So obi wɔ w’abusua mu a wanya kokoram wɔ akyi berɛmo mu? Bra, momma yɛnka saa awosu mu tebea yi (Familial Adenomatous Polyposis - FAP) ho asɛm!

So obi wɔ w’abusua mu, ebia wɔ ne mmofraase, anya kokoram wɔ akyi berɛmo mu? Anaasɛ so oduruyɛfo bi aka akyerɛ wo sɛ wowɔ nneɛma nketenkete a enyin (polyps) wɔ wo dwensɔtwaa mu a yafunu mu haw ka ho? Sɛ woate asɛm a ɛte saa anaasɛ woante no, ebetumi ayɛ nea ɛho hia yiye sɛ wubehu saa tebea a wɔfrɛ no `FAP` a yɛrebɛka ho asɛm nnɛ yi. Efisɛ ɛwom sɛ ɛntaa nsi kakra de, nanso sɛ wuhu ntɛm a, ebetumi agye wo afi ɔhaw akɛse pii mu.

Dɛn ne FAP wɔ nsɛm a ɛnyɛ den mu?

Sɛ yɛbɛka no tiawa a, Familial Adenomatous Polyposis, anaa FAP tiawa no yɛ awosu mu tebea a ɛma nnua nketenkete (polyps) pii a wɔfrɛ no adenomas, a ebetumi abɛyɛ kokoram, ba wo dwensɔtwaa mu na ɛtɔ mmere bi a ɛwɔ wo akyi berɛmo mu.

Susuw ho hwɛ, nnipa binom nya saa akisikuru yi biako anaa abien wɔ wɔn akyi berɛmo mu bere a wɔrenyin no. Ɛno yɛ ade a ɛfata. Nanso obi a ɔwɔ `FAP` fam no, wɔtaa nya saa akisikuru yi bɛboro ɔha, ɛtɔ da bi a mpempem pii , nanso efi ase nyin wɔ ne mmofraase pɛɛ, ebia bere a wɔadi mfe du pɛ. Enti, hokwan a ɛwɔ hɔ sɛ saa akisikuru yi biako bɛdan kokoram (`colorectal cancer`), kyerɛ sɛ, asiane a ɛwɔ hɔ wɔ nkwa nna nyinaa mu no dɔɔso yiye .

Nea ɛbɛyɛ na wɔadi asiane yi so no, nnuruyɛfo taa kamfo kyerɛ sɛ wɔnyɛ oprehyɛn nyi akyi berɛmo no nyinaa (total colectomy) . Ɛtɔ da bi a, woyi akyi berɛmo no nso (proctocolectomy). Eyi te saa efisɛ wɔ FAP mu no, saa akisikuru yi nyin ntɛmntɛm dodo sɛ wobetumi adi so denam yi a wobeyi afi hɔ mmiako mmiako so. Nokwarem no, sɛ wɔanyɛ oprehyɛn yi a, nnipa pii a wɔwɔ FAP no benya kokoram bere a wɔadi mfe mfinimfini .

Nnipa a wɔwɔ FAP betumi anya akisikuru ahorow afoforo, ɛnyɛ akyi berɛmo mu nko, na mmom wɔ mmeae afoforo nso, te sɛ honam ani, ntini a ɛyɛ mmerɛw, sẽ, ne nnompe. Sɛ woyi akyi berɛmo no mpo a, ebia ɛho behia sɛ wokɔ so yɛ nhwehwɛmu de hwɛ sɛ ebia akisikuru afoforo yi wɔ hɔ anaa, na ebia ebehia sɛ wɔyɛ wo oprehyɛn nso.

Asiane bɛn na ɛwɔ hɔ sɛ nnipa a wɔwɔ FAP benya kokoram?

Sɛ wɔansa obi a ɔwɔ FAP no yare a, ɛkame ayɛ sɛ obenya kokoram wɔ ne menewa mu 100% . Afei nso, kokoram no betumi anya ntɛm na bere a onnyinii sen nnipa afoforo. Sɛ wonim sɛ abusua no muni bi wɔ yare no a, ɛsɛ sɛ mmofra a wɔwɔ saa mmusua no mu yɛ wɔn akyi berɛmo mu nhwehwɛmu afe biara fi bere a wɔadi mfe 10 .

Wɔ kokoram a ɛwɔ akyi berɛmo mu akyi no, nnipa a wɔwɔ FAP no wɔ asiane mu sɛ wobenya kokoram ahorow afoforo:

• Kokoram a ɛwɔ dwensɔtwaa ketewa no atifi (`Duodenal cancer`) - bɛyɛ 8% .
• Papillary thyroid kokoram - bɛyɛ 2% .
• Pancreatic kokoram - bɛyɛ 2% .
• mmerɛbo mu kokoram a wɔfrɛ no ``Hepatoblastoma`` (titiriw wɔ mmofra mu) - bɛyɛ 1.5% .
• Yafunu mu kokoram - bɛyɛ 1% .
• Amemene ne akyi berɛmo mu akisikuru - a ennu 1% .

So FAP ahorow ahorow wɔ hɔ?

Yiw, `FAP` titiriw bi wɔ hɔ ne subtypes afoforo pii de ka ho.

• "Classic" FAP: Eyi yɛ adenoma bɛboro 100 a ɛwɔ akyi berɛmo no mu.
• "Attenuated" FAP (AFAP): Eyi yɛ subtype a emu nyɛ den kakra. Ntini a ɛyɛ 20 kosi 100 na ɛwɔ akyi berɛmo no mu.
• Gardner syndrome: Te sɛ classic `FAP` no, akisikuru bɛboro 100 na ɛwɔ akyi berɛmo no mu. Nea ɛka ho no, akisikuru ahorow afoforo sisi nipadua no mmeae afoforo.
• Turcot syndrome: Kokoram akisikuru bi ba amemene no mu ka akisikuru pii a ɛwɔ dwensɔtwaa no mu ho.

Wɔfrɛ tebea yi FAP sɛn?

FAP yɛ tebea a ɛntaa nsi koraa . Ɛka nnipa bɛyɛ 8,000 biara mu biako. FAP yɛ bɛyɛ 0.5% wɔ kokoram a ɛwɔ akyi berɛmo mu nyinaa mu. Nnuru nketewa te sɛ AFAP, Gardner yare, ne Turcotte yare no ho yɛ na mpo.

Nsonsonoe bɛn na ɛda FAP ne Lynch yare no ntam?

Lynch syndrome yɛ awosu mu tebea foforo a ɛma asiane a ɛwɔ hɔ sɛ obi benya kokoram ne kokoram afoforo no yɛ kɛse. Wɔsan frɛ Lynch yare no HNPCC (agyapade a ɛnyɛ polyposis colorectal cancer syndrome). Sɛnea edin no kyerɛ no, eyi nkyerɛ ankasa sɛ akisikuru dodow bi a ɛwɔ akyi berɛmo mu ba .

Nnipa a wɔwɔ Lynch syndrome betumi anya kokoram bere a akisikuru biako anaa nea ɛboro saa wɔ wɔn akyi berɛmo mu mpo. Afei nso, akisikuru ne kokoram ba akyiri kakra sen FAP, na asiane no sua kakra. Saa tebea abien yi fi awosu mu nkwaadɔm mu nsakrae ahorow .

Dɛn ne FAP ho sɛnkyerɛnne ahorow? Yɛyɛ dɛn hu no?

Wɔ FAP mu no, akyi berɛmo mu polyps fi ase yɛ ntɛm sen nnipa dodow no ara, mpɛn pii no wɔ mmabunbere mu . Ebia saa polyps yi rennya yare no ho sɛnkyerɛnne biara kosi sɛ ɛbɛyɛ kɛse a asiane wom. Nanso sɛ woyɛ colonoscopy a, wo duruyɛfo betumi ahu wɔn.

Ebia nnipa a wɔwɔ `FAP` no benya polyps ɔhaha anaa mpempem pii wɔ wɔn akyi berɛmo mu . Anyɛ yiye koraa no, nnipa a wɔwɔ `AFAP` no wɔ 20. Esiane sɛ polyps no dɔɔso na enyin ntɛmntɛm wɔ `FAP` mu nti, ɛda adi sɛ ɛde sɛnkyerɛnne ahorow bɛba sen polyps. Nsɛnkyerɛnne no bi ne:

• Mogya a ɛba akyi berɛmo mu
• Ayamtuo
• Yafunu mu yaw a enni sabea

Ɛtɔ mmere bi a, nnipa a wɔwɔ FAP betumi anya sɛnkyerɛnne ahorow a nnuruyɛfo betumi ahu wɔ akyi:

• Dermatofibromas: Nhama a ɛte sɛ akuru a ɛwɔ honam ani.
• Epidermal cysts: Keratin ahyɛ mu ma, a ɛyɛ kurukuruwa a ɛwɔ honam ani.
• Osteomas: Akisikuru a ɛnyɛ kokoram a ɛba nnompe no mu. Wɔtaa hu wɔ anom dompe anaa ti nhwi mu.
• Nsõ a ɛboro so anaa sẽ a abɔ:Wobetumi ahu eyinom wɔ X-ray a wɔde hwɛ sẽ no so.
• Congenital hypertrophy of the retinal pigment epithelium (CHRPE): Wobetumi ahu eyinom bere a wɔreyɛ aniwa mu nhwehwɛmu no. Nanso, mpɛn pii no, wɔmfa anisoadehu mu haw mma.

Mfe bɛn na FAP ho sɛnkyerɛnne taa fi ase?

Wɔ FAP mu no, mpɛn pii no, akyi berɛmo no nyin fi ase bɛyɛ mfe 16. Wɔ AFAP mu no, ebetumi afi ase akyiri kakra. Sɛ w’awofo ne nnuruyɛfo nim sɛ wowɔ asiane mu ma tebea no a, ebia wobefi ase asɔ wo ahwɛ bere a woadi mfe 10. Sɛ woanyɛ saa a, ebia wobehu sɛ wowɔ tebea no esiane wo sɛnkyerɛnne ahorow nti.

Dɛn ne ade titiriw a ɛde FAP ba?

Nea ɛde FAP ba titiriw ne awosu mu nkwaadɔm mu nsakrae . Wɔfrɛ saa awosu mu abɔde yi adenomatous polyposis coli (APC) awosu mu abɔde . Wɔsan frɛ no tumor suppressor gene. Eyi kyerɛ sɛ saa awosu mu abɔde yi mma nkwammoaa nnyin a wontumi nni so na ɛnyɛ akisikuru. Sɛ awosu mu nkwaadɔm mu nsakrae bi ba a, awosu mu abɔde yi dwumadi sɛe.

Awosu mu nkwaadɔm mu nsakrae a ɛde FAP ba no yɛ mmoawa mu nsakrae. Eyi kyerɛ sɛ ɛnyɛ biribi a ɛba wɔ nkwa mu, na mmom biribi a ɛba bere a wɔrenyinsɛn no . Eyi yɛ biribi a wɔde fi awo ntoatoaso so kɔ awo ntoatoaso so. Sɛ w’awofo mu biako wɔ saa mutation yi a, wowɔ hokwan 50% sɛ wubenya bi. Nanso, saa nkwaadɔm mu nsakrae yi mu bɛyɛ 30% yɛ foforo (mfitiase mu nsakrae), kyerɛ sɛ, ɛnyɛ nea wonya fi awo mu . Enti, ebia ayarefo a wɔahu sɛ wɔwɔ FAP no mu bɛyɛ 30% nni abusua abakɔsɛm biara a ɛfa yare no ho.

Dɛn ne nsɛnnennen a ebetumi afi FAP mu aba?

Ɔhaw a ɛho hia sen biara a ɛsɛ sɛ wodi ho dwuma wɔ FAP mu ne kokoram a ɛwɔ akyi berɛmo mu . Oprehyɛn a wɔbɛyɛ de ayi wo dwonku (colectomy) no betumi atew asiane yi so kɛse. Nanso, sɛ wobɛtra ase a wunni akyi berɛmo a, ebetumi anya w’asetra so nkɛntɛnso bi efisɛ ɔkwan a wofa so fa nsu mu no sesa. Ebia ɛho behia sɛ wode ileostomy kotoku anaa ileal kotoku bedi dwuma sen sɛ wode akyi berɛmo bedi dwuma.

Esiane sɛ awosu mu nkwaadɔm mu nsakrae a ɛde FAP ba no wɔ wo nipadua mu nkwammoaa biara mu nti, akisikuru betumi ayɛ wo nipadua no baabiara . Akisikuru afoforo nso tumi nyin wɔ akyi berɛmo no akyi, na ɛtɔ mmere bi a ebetumi abɛyɛ kokoram. Ebia wo duruyɛfo bɛkamfo nhyehyɛe a ɛbɛma wɔayɛ nhwehwɛmu de ahwehwɛ akisikuru ahorow yi akyerɛ:

• Duodenal/periampullary polyps a ɛwɔ nipadua no mu:Eyinom nyin wɔ wo dwensɔtwaa ketewaa no atifi (duodenum), anaa baabi a bile duct anaa pancreatic duct no ka dwensɔtwaa ketewa no ho. Ɛkame ayɛ sɛ obiara a ɔwɔ FAP no nya eyinom. Nnipa kakraa bi betumi anya kokoram a ɛwɔ akyi berɛmo mu, ansa mu kokoram, dwensɔtwaa mu kokoram wɔ ntini mu, anaa mogya ntini mu kokoram.
• Yafunu mu yare: Nnipa a wɔwɔ FAP no mu bɛyɛ 90% nya yafunu mu yare, nanso eyinom mu 1% pɛ na wonya kokoram.
• Desmoid tumors: Eyinom yɛ akisikuru a ɛnyɛ kokoram a ɛba wɔ ntini a ɛka bom mu. Wɔba wɔ nnipa a wɔwɔ FAP no mu bɛyɛ 15% mu. Ɛwom sɛ wɔnyɛ kokoram de, nanso ɛtɔ mmere bi a (bɛyɛ 5%) wobetumi de akwahosan ho haw a emu yɛ den aba na wɔawuwu mpo. Wobetumi ayɛ basabasa kɛse, atrɛw akɔ nneɛma a ɛbɛn hɔ mu, na wɔamia mogya ntini, akwaa, ne ntini ahorow so anaasɛ asiw ano. Ɛyɛ den sɛ wobeyi afi hɔ na ebetumi asan aba bio.
• Papillary thyroid cancer: Saa thyroid kokoram yi ba nnipa a wɔwɔ FAP no mu bɛyɛ 2% mu. Asiane nnim koraa na mpɛn pii no wotumi sa.
• Mmofra a wɔwɔ mmerɛbo mu kokoram: Mmofra a wɔwɔ FAP titiriw no, asiane kakraa bi na ɛwɔ hɔ sɛ wobenya mmerɛbo mu kokoram a wɔntaa nhu a wɔfrɛ no hepatoblastoma.
• Medulloblastoma: Eyi yɛ amemene mu kokoram. Ebetumi aba wɔ Turcot syndrome a ɛne FAP wɔ abusuabɔ no ho. Wɔ FAP mpo mu no, ɛntaa nsi koraa.
• Rectal polyps: Sɛ woannyi wo rectum no nka wo dwensɔtwaa ho a, wowɔ asiane mu sɛ wubenya rectal polyps, enti ɛho behia sɛ wɔyɛ wo proctoscopy nhwehwɛmu wɔ w’asetra nyinaa mu.

Wobɛyɛ dɛn ahu no yiye sɛ wowɔ FAP?

Sɛ wopɛ sɛ wuhu sɛ ebia woanya APC awosu mu nkwaadɔm mu nsakrae no a, wubetumi ahu denam awosu mu nhwehwɛmu a wobɛyɛ so . Awosu mu nhwehwɛmu gye wo DNA (te sɛ mogya anaa nnompe) bi na ɛhwehwɛ awosu mu nkwaadɔm mu nsakrae pɔtee bi. Sɛ wowɔ mutation no a, ade a edi hɔ ne sɛ wobɛyɛ colonoscopy de ahwɛ sɛ adenomas anaa.

Wohu FAP bere a anyɛ yiye koraa no polyp 100 (sɛ ɛyɛ AFAP a, 20) na APC awosu mu nkwaadɔm mu nsakrae wɔ hɔ no . Ɛnyɛ FAP nkutoo ne awosu mu tebea a ɛma adenomatous polyps ba. Polyposis a ɛne MUTYH wɔ abusuabɔ no yɛ tebea a ɛte saa ara, nanso ɛnam nkwaadɔm mu nsakrae a ɛba awosu mu nkwaadɔm soronko bi a wɔfrɛ no MUTYH mu so na ɛba.

Dɛn ne ayaresa nhyehyɛe a wɔayɛ ama obi a ɔwɔ FAP?

FAP ayaresa nhyehyɛe no bi ne nkwa nna nyinaa a wɔbɛhwɛ so ne oprehyɛn a ɛyɛ ahyɛde.Wɔ mfiase no, sɛ wowɔ polyps (anaa AFAP) kakraa bi a, wo duruyɛfo betumi ayi afi hɔ mmiako mmiako bere a wɔreyɛ colonoscopy (polypectomy) no. Sɛ polyps no yɛ kɛse paa anaasɛ ɛbɛyɛ kokoram a, ebia ɛho behia sɛ wɔyɛ oprehyɛn.

Sɛɛgyiri

Nnipa dodow no ara a wɔwɔ classic FAP no behia sɛ wɔyɛ colectomy nyinaa wɔ wɔn mfe aduonu awiei anaa aduasa mfiase mu hɔ . Wo duruyɛfo begyina asiane pɔtee a ɛwɔ wo mu so asi bere a wɔbɛyɛ wo oprehyɛn no ho gyinae. Ɔne wo nso bɛkasa afa colectomy ahorow a wubetumi ayɛ ho.

Sɛ woyi wo dwensɔtwaa no a, ɔkwan bi da wo dwensɔtwaa ketewaa ne wo dwensɔtwaa (anaasɛ wo dwensɔtwaa) ntam. Ɛtɔ mmere bi a, oduruyɛfo a ɔyɛ oprehyɛn tumi san de n’afã abien yi bom. Afei wubetumi anya wo dwensɔtwaa afa wo dwensɔtwaa mu sɛnea wotaa yɛ no. Sɛ ɛno ntumi nyɛ yiye a, wɔbɛyɛ ‘ostomy’, a ɛyɛ ɔkwan foforo a wobɛbue wɔ wo yafunu mu ma wo nsuo afiri mu.

Nhwehwɛmu a wɔyɛ

W’aduruyɛfo kuw no betu wo fo wɔ mpɛn dodow a ɛsɛ sɛ woyɛ nhwehwɛmu de hwehwɛ akisikuru ahorow mu, a egyina w’ankasa asiane ahorow so. Wɔ FAP a wɔtaa de di dwuma ho no, wɔkamfo kyerɛ sɛ wɔnyɛ afe afe colonoscopie fi mfe 10 kosi sɛ wobetwa colectomy . Wɔ AFAP fam no, ɛsɛ sɛ wofi ase yɛ nhwehwɛmu afe biara, fi ase wɔ mfe 20 mu.

Sɛ wotwa wo colectomy wie a, ɛsɛ sɛ wokɔ so yɛ sigmoidoscopy nhwehwɛmu, a ɛhwehwɛ wo GI tract no fã a ɛwɔ fam no mu. Sɛ aka wo akyi berɛmo no fã bi a, ɛsɛ sɛ woma wɔhwɛ mu asram 6 kosi 12 biara. Sɛ woyii wo rectum na wɔde ileal pouch si ananmu a, ɛsɛ sɛ woma wɔhwɛ mu mfe 1 kosi 4 biara.

Sɔhwɛ afoforo a wɔayɛ ho nhyehyɛe betumi ayɛ:

• Upper endoscopy: Eyi te sɛ colonoscopy, nanso wɔyɛ no wɔ wo aduan mu ntini a ɛwɔ soro no so. Wɔde endoscope kɔ wo menewam na ɛkɔ wo yafunu ne wo dwensɔtwaa ketewa (duodenum) no atifi de hwɛ sɛ ebia polyps anaa. Sɛ ebi wɔ hɔ a, wo duruyɛfo betumi ayi afi hɔ bere koro no ara a wɔreyɛ no.
• Ultrasound nhwehwɛmu a wɔyɛ de hu thyroid anaa mmerɛbo mu kokoram.
• CT scan (computed tomography scan) anaa MRI (magnetic resonance imaging) nhwehwɛmu a wɔyɛ de hu akisikuru a ɛyɛ desmoid.

So wobetumi asiw FAP ano?

Awosu mu afotu a wode bɛma wo na ama woate asiane a ɛwɔ FAP tebea no a wode bɛma wo mma no aseEbetumi aboa. Asiane ahorow yi ho asɛm a wobɛka no betumi aboa wo ma woayɛ w’abusua ho nhyehyɛe. Mpɛn pii no, ɛrentumi nyɛ yiye sɛ wobesiw awosu mu nsakrae bi ano wɔ nyinsɛn mu, nanso abusua nhyehyɛe ahorow bi wɔ hɔ a wubetumi asusuw ho.

Dɛn ne obi a ɔwɔ FAP nkwa nna?

Sɛ wɔansa no yare a, sɛ wɔkyekyem pɛpɛɛpɛ a, nnipa nkwa nna bɛyɛ mfe 42 . Nanso, sɛ wonya ayaresa ne ayaresa a ɛfata a, wubetumi atra ase sɛnea ɛsɛ . Bere a woyi wo dwonku akyi no, asiane kɛse a ɛwɔ hɔ no fi kokoram afoforo a ɛwɔ aduan mu ne ‘desmoid’ akisikuru a ɛde ɔhaw kɛse ba no mu. Eyinom ntaa mma koraa te sɛ kokoram a ɛwɔ akyi berɛmo mu.

Sɛ mewɔ saa tebea yi a, dɛn na ɛsɛ sɛ mehwɛ kwan?

Sɛ wohu sɛ wowɔ FAP a, wubetumi ahwɛ kwan sɛ wɔbɛyɛ wo nkwa nna nyinaa aduruyɛ mu nhwehwɛmu na ebia wɔayɛ oprehyɛn pii de ayi akisikuru no afi hɔ . Akuru a ɛba wo dwensɔtwaa akyi no ntaa nyɛ kokoram te sɛ polyps a ɛwɔ wo dwensɔtwaa mu no. Ɛwom sɛ desmoid akisikuru nyɛ kokoram de, nanso ɛtɔ mmere bi a ebetumi ayɛ ɔhaw ketewaa bi anaasɛ ɔhaw kɛse.

Wubetumi ahwɛ kwan sɛ wobetwa colectomy koraa wɔ w'asetra mfiase . Ɛno akyi no, ebia wo dwensɔtwaa bɛsan abɔ mu, anaasɛ ebia wɔbɛyɛ ileal pouch anaa ostomy. Saa akwan yi mu biara de asiane ba sɛ nsɛnnennen pɔtee bi bɛba. Nanso, woda so ara betumi atra ase akyɛ na apɔwmuden bere a woayɛ colectomy akyi.

Ɛyɛ ade a ɛfata sɛ wobɛte awerɛhow ne dadwen nka bere a wuhu sɛ wowɔ awosu mu yare bi a ebehia sɛ wohwɛ wo nkwa nna nyinaa no. Nanso, sɛ wuhu wie a, wubetumi ayɛ nneɛma bi de adi kokoram ho asiane a ɛwɔ hɔ no ho dwuma . Bere a akyinnye biara nni ho sɛ oprehyɛn wɔ wo daakye mu no, nnuruyɛfo bɛbɔ mmɔden sɛ wɔbɛma ayɛ nea ɛnyɛ den sɛnea wobetumi.

Nnipa pii betumi ayɛ laparoscopic oprehyɛn de yi akyi berɛmo no, na wɔyɛ no denam ntwitwiridii nketenkete so na ɛsa ntɛmntɛm . Ebia ɛsɛ sɛ wɔyɛ nnipa a wɔwɔ ileal kotoku no oprehyɛn mpɛn pii, nanso awiei koraa no wobetumi de tiafi adi dwuma sɛnea na wɔyɛ kan no.

Nneɛma a ɛho hia sen biara a ɛsɛ sɛ yɛkae fi nea yɛaka ho asɛm no mu (Take-Home Message) .

Okay, enti, ɛfiri deɛ yɛaka `FAP` ho asɛm no, nneɛma a ɛho hia paa a ɛsɛ sɛ wokae nie:

• FAP yɛ awosu mu tebea a wobetumi de akɔ awo ntoatoaso ahorow mu.
• Eyi ma polyps ɔhaha anaa mpempem pii ba wɔ akyi berɛmo no mu, na ebetumi abɛyɛ kokoram.
• Sɛ wɔansa a, asiane a ɛwɔ hɔ sɛ obi benya kokoram wɔ akyi berɛmo mu no yɛ kɛse yiye .
• Ɛho hia yiye sɛ wofi ase yɛ colonoscopy nhwehwɛmu fi wo mmofraase (mfe 10-12) .
• Ayaresa titiriw ne oprehyɛn a wɔyɛ de yi akyi berɛmo no (colectomy) .
• Bere a wɔayi akyi berɛmo no akyi mpo no, ɛho hia sɛ wɔyɛ wɔn nkwa nna nyinaa mu nhwehwɛmu de hwɛ sɛ akisikuru a ɛrenya nkɔso wɔ nipadua no mmeae afoforo anaa.
• Ɛwom sɛ eyi yɛ asetra nyinaa tebea a ɛsɛ sɛ wodi ho dwuma de, nanso sɛ wɔyɛ aduruyɛ ne sɔhwɛ a ɛfata a, wobetumi abɔ bra a ɛfata na apɔwmuden .

Sɛ wo anaa w’abusua mu obi wɔ saa sɛnkyerɛnne ahorow yi bi, anaasɛ wopɛ sɛ wuhu eyi ho nsɛm pii a, akyinnye biara nni ho sɛ hwehwɛ aduruyɛ mu afotu . Nhumu a wonya ntɛm ne adeyɛ a wɔyɛ no ntɛm ne nneɛma a ɛho hia sen biara.

` FAP, Abusua mu Adenomatous Polyposis, Awosu mu Nyarewa, Colon Polyps, Colon Kokoram, APC Awosu mu Awosu, Colonoscopy, Colectomy, Oprehyɛn