai, pramaadaalu prakriya yokka prayojanaalanu minchipothayi.
saanketikata.
saanketikata, american academy off dermatology eee krindi samsthala sahakaaramtho mohs micrographic sarjareepai tagina viniyoga pramaanaalanu (eyusi) prachurinchindih american college off mohs surgery; american society pharr mohs surgery; mariyu american society pharr dermatologic surgery association. american academy off dermatology und dermatologic surgery jarnallo prachurinchabadina mose sarjariaak abhivruddhiki 75 mandiki paiga vaidyulu dohadapaddaru.
australian college off dermatologists, australian mohs surgery kamiteetho kalisi, mohs shastrachikitsaku aadhaaraala aadhaarita maargadarsakaalanu kooda abhivruddhi chesindi.
mohs vidhanam anedi shastrachikitsa margine yokka puurti pareekshaku anumatinche pathology sectioning paddhati. idhi sectioning yokka praamaanika rotte rottela saanketikataku bhinnamgaa untundi, ikkada shastrachikitsa margine yokka yaadruchchika namuunaalanu pariseelistaaru.
mohs shastrachikitsa naalugu dasallo nirvahinchabadutundih
eee prakriya saadhaaranamgaa sthaanika mattumandu krinda vaidyudi karyalayamlo nirvahinchabadutundi. kanipinche kaniti chuttoo kattirinchadaaniki oka chinna scalpel upayoginchabadutundi. chaalaa chinna shastrachikitsa margine upayoginchabadutundi, saadhaaranamgaa 1 nundi 1.5 mimi "free margine" ledhaa parishkaram kaani charmamtho. tolaginchina free margine mottam charma cancerla praamaanika tolagimpuku avasaramaina saadhaarana 4 nundi 6 mimi kante chaalaa takkuvagaa untundi. kanajaalaanni prati shastrachikitsa tolaginchina taruvaata, namuunaanu proses chesi, chryostatpy kattirinchi, slidelapy unchi, hetch & eee thoo tadipi, aapai cancer kanaala kosam vibhaagaalanu pariseelinchae mohs sarjan/pathologist dwara chadavabadutundi. cancer kanugonabadithe, daani sthaanam maplo gurtinchabadutundi (kanajaalam yokka droying) mariyu sarjan roogi nundi suuchimchina cancer kanajaalaanni tolagistaadu. tadupari cancer kanipinchani varaku eee prakriya punaraavrutamavutundi. chaalaa varaku kesulanu mohs sarjan punarnirmistaaru. kontamandi shastravaidyulu prati vibhagam madhya 100 micrometerlanu upayogistaaru, mariyu kondaru modati rendu vibhagala madhya 200 micrometers mariyu tadupari vibhagala madhya 100 micrometerlanu upayogistaaru (6 nundi 10 micrometers vadda 10 crank kanajaalam sett anedi blade kaaranamgaa bhouthika kudimpuku anumatinchinatlayithe sumaru 100 micrometerlaku samanam).
raktaanni sannaga chesevaaru.
gatha 10 samvatsaraalugaa charma shastrachikitsalo dhorani charma shastrachikitsa chestunnappudu pratiskandakaalanu konasaginchadam. chaalaa charma raktasraavam electrocatorytho, mukhyamgaa bipolar forceplatho niyantrinchavacchu. haemostasis yokka soulabhyam dwara pondina prayojanam pratiskandakaalanu aapivese pramaadaaniki vyatiraekamgaa baruvu untundi; mariyu saadhaaranamgaa pratiskandakaalanu konasaaginchadaaniki praadhaanyata istaaru.
chikitsa raetu.
kontamandi nipunulu mohs kosam nivaarana retunu, mukhyamgaa prakriyatho suparichitamaina paathaalajistulanu vivaadam chestaaru. sthira kanajaalam mariyu taja kanajaalam kesulato vaelaadi mandhi rogulatho kuudina mohs nirvahinchina vistrutamaina adhyayanalu saahityamlo nivedinchabaddaayi. itara shastravaidyulu kooda vaelaadi kesulato adhyayanalanu punaraavrutam chesaaru, daadaapu adhe phalitaalu.
mohs shastrachikitsato clinical 5 samvatsaraala nayam ratelu
ivi mohs dwara nivedinchabadina koddi sankhyalo kesulu matrame, mariyu itara rachayitala aneka itara kathanaalu praadhamika besal-sell carcinomacu adbhutamaina nivaarana retlanu choopinchaayi. smeat, mariyu itarula dwara adhyayanalu. mohs nayam chese raetu sumaru 95 saatam, mariyu sweeden loe maroka adhyayanam mohs nayam chese raetu sumaru 94 saatam choopistundi.
chikitsa raetu vaividhyam.
konni mohs dayta 96 saatam varaku takkuva nivaarana retunu velladinchindi, conny ivi tarachugaa chaalaa pedda kanitulu, gatamlo itara paddhatula dwara chikitsa cheyabaddaayi. kontamandi rachayitalu praathamika besal-sell cancerku vaari 5 samvatsaraala nivaarana raetu 99 saataanni minchipoyindani, marikondaru 97 saatam ekkuva sampradaayabaddhamaina nivaarana retunu kaligi unnaarani paerkonnaaru. gatamlo chikitsa chesina besal-sell cancerpy mohs shastrachikitsaku coat chesina nivaarana raetu 94 saatam. chikitsa retulo maarpulaku kaaranaalu eee krindi vidhamgaa unnaayi.
chikitsa yokka itara paddhathulatho polchandi.
mohs shastrachikitsa anni charma cancerlaku anukuulamgaa undadu.
mohs micrographic shastrachikitsa anedi margine niyantrana yokka atyanta nammadagina roopam; oka pratyaekamaina stambhimpachesina vibhaga hystology prosessing saanketikatanu upayoginchadam-shastrachikitsa margine yokka 100% yokka puurti pareekshaku anumatistundi. eee paddhati pratyekamainadi, idhi mruduvaina, kathinamaina kanajaalaanni nirvahinchadaaniki oka saadhaarana maargam. merugaina tappudu pratikuula dosham raetu kosam 0.01 mimi viramamlo seeriyal bread rottela kante idhi uttamamainadi, dheeniki takkuva samayam, kanajaala nirvahana mariyu takkuva gaaju slidelu avasaram.
kottagaa nirdhaarana cheyabadina besal-sell cancer (bisisi) kosam 5 samvatsaraala taruvaata 97 saatam nundi 99.8% varaku mohs shastrachikitsa yokka nivaarana raetu kosam clinical coats, punaraavruta besal-sell cancerku 94 saatam ledhaa anthakante takkuvaku taggutaayi. radiation oncologistlu 1 ledhaa 2 sem. mea. kante takkuva unna bisisilaku 90 nundi 95 saatam varaku mariyu 1 ledhaa 2 sem. mea. kante pedda bisisilaku 85 nundi 90 saatam varaku nivaarana retlanu utamkimchaaru. shastrachikitsa dwara tolagimpu nayam chese raetu vistruta anchulu (4 nundi 6 mimi) mariyu chinna kanitulaku 90 nundi 95 saatam varaku untundi, irukaina anchulu mariyu pedda kanitulaku 70 saatam varaku untundi.
samajam mariyu samskruti.
charma cancer shastrachikitsa raetlu prapanchavyaaptamgaa perugutunnanduna mohs shastrachikitsato sahaa charma cancer shastrachikitsa atigaa upayoginchabadutundani kondaru vyaakhyaatalu vaadistunnaaru. idhi charma cancer yokka adhika raetlu, rooga nirdhaaranalo perigina apramattata mariyu prakriya yokka labhyata ledhaa roogi mariyu vaidyula praadhaanyatalaku sambandhinchinadaa anedi aspashtamgaa undhi. 2004 mariyu 2014 madhya dasaabdamloo mohs shastrachikitsa sambhavam gananeeyamgaa perigindi. 100 mohs shastrachikitsala namoonaalo, aasupatri aadhaarita sanklishta vidhaanaalaku adhika kharchulatho, mottam kharchu $474 nundi $7,594 varaku undhi. australialo, rogulaku neerugaa jebu nundi kharchu $0 nundi $4000 varaku maaravacchu. roganirdhaarana nipunulatoe sahaa bahula vaidyulu mohs kaani shastrachikitsa chesinappudu kharchulu marinta peragavacchu. cancer asampuurnamgaa tolaginchabadinappudu mariyu punaraavruta shastrachikitsa avasaramainappudu idhi pratyaekamgaa vartistundi.
charitra.
modata, mohs kanajaalaanni rakshinchadaaniki mariyu champadaaniki rasayana payst (escarotic agent) nuu upayoginchaaru. idhi jink chloride mariyu blood ruut (alcoloid sangunerine kaligi unna "sanguneria canadensis" mokka yokka muulam) thoo tayaaru cheyabadindi. asalu padaarthaalu 40 graa stibnite, 10 graa "sanguneria canadensis" mariyu 34.5 ml santrupta jink chloride draavanam.
eee payst block salve ledhaa "hoxies payst" (hoxy therapy chudandi), mosapurita patent aushadham maadirigaane untundi, conny daani upayogam bhinnamgaa untundi. hoxy eee paestnu ekkuva kaalam upayoginchaaru, idhi vaegamgaa apakeerti pondina haanikaramaina paddhati. mohs aaa paestnu ratriputa matrame gayampai vadilivesi, marusati roeju, cancer mariyu chuttupakkala charmam mattumandu cheyabadi, cancer tolaginchabadutundi. aaa namuunaanu appudu tolaginchi, suukshmadarshini krinda kanajaalaanni pareekshinchaaru. cancer migili unte, marinta payst veyabadindi, mariyu roogi marusati roeju tirigi vastaadu. taruvaata, taja kanajaalaaniki vartimpajesina sthaanika mattumandu mariyu stambhimpachesina vibhagam hystopathology, takkuva kanajaala vidhvamsam mariyu adhe vidhamaina nivaarana retutho adhe roeju prakriyanu nirvahinchadaaniki anumatinchindi.

