Hena ne oduruyɛfo a ɔyɛ colorectal oprehyɛn yi? Momma yɛnhwehwɛ mu pɛpɛɛpɛ!

Ebia ɛbɛyɛ wo nwonwa kakra bere a wote edin 'Colorectal Surgeon' no, na wususuw sɛ, "Hena ne oyi? Dɛn na wɔyɛ?" Mma ɛnhaw wo, ɛnyɛ nea ɛyɛ den saa. Sɛ yɛbɛka no tiawa a, eyi yɛ oprehyɛn ho ɔbenfo a ne ho akokwaw wɔ nyarewa a wɔsa ne wo dwensɔtwaa kɛse, wo dwensɔtwaa , ne wo dwensɔtwaa mu oprehyɛn mu . Enti momma yɛnka eyi ho asɛm nkɔ akyiri kakra, te sɛ nea wo ne w’adamfo bi rekasa, ɛyɛ?

Hena ne oduruyɛfo a ɔyɛ colorectal oprehyɛn yi? So kan no na wɔfrɛ no proctologist?

Yiw, ebia woate asɛmfua ‘proctologist’. Nokwarem no, bere bi a atwam no, na wɔfrɛ nnuruyɛfo a wɔsa nyarewa ahorow yi sɛ proctologists. ‘Colorectal surgeon’ ne nnɛyi din a wɔayɛ no foforo kɛse, a wɔde frɛ saa aduruyɛ adwuma no.

Nsonsonoe kakra wɔ ntease mu wɔ edin abien yi ntam. Sɛ yɛka sɛ ‘proctologist’ a, ɛkyerɛ akyi berɛmo ne akyi berɛmo titire. Nanso sɛ yɛka sɛ ‘colorectal’ a, ɛka akyi berɛmo ne akyi berɛmo nyinaa ho. Wunim, saa abien yi ne dwensɔtwaa kɛse no afã horow a ɛsõ sen biara. Nanso, wɔ nneyɛe mu no, ɛmfa ho din abien yi mu nea wɔbɛfrɛ wɔn no, saa animdefo yi sa afã horow yi nyinaa . Enti biribiara nni hɔ a ɛsɛ sɛ yesusuw ho dodo.

Dɛn nti na ɛsɛ sɛ yɛkɔ oduruyɛfo a ɔhwɛ yɛn akyi berɛmo mu oprehyɛn nkyɛn?

Fa no sɛ wowɔ ɔhaw anaa sɛnkyerɛnne bi wɔ wo yafunu ase, kyerɛ sɛ, wo yafunu a ɛwɔ fam (GI) no mu. Afei ebia wubedi kan akɔ oduruyɛfo a ɔhwɛ yafunu so anaa yafunu mu ɔyaresafo nkyɛn.

Sɛ, bere a oduruyɛfo no ahwehwɛ wo mu awie no, osusuw sɛ wo tebea no hwehwɛ sɛ wɔyɛ oprehyɛn , ɔde wo bɛkɔ oduruyɛfo a ɔyɛ wo kokoram oprehyɛn nkyɛn.

Colorectal tebea horow bi a ebia ɛtaa hwehwɛ sɛ wɔyɛ oprehyɛn no bi ne:

• Kokoram ne polyposis : Eyi kyerɛ kokoram tebea horow a ɛwɔ akyi berɛmo mu anaasɛ nnua nketenkete a enyin (polyps) a ebetumi abɛyɛ kokoram.
• Inflammatory bowel disease (IBD): Eyi yɛ ɔfe a ɛtra hɔ kyɛ wɔ dwensɔtwaa no mu. Nhwɛso ahorow bi ne tebea horow te sɛ Crohn yare ne akisikuru a ɛma akisikuru .
• Ischemia: Eyi ne bere a dwensɔtwaa no fã bi yɛMogya a ɛso tew anaasɛ ɛyera . Sɛ ɛba saa a, saa ɔfã no betumi awu mpo.
• Nhyehyeɛ mu sintɔ: Sɛ nhwɛsoɔ no, fistulas - nkitahodiɛ a ɛnteɛ a ɛda dwensɔtwaa ne akwaa foforɔ ntam, hernias - dwensɔtwaa no fã bi a ɛpue fa baabi a ɛyɛ mmerɛ, ne prolapse - nipadua no fã bi a ɛpuepue anaa ɛpuepue, te sɛ rectum.

So nnuruyɛfo a wɔyɛ oprehyɛn a wɔde kɔ akyi berɛmo mu no sa akyi berɛmo no nkutoo yare?

Dabi, ɛno nyɛ nokware. Ɛwom sɛ nnuruyɛfo a wɔyɛ oprehyɛn a wɔyɛ wɔ dwensɔtwaa kɛse no mu titiriw de, nanso wɔatete wɔn nso sɛ nnuruyɛfo a wɔyɛ oprehyɛn a wɔyɛ no nyinaa .

Ɛno da nkyɛn a, ɔhaw bi a ɛwɔ yɛn nipadua akwaa biako mu betumi aka akwaa afoforo, ɛnte saa? Enti, ɛsɛ sɛ saa animdefo yi sa akwaa afoforo a ɛne akyi berɛmo no wɔ abusuabɔ tẽẽ anaasɛ yare koro no ara aka no. Akwaa a ɛtete saa ne:

• Nkwammoaa Ketekete
• Ntini a ɛwɔ akyi berɛmo mu (eyinom boa ma wɔhwɛ dwensɔtwaa ne akisikuru so) .
• Nsuo a ɛkɔ nipadua no mu
• Mmea Awo Nhyehyɛe

Ahwehwɛde bɛn na ɛsɛ sɛ obi nya ansa na wabɛyɛ oduruyɛfo a ɔyɛ oprehyɛn wɔ akyi berɛmo mu?

Eyi yɛ asɛm a ɛho hia ankasa. Oduruyɛfo a ɔyɛ colorectal oprehyɛn yɛ obi a ɔwɔ ntetee ne nimdeɛ a ɛkorɔn yiye . Sɛ nhwɛso no, wɔ ɔman te sɛ United States mu no, sɛ obi bɛyɛ oprehyɛn a ɔhwɛ akyi berɛmo so a, anyɛ yiye koraa no, ɛsɛ sɛ ɔtete ne ho sɛ oduruyɛfo a ɔyɛ oprehyɛn nyinaa mfe anum. Ɛno akyi no, ɛsɛ sɛ obi kɔ afe foforo anaa nea ɛboro saa ntetee a ɛfa trabea ho wɔ colorectal tebea horow mu.

Saa ntetee yi akyi no, wɔtwa sɔhwɛ a wɔkyerɛw ne anom na wɔbɛyɛ animdefo a wɔagye wɔn atom wɔ bagua no mu fi aduruyɛ bagua ahorow a ɛfa ho (e.g., American Board of Colorectal Surgery). Enti sɛnea wubetumi ahu no, eyi nyɛ akwantu a ɛyɛ mmerɛw, ɛno nti na yebetumi de yɛn ho ato wɔn nimdeɛ ne wɔn tumi so.

Dɛn pɔtee na oduruyɛfo a ɔyɛ oprehyɛn wɔ akyi berɛmo mu sua sen oduruyɛfo a ɔyɛ oprehyɛn nyinaa?

Saa abenfo yi sua dwensɔtwaa ne dwensɔtwaa mu nipadua ho ade kɔ akyiri , kyerɛ sɛ, sɛnea saa akwaa ahorow yi yɛ adwuma ne sɛnea wɔne wɔn ho wɔn ho di nkitaho.

Esiane nimdeɛ a emu dɔ yi nti, ɔhaw ahorow a ɛsɔre wɔ dwensɔtwaa ne akyi berɛmo muWɔwɔ tumi soronko a wɔde hwehwɛ nipadua mu haw ahorow a emu yɛ den mu na wɔde ayaresa a ɛyɛ mmerɛw a ɛho hia ma . Nokwarem no, wɔn na wɔyɛ saa adwuma yi ho abenfo.

Dɛn ankasa na oduruyɛfo a ɔyɛ colorectal oprehyɛn yɛ?

Nnuruyɛfo a wɔyɛ oprehyɛn wɔ akyi berɛmo mu no de endoscopic ne oprehyɛn akwan a wobetumi nyinaa di dwuma de sa wo aduan mu ntini. Eyi kyerɛ sɛ wɔwɔ nnwinnade a wohia nyinaa de sa tebea horow a emu yɛ den.

Wobetumi asa wo yare a wɔnyɛ oprehyɛn (sɛ nhwɛso no, denam endoscopy so), denam oprehyɛn a wɔmfa biribiara nhyɛ mu , anaasɛ, sɛ ɛho hia a, wɔbɛyɛ oprehyɛn a wɔabue ano .

Akwan bi a nnuruyɛfo a wɔyɛ oprehyɛn wɔ akyi berɛmo mu de di dwuma no bi ne:

• Colonoscopy: Eyi hwehwɛ sɛ wɔde afiri a ɛyɛ tratraa a ɛyɛ mmerɛw (endoscope) a mfoninitwa afiri ne hann fa akyi berɛmo no mu bɛhyɛ mu de ahwehwɛ dwensɔtwaa kɛse no nyinaa mu . Wobetumi de eyi ayi polyps nketewa na wɔafa ntini mu nhwɛsode (biopsies).
• Enteroscopy: Eyi nso yɛ ɔkwan a wɔfa so de endoscope hwehwɛ dwensɔtwaa ketewa no mu .
• Sigmoidoscopy: Eyi hwehwɛ dwensɔtwaa kɛse no fã a etwa to (sigmoid colon), akyi berɛmo, ne akyi berɛmo mu.
• Laparoscopy: Wɔtwa yafunu no mu ketewaa bi, na wɔnam so de mfoninitwa afiri soronko bi (laparoscope) hyɛ mu de hwehwɛ yafunu no mu akwaa ahorow mu.
• Laparoscopic oprehyɛn: Wɔsan frɛ no "keyhole surgery," eyi yɛ adeyɛ a ɛhwehwɛ sɛ wotwa yafunu no mu nketenkete pii na wɔde laparoscope ne nnwinnade titiriw di dwuma. Eyi ma wotumi yɛ oprehyɛn no a wɔmfa ntwitwiridii kɛse, na ɛtew bere a wɔde ma obi ho tɔ no so.
• Robot oprehyɛn: Eyi nso yɛ oprehyɛn bi a wɔde laparoscopic yɛ. Nanso, ɛha no, oduruyɛfo a ɔyɛ oprehyɛn no nam kɔmputa so afiri bi so di robɔt basa bi so. Eyi ma wotumi yɛ oprehyɛn a ɛyɛ mmerɛw na ɛyɛ den yiye .

Oprehyɛn ne akwan a nnuruyɛfo a wɔyɛ oprehyɛn a wɔde kɔ akyi berɛmo mu yɛ no bi ne:

• Polypectomy: Wɔnam endoscopy so yi polyps (nneɛma nketenkete) a ɛwɔ akyi berɛmo mu no fi hɔ.
• Endoscopic mucosal resection (EMR) / endoscopic submucosal dissection (ESD): Akwan a ɛkɔ akyiri a wɔfa so yi akisikuru a ɛwɔ dwensɔtwaa no mu a ɛyɛ den sɛ wobeyi afi hɔ no fi nipadua no mu.
• Transanal endoscopic microsurgery: Oprehyɛn a wɔde adwinnade titiriw bi (proctoscope) fa akyi berɛmo no mu de yi akisikuru akɛse anaa akwanside ahorow a ɛwɔ akyi berɛmo no mu no fi hɔ.
• Oprehyɛn a wɔde twa dwensɔtwaa: Woyi dwensɔtwaa kɛse no fã bi anaa ne nyinaa fi hɔ, a egyina tebea no so.
• Ostomy oprehyɛn: Eyi hwehwɛ sɛ wɔsakra ɔkwan a nsu fa so fi nipadua no mu na wɔyɛ stoma denam dwensɔtwaa no ano biako a wɔde bɛka yafunu no honam ani honam ani no so. Wɔfrɛ eyi sɛ colostomy anaa ileostomy.
• Anastomosis oprehyɛn: Wɔsan de dwensɔtwaa no afã abien bom denam ostomy a wɔadi kan ayɛ a woyi fi hɔ no so.
• Appendectomy: Woyi appendix no bere a ɛho ayɛ hyew (appendicitis).
• Anoplasty: Wosiesie anaa wɔsan yɛ akyi berɛmo no.
• Rectopexy: Wɔyɛ oprehyɛn a wɔde san ma akyi berɛmo no ahwe ase.
• Sacrocolpopexy: Wosiesie akyi berɛmo akwaa a ahwe ase.
• Hernia repair: Wɔde laparoscopic anaa robɔt akwan siesie hernias a ɛwɔ dwensɔtwaa mu (e.g. inguinal hernia, incisional hernia).
• Cecostomy / antegrade colonic enema (ACE) oprehyɛn: Wɔde afiri bi hyɛ akyi berɛmo no mu de enema ano aduru ma sɛ ayaresa ma tebea horow bi, te sɛ akisikuru.

Wɔyɛ nneɛma te sɛ eyi nso de hwɛ sɛnea wo colorectal ne rectal tract no yɛ adwuma:

• Digital rectal exam: Sɔhwɛ a oduruyɛfo no de nsateaa a wɔde nsateaa ahyɛ mu hyɛ akyi berɛmo no mu.
• Anoscopy / Proctoscopy: Adwinnade ketewa bi a wɔde hyɛ mu de hwɛ akyi berɛmo ne akyi berɛmo a ɛwɔ fam.
• Defecography: Wɔde X-ray anaa MRI hwehwɛ dwensɔtwaa mu.
• Endorectal ultrasound: Wɔyɛ akyi berɛmo no ne ntini a atwa ho ahyia ho nhwehwɛmu denam ultrasound nhwehwɛmu a wɔde fa akyi berɛmo no mu so.
• Anorectal manometry: Ntini a ɛwɔ akyi berɛmo ne akyi berɛmo mu no nhyɛso ne dwumadie a wɔsusu.

Tebea ahorow bɛn na nnuruyɛfo a wɔyɛ oprehyɛn wɔ akyi berɛmo mu no sa?

Tebea horow pii wɔ hɔ a ɛhwehwɛ sɛ wokɔ oduruyɛfo a ɔyɛ oprehyɛn a ɔhwɛ akyi berɛmo so nkyɛn. Momma yɛnhwɛ wɔn mu binom wɔ akuw mu:

Kokoram a ɛwɔ akyi berɛmo mu, nhwɛso ahorow:

• Kokoram a ɛwɔ akyi berɛmo mu
• Kokoram a ɛwɔ akyi berɛmo mu
• Kokoram a ɛwɔ akyi berɛmo mu
• Appendix kokoram
• Peritoneal carcinomatosis - kokoram a etrɛw kɔ yafunu no mu
• Yafunu mu akisikuru (GIST) .
• Ntini mu ntini mu akisikuru
• Kokoram tebea horow bi a wonya fi awo mu, te sɛ kokoram a wonya fi awo mu a ɛnyɛ polyposis colorectal cancer (HNPCC) anaa Lynch syndrome

Colorectal polyps ne polyposis syndromes a wonya fi awo mu, nhwɛso ahorow:

• Family adenomatous polyposis syndrome (FAP) - Eyi betumi ama polyps ɔhaha anaa mpempem pii aba akyi berɛmo no mu.
• Lynch syndrome - (wɔsan ka ho asɛm wɔ kokoram ase) .
• Polyposis a ɛne MUTYH wɔ abusuabɔ (MAP) .
• Serrated polyposis yare a ɛma obi nya ɔyare mmoawa
• Desmoid akisikuru
• Peutz-Jeghers yare a ɛma obi nya ɔyare no
• Mmofra a wɔyɛ polyposis syndrome
• PTEN hamartoma yare a ɛma obi nya ɔyare no

Colitis a ɛyɛ den (akisikuru a ɛyɛ hyew), nhwɛso ahorow:

• Diverticulitis - Nyarewa anaa ɔfe a ɛba nkotoku nketewa (diverticula) a ɛwɔ dwensɔtwaa no fasu mu.
• Akisikuru a ɛyɛ kurukuruwa
• Crohn yare no
• Microscopic colitis a ɛyɛ mmerɛw
• Pseudomembranous colitis - Tebea a ɛtaa ba bere a wɔde nnuru bi a ekum ɔyare mmoawa adi dwuma akyi.
• Appendicitis - Ntini a ɛyɛ hyew.
• Necrotizing enterocolitis - Tebea a emu yɛ den a ɛka mmofra a wɔawo wɔn foforo.
• Ischemic colitis - Ɔfe a ɛba esiane mogya a ɛkɔ akyi berɛmo no mu a ɛso tew nti.

Ntini a ɛma nipadua no yɛ adwuma, nhwɛso ahorow:

• Pelvic floor dysfunction - tebea a ɛma ɛyɛ den sɛ wobɛtow nsuo.
• Nsu a wontumi nni so (Fecal incontinence) .
• Nsu a wɔtow gu a wɔasiw ano
• Anismus - a entumi mma ntini a ɛwɔ akyi berɛmo mu no dwo yie wɔ berɛ a wɔretu nsuo.

Nsiesiei mu sintɔ ahorow, nhwɛso ahorow:

• Ntini kɛse a ɛsiw dwensɔtwaa
• Anal fistula - Akwan a ɛnyɛ awosu mu a ɛba honam ani ne dwensɔtwaa ntam a ɛbɛn akyi berɛmo no.
• Rectovaginal fistula - nkitahodi a ennye awosu mu a eda rectum ne vagina ntam.
• Perineal hernia a ɛyɛ mmerɛw
• Perianal akisikuru a ɛwɔ nipadua no mu
• Rectal a ɛhwe ase
• Pelvic akwaa a ɛhwe ase

Tebea afoforo a ɛnyɛ hu a ɛwɔ akyi berɛmo mu, nhwɛso ahorow bi ne:

• Mogya a ɛba yafunu mu / mogya a ɛba akyi berɛmo mu
• Anal mu mpaapaemu
• Anal warts a ɛyɛ mmerɛw
• Akisikuru a ɛma obi ho yɛ hyew
• Akuru a ɛwɔ akyi berɛmo mu
• Akisikuru ne fecal impaction

Nkaebɔ ketewaa bi a ɛfa wo dwensɔtwaa ne wo aduan mu ntini a ɛwɔ fam ho

Wo dwensɔtwaa kɛse no yɛ wo yafunu mu ntini a ɛwɔ fam no fã titiriw . Aduan a yedi no fa wo aduan mu, na ɛnam eyi so na awiei koraa no, nneɛma a wɔsɛe no fi wo nipadua mu. Enti, sɛ worehyia sɛnkyerɛnne ahorow te sɛ yafunu ase yaw anaa nsakrae a ɛba wo dwensɔtwaa mu (sɛ nhwɛso no, mogya a ɛretu, akisikuru, akisikuru) a, ɛda adi sɛ ɛyɛ ɔhaw wɔ wo yafunu mu ntini a ɛwɔ fam no ho.

Eyi ne bere a afotu ne ayaresa a oduruyɛfo a ɔyɛ oprehyɛn a ɔde ma wɔ akyi berɛmo mu no bɛyɛ nea ɛho hia. Ɛnyɛ tebea horow nyinaa na ɛhwehwɛ sɛ wɔyɛ oprehyɛn . Nanso, sɛ ɛho hia sɛ woyɛ oprehyɛn a, sɛ wokɔ oduruyɛfo titiriw bi a ɔte sɛ eyi nkyɛn a, ebetumi aboa wo ma woanya ayaresa a etu mpɔn sen biara. Wo oduruyɛfo a ɔhwɛ wo yafunu mu anaa wo yafunu mu ɔyaresafo de wo bɛkɔ oduruyɛfo a ɔyɛ wo yafunu mu oprehyɛn nkyɛn sɛ wɔte nka sɛ saa oduruyɛfo titiriw yi betumi adi wo tebea no ho dwuma yiye a.

Awiei koraa no, ɛsɛ sɛ meka kyerɛ wo... (Take-Home Message)

Mewɔ anidaso sɛ seesei woanya adwene pa wɔ onii ko a ɔyɛ oprehyɛn a ɔyɛ colorectal oprehyɛn, nea wɔyɛ, ne nyarewa ahorow a wɔsa ho.

Nea ɛho hia ne sɛ saa nnuruyɛfo atitiriw yi wɔ hɔ sɛ wɔbɛboa wo . Wɔwɔ nimdeɛ ne ntetee a ehia ma wo tebea no.

• Sɛ wowɔ sɛnkyerɛnne ahorow bi a ɛyɛ soronko a ɛfa wo dwonku, wo akyi berɛmo, anaa wo akyi berɛmo ho (sɛ nhwɛso no, yafunu mu yaw a ɛkɔ so, mogya a ɛba wo nsu mu, nsakrae a ɛba wo dwensɔtwaa mu, wo mu duru a ɛso tew a wontumi nkyerɛkyerɛ mu) a, mmu w’ani ngu so . Hwehwɛ nnuruyɛfo afotu ntɛm ara.
• Sɛ wo duruyɛfo de wo kɔ oduruyɛfo a ɔyɛ wo kokoram oprehyɛn nkyɛn a, mma wo ho nnyɛ wo hu . Nea ɛkyerɛ ara ne sɛ ebia wubehia ayaresa titiriw bi .
• Kae sɛ, ɛdenam nnɛyi aduruyɛ ho nyansahu a ɛkɔ anim so no, wobetumi adi tebea horow pii a ɛfa saa adwuma yi ho no ho dwuma yiye na wɔasa .

Enti, ɛsɛ sɛ wokɔ so nya apɔwmuden! Sɛ wowɔ ɔhaw bi a, nea ehia paa ne sɛ wubenya afotu a ɛfata afi baabi a ɛfata.

` Colorectal oprehyɛn, akyi berɛmo mu nyarewa, colorectal oprehyɛn, akyi berɛmo mu kokoram, colonoscopy, aduan mu nhyehyɛe, oprehyɛn