Amekae nye dɔgbomedɔdala sia? Mina míakpɔe ɖa godoo!

Ðewohĩ awɔ nuku na wò vie ne èse ŋkɔ 'Colorectal Surgeon', eye nèle susum be, "Amekae nye esia? Nukae wowɔna?" Mègatsi dzi o, mesesẽ nenema gbegbe o. Kpuie ko la, amekola aɖee nye esia si bi ɖe dɔlélewo dada kple amekoko na wò dɔgbo gã, dɔgbo , kple dɔgbo me . Eyata mina míaƒo nu tso esia ŋu tsitotsito vie, abe ɖe nèle nu ƒom na xɔ̃wò aɖe ene, enyoa?

Amekae nye dɔgbomedɔdala sia? Ðe woyɔnɛ tsã be proctologist?

Ẽ, ɖewohĩ èse nya ‘proctologist’ kpɔ. Le nyateƒe me la, tsã la, woyɔa ɖɔkta siwo daa dɔléle siawo ƒomevi be proctologists. ‘Colorectal surgeon’ ye nye ŋkɔ yeye si wotsɔ na atikewɔwɔ ƒe akpa ma si nye egbegbe tɔ .

Vovototo vi aɖe le ŋkɔ eve siawo dome le gɔmesese me. Ne míegblɔ be ‘proctologist’ la, efia akɔta kple akɔta koŋ. Gake ne míegblɔ be ‘colorectal’ la, elɔ dɔgbo kple dɔgbo siaa ɖe eme. Ènyaa, eve siawoe nye dɔgbo gã la ƒe akpa gãtɔ kekeake. Gake le nuwɔna me la, ŋkɔ eve siawo dometɔ ka kee woɖayɔ o, eŋutinunyala bibi siawo daa dɔ na akpa siawo katã . Eyata naneke meli woabu eŋu fũu akpa o.

Nukatae wòhiã be míayi dɔdala si wɔa dɔ na dɔgboa?

Tsɔe be yeƒe ƒodo ƒe akpa si le anyime, si fia be yeƒe dɔgbo ƒe akpa si le anyime (GI) la, meɖea fu na wò o alo dzesi aɖe le ŋuwò. Emegbe àte ŋu ayi atikewɔla gã alo dɔgboŋutinunyala gbɔ gbã.

Ne, le wò dodokpɔ vɔ megbe la, ɖɔktaa susu be wò dɔlélea hiã be woawɔ dɔ na wò , la, aɖo wò ɖe dɔdala si wɔa dɔ na wò dɔgbo kple dɔgbo me.

Dɔgbo ƒe dɔléle aɖewo siwo ate ŋu ahiã be woawɔ dɔ na ame zi geɖe dometɔ aɖewoe nye:

• Kansa kple polyposis : Esia fia kansa ƒe nɔnɔme siwo le dɔgboa me alo nu suesuesue siwo tsi (polyps) siwo ate ŋu azu kansa.
• Dɔgbo ƒe dɔléle (IBD): Esia nye dɔgbo ƒe lãkusi ƒe dɔdzẽ si nɔa anyi didi. Kpɔɖeŋu aɖewoe nye nɔnɔmewo abe Crohn ƒe dɔléle kple abi ƒe dɔdzẽ ene .
• Ischemia: Esia nye ɣeyiɣi si me dɔgboa ƒe akpa aɖe leƲu ƒe agbɔsɔsɔ si dzi ɖe kpɔtɔ alo esi bu . Ne edzɔ alea la, akpa ma ate ŋu aku gɔ̃ hã.
• Dzɔdzɔmeŋutete ƒe gbɔdzɔgbɔdzɔ: Le kpɔɖeŋu me, fistulas - kadodo si mesɔ o si le dɔgboa kple ŋutinu bubu dome, hernias - dɔgboa ƒe akpa aɖe ƒe dodo to teƒe si gbɔdzɔ, kple prolapse - ŋutilã ƒe akpa aɖe ƒe dodo alo dodo ɖe gota, abe aɖuɖɔtoe ene.

Ðe dɔgbo me dɔdzẽ koe dɔdalawo daa dɔ naa?

Ao, menye nyateƒee o. Togbɔ be dɔgbo gã ƒe amekolawo koŋ bi ɖe dɔgboa me hã la , wona hehe wo hã be woanye amekola siwo wɔa dɔ le dɔgboa me .

Gakpe ɖe eŋu la, kuxi aɖe si le míaƒe ŋutilã ƒe ŋutinu ɖeka me ate ŋu agblẽ nu le ŋutinu bubuwo ŋu, alo? Eyata ele be eŋutinunyala bibi siawo nada dɔ na ŋutinu bubu siwo do ƒome kple dɔgboa tẽ alo esiwo ŋu dɔléle ma ke le. Ŋutinu mawoe nye:

• Dɔgbo Sue
• Lãmetsi siwo le akɔta (esiawo kpena ɖe ame ŋu be woaɖu dɔgbo kple tsinyegoe dzi) .
• Aɖuɖɔtoe ƒe ɖoɖo
• Nyɔnuwo ƒe Vidzidzi ƒe Dɔwɔɖoɖo

Dzeside kawoe hiã hafi woate ŋu azu dɔdala si wɔa dɔ le dɔgboa me?

Esia nye nya vevi aɖe ŋutɔŋutɔ. Dɔwɔla si wɔa dɔ le dɔgboa me nye amesi xɔ hehe kple nunya deŋgɔ ŋutɔ . Le kpɔɖeŋu me, le dukɔ abe United States ene me la, hafi ame nazu amekola si wɔa dɔ le dɔgboa me la, ele be wòaxɔ hehe abe amekola si wɔa dɔ le dɔgboa me ene ƒe atɔ̃ ya teti. Le ema megbe la, ele be ame naxɔ hehe ƒe ɖeka alo esi wu nenema le afisi woanɔ le dɔgboa ƒe nɔnɔmewo me.

Le hehe sia megbe la, wotoa dodokpɔ siwo woŋlɔ kple nu me me eye wozua eŋutinunyala bibi siwo xɔ ɖaseɖigbalẽ tso atikewɔha siwo sɔ gbɔ (e.g., American Board of Colorectal Surgery). Eyata abe alesi nàte ŋu akpɔe ene la, esia menye mɔzɔzɔ bɔbɔe o, si tae míate ŋu aka ɖe woƒe sidzedze kple ŋutetewo dzi ɖo.

Nuka koŋue dɔdala si wɔa dɔ le dɔgboa me srɔ̃na wu amekola si wɔa dɔ le dɔgboa me?

Eŋutinunyala bibi siawo srɔ̃a nu tso dɔgbo kple dɔgbo ƒe dɔwɔwɔ ŋuti nunya ŋu tsitotsito , si fia alesi ŋutinu siawo wɔa dɔe kple alesi wowɔa dɔ kple wo nɔewoe.

Le sidzedze deto sia ta la, kuxi siwo doa mo ɖa le dɔgbowo kple dɔgbo meŊutete tɔxɛ aɖe le wo si be woaku ŋutilã me kuxi sesẽwo me ahawɔ atike sesẽ siwo hiã . Le nyateƒe me la, woawoe nye eŋutinunyalawo le go sia me.

Nuka tututue dɔdala si wɔa dɔ le dɔgboa me wɔna?

Amekola siwo wɔa dɔ le dɔgboa me zãa mɔnu siwo katã woate ŋu azã le dɔgboa me kple amekoko tsɔ daa wò nuɖuɖumeŋusẽ. Esia fia be dɔwɔnu siwo katã hiã be woatsɔ ada nɔnɔme sesẽwo la le wo si.

Woate ŋu ada dɔ na wò to amekoko manɔmee (e.g., to endoscopy dzi), kple amekoko si me womewɔa nu boo aɖeke le o , alo, ne ehiã la, to amekoko le gaglãgbe me .

Mɔnu aɖewo siwo amekola siwo wɔa dɔ le dɔgboa me zãna dometɔ aɖewoe nye:

• Dɔgbomekpɔkpɔ: Esia bia be woade mɔ̃ tsɛ aɖe si te ŋu trɔna bɔbɔe (endoscope) si me fotoɖemɔ̃ kple kekeli le to aɖuɖɔtoea me be woatsɔ ado dɔgbo gã bliboa kpɔ . Woate ŋu azã esia atsɔ aɖe polyp suesuesuewo ɖa eye woaɖe lãmenugbagbeviwo ƒe kpɔɖeŋuwo (biopsies).
• Enteroscopy: Esia hã nye mɔnu si dzi woato ado dɔgbo suea kpɔ to endoscope zazã me.
• Sigmoidoscopy: Esia doa dɔgbo gã (sigmoid colon), dɔgbo, kple dɔgbo ƒe akpa mamlɛa kpɔna.
• Laparoscopy: Woɖea nu sue aɖe ŋutɔ le ƒodoa me, eye wotoa fotoɖemɔ̃ tɔxɛ aɖe (laparoscope) dea ƒodoa me tsɔ doa ƒodoa ƒe ŋutinu ememetɔwo kpɔna.
• Amekoko to dɔgbo me: Wogayɔnae be "keyhole surgery," esia nye dɔdamɔnu si me woɖea nu suesuesue geɖe le ƒodoa me eye wozãa dɔdamɔnu kple dɔwɔnu tɔxɛwo. Esia wɔnɛ be woate ŋu awɔ amekokoa evɔ womatsoe gã aɖeke o, si wɔnɛ be ɣeyiɣi si woatsɔ ahayae dzi ɖena kpɔtɔna.
• Robot-dɔdamɔnu: Esia hã nye amekoko to dɔgboa me ƒomevi aɖe. Gake le afisia la, amekolaa toa kɔmpiutadziɖoɖo aɖe dzi kpɔa robot ƒe alɔ aɖe dzi. Esia wɔnɛ be woate ŋu awɔ amekoko si me kɔ ŋutɔ eye wòsesẽ ŋutɔ .

Amekoko kple dɔ siwo amekola siwo wɔa dɔ le dɔgboa me wɔna dometɔ aɖewoe nye:

• Polypectomy: Woɖea polyp (nu suesuesue siwo tsina) le dɔgboa me to endoscopy me.
• Endoscopic mucosal resection (EMR) / endoscopic submucosal dissection (ESD): Mɔnu deŋgɔ siwo wozãna tsɔ ɖea dɔdzẽ siwo le dɔgboa ƒe akpa ememetɔ siwo ɖeɖeɖa sesẽ la ɖa to dɔgboa me.
• Transanal endoscopic microsurgery: Amekoko si me wotsɔa dɔwɔnu tɔxɛ aɖe (proctoscope) dea dɔgboa me be woaɖe dɔdzẽ gãwo alo mɔxenu siwo le dɔgboa me ɖa.
• Dɔgbo ƒe dɔwɔwɔ: Dɔgbo gã la ƒe akpa aɖe alo wo katã ɖeɖe ɖa, le nɔnɔmea nu.
• Ostomy surgery: Esia bia be woatrɔ alesi aɖuɖɔ dona le ŋutilãa me eye woawɔ stoma to dɔgboa ƒe nugbɔ ɖeka tsɔtsɔ do ƒome kple ƒodoa ƒe ŋutigbalẽ ƒe anyime. Woyɔa esia be colostomy alo ileostomy.
• Anastomosis amekoko: Dɔgboa ƒe akpa eve gbugbɔgaƒo ƒu to ostomy si wowɔ va yi ɖeɖeɖa me.
• Appendectomy: Woɖea appendex la ɖa ne exɔ abi (appendicitis).
• Anoplasty: Aɖuɖɔtoea dzadzraɖo alo egbugbɔ trɔ asi le eŋu.
• Rectopexy: Amekoko be woagbugbɔ dɔgboa ƒe gege ɖe lãme na ame.
• Sacrocolpopexy: Akɔta ƒe ŋutinuwo ƒe gege dzadzraɖo.
• Hernia repair: Dzadzraɖo na hernia siwo le dɔgboa me (e.g. inguinal hernia, incisional hernia) to laparoscopic alo robot mɔnuwo zazã me.
• Cecostomy / antegrade colonic enema (ACE) amekoko: Wotsɔa mɔ̃ aɖe dea dɔgboa me be woatsɔ enema solution ana abe dɔléle aɖewo abe dɔgbo ƒe dɔléle ene dada ene.

Wowɔa nu siawo tɔgbe hã tsɔ léa ŋku ɖe wò dɔgbo kple dɔgbo ƒe dɔwɔwɔ ŋu:

• Digital rectal exam: Dodokpɔ si me ɖɔkta tsɔa asibidɛ si ŋu asigɛ le dea dɔgboa me.
• Anoscopy / Proctoscopy: Dɔwɔnu sue aɖe dede eme be woakpɔ akɔta kple dɔgbo ƒe akpa si le ete.
• Defecography: Aɖuɖɔtoe me dzodzro to X-ray alo MRI zazã me.
• Endorectal ultrasound: Aɖuɖɔtoe kple lãmenugbagbevi siwo ƒo xlãe ƒe fotoɖeɖe to ultrasound probe dede to aɖuɖɔtoea me.
• Anorectal manometry: Lãmetsi siwo le dɔgboa kple dɔgbo me ƒe nyaƒoɖeamenu kple dɔwɔwɔ dzidzedze.

Nɔnɔme kawo ƒomevie dɔdamɔnu siwo wɔa dɔ le dɔgboa me la daa?

Nɔnɔme geɖe li siwo hiã be woayi dɔdala si wɔa dɔ le dɔgboa me gbɔ. Mina míalé ŋku ɖe wo dometɔ aɖewo ŋu le ƒuƒoƒo me:

Dɔdzẽ si le dɔgboa me, eƒe kpɔɖeŋuwo:

• Dɔgbo me dɔdzẽ
• Dɔdzẽ si le dɔgboa me
• Anal cancer
• Dɔdzẽ si le megbeƒu me
• Peritoneal carcinomatosis - kansa ƒe kaka ɖe ƒodo ƒe lãkusi me
• Dɔgbo ƒe dɔgbo ƒe stromal tumors (GIST) .
• Ahɔhɔ̃mekawo ƒe dɔdzẽwo
• Kansa ƒe nɔnɔme aɖewo siwo wodzina, abe domenyinyi nonpolyposis colorectal cancer (HNPCC) alo Lynch syndrome ene

Colorectal polyps kple domenyinyi ƒe polyposis syndromes, kpɔɖeŋuwo:

• Familial adenomatous polyposis syndrome (FAP) - Esia ateŋu ahe polyp alafa alo akpe geɖe vɛ le dɔgboa me.
• Lynch syndrome - (woyɔe hã le kansa te) .
• MUTYH-si do ƒome kple polyposis (MAP) .
• Serrated polyposis ƒe dɔléle si nye Serrated polyposis ƒe dɔléle
• Desmoid ƒe dɔdzẽwo
• Peutz-Jeghers ƒe dɔlélea
• Ðeviwo ƒe polyposis ƒe dɔléle
• PTEN ƒe hamartoma ƒe dɔléle

Dɔgbo ƒe dɔléle sesẽ (dɔgbo ƒe dɔdzẽ), kpɔɖeŋuwo:

• Diverticulitis - Dɔlékui alo dɔdzẽ le kotoku suewo (diverticula) me le dɔgboa ƒe gli me.
• Dɔdzẽ si me abi le
• Crohn ƒe dɔlélea
• Dɔdzẽ si wokpɔna le nusuekpɔmɔ̃ me
• Pseudomembranous colitis - Nɔnɔme si dzɔna zi geɖe le dɔlékuiwutike aɖewo zazã vɔ megbe.
• Appendicitis - Dɔdzẽ le ƒunukpeƒetetedɔ.
• Necrotizing enterocolitis - Nɔnɔme sesẽ aɖe si dzea vidzĩ yeyewo dzi.
• Ischemic colitis - Dzoxɔxɔ si tsoa ʋu ƒe sisi ɖe dɔgboa me ƒe ɖiɖi gbɔ.

Dɔgbo ƒe dɔmawɔmawɔ nyuie, kpɔɖeŋuwo:

• Pelvic floor dysfunction - nɔnɔme si nana wòsesẽna be woaɖe aɖuɖɔ.
• Aɖuɖɔtoe dzi ɖuɖu ƒe ŋutetemanɔamesi (Fecal incontinence) .
• Aɖuɖɔtoe si woxe mɔ na
• Anismus - Ŋutete manɔanyi be wòaɖe dzi ɖi le aɖuɖɔtoe ƒe lãmekawo ŋu nyuie le aɖuɖɔtoe me.

Xɔtuɖaŋu ƒe gbɔdzɔgbɔdzɔwo, kpɔɖeŋuwo:

• Dɔgbo gã ƒe xexe
• Anal fistula - Mɔ si mele dzɔdzɔme nu o ƒe wɔwɔme le ŋutigbalẽ kple dɔgbo dome le aɖuɖɔtoe gbɔ.
• Rectovaginal fistula - kadodo si mele dzɔdzɔme nu o le aɖuɖɔtoe kple nyɔnu ƒe vidzidɔ dome.
• Perineal hernia ƒe ʋuʋu
• Perianal ƒe ʋuʋudedi
• Aɖuɖɔtoe ƒe gbagbã
• Akɔta ƒe ŋutinu ƒe gbagbã

Dɔgbo ƒe nɔnɔme bubu siwo mebɔ o, ƒe kpɔɖeŋuwoe nye:

• Ʋu si dona le dɔgboa me / ʋu si dona le dɔgboa me
• Anal ƒe gbagbãƒewo
• Anal warts
• Ʋusisidɔ
• Aɖuɖɔtoe me abiwo
• Dɔmeɖui kple aɖuɖɔ ƒe ʋuʋu

Ŋkuɖodzinya vi aɖe tso wò dɔgbo kple nuɖuɖumeŋusẽ ƒe akpa si le ete ŋu

Wò dɔgbo gã la nye wò dɔgbo ƒe akpa si le ete ƒe akpa vevi aɖe . Nuɖuɖu si míeɖuna la toa wò nuɖuɖumeŋusẽ me, eye esia dzie gbeɖuɖɔwo dona le wò ŋutilã me mlɔeba. Eyata, ne èle dzesiwo abe ƒodo ƒe vevesese alo tɔtrɔ le wò dɔgbo ƒe nɔnɔmewo me (e.g., ʋu dodo, aɖuɖɔtoe, dɔgbo ƒe ʋuʋu) ene la, anɔ eme be enye kuxi na wò dɔgbo ƒe akpa si le ete.

Esiae nye ɣeyiɣi si me dɔdala si wɔa dɔ le dɔgboa me ƒe aɖaŋuɖoɖo kple atikewɔwɔ va le vevie. Menye nɔnɔmeawo katãe hiã be woawɔ dɔ na wo o . Gake ne ehiã be woawɔ dɔ na wò la, eŋutinunyala bibi aɖe si le abe esia ene gbɔ yiyi ate ŋu akpe ɖe ŋuwò nàkpɔ atike si awɔ dɔ nyuie wu. Wò dɔdala alo dɔgboŋutinunyala aɖo wò ɖe dɔgbomedɔdala gbɔ ne wokpɔe be dɔdala bibi sia ate ŋu akpɔ wò nɔnɔmea gbɔ nyuie wu.

Mlɔeba la, ele nam be magblɔe na wò... (Take-Home Message)

Mele mɔ kpɔm be azɔ la, ènya amesi nye dɔdala si wɔa dɔ le dɔgboa me, nusi wowɔna, kple dɔléle ƒomevi siwo wodaa.

Nu vevitɔe nye be eŋutinunyala bibi siawo nanɔ afima be yewoakpe ɖe ŋuwò . Woƒe nunya kple hehe si hiã na wò nɔnɔmea le wo si.

• Ne dzesi aɖewo siwo mebɔ o siwo ku ɖe wò dɔgbo, dɔgbo, alo aɖuɖɔtoe ŋu le ŋuwò (e.g., ƒodo me vevesese atraɖii, ʋu si le wò aɖuɖɔ me, dɔgbo ƒe tɔtrɔ, lolo si meɖe o) la, mègaŋe aɖaba ƒu edzi o . Di atikewɔlawo ƒe aɖaŋuɖoɖo enumake.
• Ne wò ɖɔkta ɖo wò ɖe dɔdala si wɔa dɔ le dɔgboa me gbɔ la, mègavɔ̃ o . Ðeko wòfia be ɖewohĩ àhiã atikewɔwɔ tɔxɛ aɖe .
• Ðo ŋku edzi be to egbegbe atikewɔwɔ ŋuti dzɔdzɔmeŋutinunya deŋgɔ me la, woate ŋu akpɔ nɔnɔme geɖe siwo do ƒome kple dɔ sia gbɔ dzidzedzetɔe ahada wo .

Eyata, ele be nànɔ lãmesẽ me! Ne kuxi aɖewo le ŋuwò la, nu vevitɔ kekeakee nye be nàxɔ aɖaŋuɖoɖo nyuitɔ tso teƒe nyuitɔ.

` Dɔgbomedɔdala, dɔgbomedɔlélewo, dɔgbomedɔdala, dɔgbo me kansa, dɔgbomekpɔkpɔ, nuɖuɖumeŋusẽ, amekoko