Ua loaʻa anei iā ʻoe kahi endoscopy a ʻōlelo mai ke kauka, "Aia kahi puʻupuʻu liʻiliʻi i loko o kou ʻōpū, pono mākou e wehe iā ia"? A i ʻole "Aia kahi polyp liʻiliʻi i loko o kou colon, e wehe kākou iā ia ma mua o ka lilo ʻana i maʻi kanesa"? Ke lohe ʻoe i kēlā, ke noʻonoʻo nei paha ʻoe, "ʻAuē, ʻoki kino?". Ke noʻonoʻo nei paha ʻoe inā pono ʻoe e ʻoki i kou ʻōpū, e noho i ka haukapila no kekahi mau lā, a pehea ka nui o ka ʻeha e hana ai. Akā hiki iā ʻoe ke hauʻoli, no ka mea, ʻaʻole pono nā mea āpau i ke ʻoki kino nui. I kēia lā e kamaʻilio mākou e pili ana i kahi ʻenehana holomua a palekana loa e wehe ana i kēia mau ʻiʻo ʻē mai loko mai o kāu ʻōmole endoscopy, me ka ʻoki ʻole i kou ʻōpū.
He aha ka Endoscopic Mucosal Resection (EMR)?
He mea paʻakikī paha kēia inoa, akā he mea maʻalahi loa ia. E kapa kākou iā ia ʻo EMR no ka pōkole.
I ka ʻōlelo maʻalahi, ʻaʻole kēia he ʻoki kino. He hana ia e wehe ai i nā ʻiʻo ʻē mai loko mai o kou ʻōpū, me ka ʻole o ka ʻoki ʻana i kou ʻōpū. Hiki i kēia ʻiʻo ʻē ke lilo i mau ʻāpana kanesa, a i ʻole he mau ulu mua o ka maʻi kanesa e hiki ke lilo i kanesa i ka wā e hiki mai ana.
E noʻonoʻo i kāu ʻōnaehana hoʻoheheʻe e like me kahi paipu lōʻihi. Ulu nā ʻāpana ʻē ma ka paia o loko o kēia paipu (kapa mākou iā ia he mucosa). Ma ke kaʻina hana EMR, e like me kāu e hana ai me kahi endoscopy, hoʻokomo ʻia kahi paipu lōʻihi a palupalu me kahi kāmela i hoʻopili ʻia iā ia (he endoscope) ma kou waha a i ʻole rectum, i loko o kahi i loaʻa ai nā ʻiʻo ʻē, a me ka hoʻohana ʻana i nā mea hana liʻiliʻi i hoʻokomo ʻia ma o ka paipu, ʻokiʻoki ke kauka lapaʻau i kēlā ʻāpana o ka ʻiʻo a wehe iā ia.
Hana ʻia kēia e ke kauka gastroenterologist. ʻO ka pōmaikaʻi nui o kēia ʻano hana, ʻaʻohe ʻoki waho, no laila ʻaʻole ʻoe e ʻeha iki, a hiki iā ʻoe ke hoʻōla koke a hoʻi i kou ola maʻamau.
He aha nā ʻano maʻi e hoʻohana ʻia ai kēia ʻōnaehana EMR?
Hoʻohana nui ʻia kēia ʻano hana no ka mālama ʻana i ke kanesa a me nā kūlana precancerous. ʻO ka mea nui, ʻo kēia ʻano hana e holomua wale nō inā ʻike ʻia ka maʻi i ka wā mua . ʻO ia hoʻi, i ka wā e noho wale ai ka ʻiʻo ʻē ma ka papa o loko o ka paia o ka esophagus.
Hoʻohana pinepine ʻia ke ʻano EMR i nā kūlana aʻe:
- Ka maʻi ʻaʻai ʻōpū: Ke kanesa o ka esophagus i ka wā mua (ka ʻōmole e ale ai mākou i ka meaʻai).
- ʻO ka esophagus Barrett: ʻO kēia ka manawa e loli ai nā pūnaewele i loko o kou esophagus a lilo i mea maʻalahi ke ulu i ka maʻi kanesa. Hoʻohana ʻia kēia kaʻina hana e wehe i kēia mau pūnaewele ʻano ʻē.
- Ka maʻi ʻōpū: Ke kanesa o ka wā mua e hoʻomaka ana ma ka ʻili o ka paia o ka ʻōpū.
- Ka maʻi ʻaʻai colorectal:He kūpono loa kēia ʻano hana no ka wehe ʻana i nā polyp a i ʻole nā maʻi ʻaʻai mua i loko o ka kolona a i ʻole ka rectum.
- ʻAʻai ʻōpū liʻiliʻi: Hoʻohana ʻia kēia no ke kanesa e kū mai ana ma ka ʻāpana mua o ka ʻōpū liʻiliʻi (duodenum).
ʻO ka mea nui loa, ʻo ia ka ʻike a me ka wehe ʻana i ke kanesa ma mua o kona ulu ʻana, komo i loko o ka paia, a metastasizes. ʻO EMR ka hopena kūpono no kēlā.
No wai kēia lāʻau lapaʻau kūpono loa?
Na kāu kauka e hoʻoholo inā kūpono ka lāʻau EMR iā ʻoe. Aia ia i kekahi mau kumu. ʻO nā mea nui ka nui o nā ʻiʻo ʻē a me ka hohonu o kona pālahalaha ʻana .
Ma keʻano laulā, kūpono paha kēia lāʻau lapaʻau iā ʻoe:
- Inā he liʻiliʻi ka nui o kāu ʻiʻo ʻē (puʻupuʻu a nuipa paha).
- Ke ʻole ua komo i loko o nā papa hohonu o ka paia o ke ala ʻai.
Eia nō naʻe, inā nui ka puʻupuʻu a ua komo hohonu paha i loko o ka paia, ʻaʻole lawa paha ka EMR wale nō. I ia mau hihia, pono paha ʻoe e hoʻohana i nā ʻano lapaʻau ʻē aʻe.
| ʻAno lapaʻau | Kūlana hoʻohana |
|---|---|
| EMR (Endoscopic Mucosal Resection) | No nā maʻi ʻaʻai liʻiliʻi a ʻiliʻili hoʻi i ka wā mua a i ʻole nā pūnaewele i hiki ke lilo i maʻi ʻaʻai. |
| ʻO ka hoʻokaʻawale ʻana o ka Endoscopic Submucosal (ESD) | ʻO kekahi ʻano endoscopic ʻē aʻe i hoʻohana ʻia no nā maʻi ʻaʻai i ʻoi aku ka nui ma mua o EMR a ua hele hohonu iki i loko o ka paia. |
| ʻoki kino | Inā nui ka maʻi kanesa, hohonu, a ua pālahalaha paha i nā lymph node, hana ʻia kahi ʻoki ma ka ʻōpū a wehe ʻia kēlā ʻāpana. |
| Kemoterapia / Lapaʻau Kukui | Ke pālahalaha ke kanesa i nā ʻāpana ʻē aʻe o ke kino a i ʻole ma ke ʻano he lāʻau lapaʻau kōkua ma mua/ma hope o ke ʻoki kino. |
Pehea ʻoe e hoʻomākaukau ai no kēia kaʻina hana ma mua?
E hāʻawi aku kāu kauka iā ʻoe i kahi hoʻonohonoho maopopo o nā kuhikuhi no ka hoʻomākaukau ʻana no kēia, a he mea nui loa ia e hahai pololei iā lākou.
- No ke ala ʻai o luna (esophagus, ʻōpū): E noi ʻia ʻoe e hōʻole loa i ka ʻai ʻana a i ʻole ka inu ʻana no kekahi mau hola ma mua o ke kaʻina hana. ʻO kēia no ka mea hiki i ke kauka ke ʻike maopopo a palekana i ka wehe ʻana i nā ʻiʻo inā ʻaʻohe mea i loko o ka ʻōpū.
- No ka ʻōpū nui (colon): No kēia, pono ʻoe e loaʻa kahi "hoʻomākaukau ʻōpū." E hāʻawi ke kauka iā ʻoe i kahi lāʻau lapaʻau kūikawā ( laxative ) e inu. Ma hope o kou inu ʻana i kēia, pono ʻoe e hele pinepine i ka lua. ʻOiai he mea ʻoluʻolu ʻole kēia, he mea nui e hana i kēia e hoʻomaʻemaʻe pono i loko o kou colon. E ʻae kēia i ke kauka e ʻike maopopo i ka wā e hoʻokomo ai ʻo ia i ka ʻōmole.
He aha ka mea e hana ʻia ana i ke kaʻina hana?
E hana mākou i nā hana e pono ai e hōʻoia i ʻole ʻoe e manaʻo i kekahi ʻeha a pilikia paha i kēia kaʻina hana.
E hoʻokomo ʻia ʻoe ma lalo o ka anesthesia laulā , ʻo ia hoʻi e hiamoe loa ʻoe. I kekahi manawa e manaʻo ʻoe ua ala ʻoe, akā ʻaʻole ʻoe e hoʻomanaʻo i kekahi mea ma hope (hoʻomaha ʻike) . No laila, ʻaʻole ʻoe e manaʻo a hoʻomanaʻo paha i kekahi mea.
A laila hahai ke kauka i kēia mau hana:
1. Inā pilikia kou ʻōnaehana hoʻoheheʻe ʻana o luna, hana ʻia ka lāʻau lapaʻau ma o ka waha . Inā pilikia kou ʻōnaehana hoʻoheheʻe ʻana o lalo, hoʻokomo mālie ʻia ka ʻōmole endoscope ma o ka anus .
2. Me ka hoʻohana ʻana i ke kāmela, ua kuhikuhi ʻia ka ʻōmole i kahi kikoʻī o ka ʻiʻo ʻē.
3. A laila, hoʻokomo ʻia nā mea hana ʻoki liʻiliʻi ma o ka ʻōmole a wehe ʻia ke kino. Nui nā ala e hana ai i kēia. I kekahi manawa huki ʻia ke kino i luna me ka hoʻohana ʻana i ka omo ʻana, a i ʻole e hoʻokomo ʻia kahi wai ma lalo o ke kino a hāpai ʻia a ʻoki ʻia, a i ʻole e ʻoki ʻia me kahi kaula uea uila.
4. E wehe pono i ka ʻāpana ʻiʻo i wehe ʻia.
ʻO ka maʻamau, he 30 a 60 mau minuke ka lōʻihi o kēia kaʻina hana holoʻokoʻa.
He aha ka mea e hana ʻia ma hope o ke kaʻina hana?
Ma hope o ka pau ʻana o ka lāʻau lapaʻau, e hoʻoneʻe ʻia ʻoe i kahi lumi hoʻōla. Pono ʻoe e noho ma lalo o ka nānā ʻana o ke kauka no kekahi mau hola a pau nā hopena o ka anesthesia.
- Ma ke ala e hoʻi ai i ka home:ʻOiai hiki ke hala a hiki i 24 mau hola no ka pau ʻana o nā hopena o ka anesthesia, pono ʻoe i kekahi e lawe iā ʻoe i ka home. ʻAʻole ʻoe e ʻae ʻia e hoʻokele a hoʻi wale paha i ka home.
- : (laboratory) . (Pathologist) , , .
Aia kekahi mau hopena ʻaoʻao liʻiliʻi?
ʻAe, hiki iā ʻoe ke loaʻa i kahi ʻoluʻolu iki no hoʻokahi a ʻelua paha lā. He mea maʻamau kēia a e nalo koke aku.
- Pehu ʻana
- ʻŌpū ʻeha (Cramping)
- ʻEha kinoea a me ka palahēhē
- Ka luaʻi a i ʻole ka luaʻi
- ʻEha iki ka ʻāʻī inā hoʻokomo ʻia ka ʻōmole ma ka waha
Ho'ōla loa kēia i hoʻokahi a ʻelua paha lā.
He aha nā pōmaikaʻi a me nā pilikia o kēia ʻōnaehana EMR?
E like me nā lāʻau lapaʻau āpau, aia nā pono a me nā pilikia liʻiliʻi loa.
| Nā Pōmaikaʻi | Nā Pōʻino - (Kākaʻikahi loa) |
|---|---|
| Hiki ke wehe ʻia ke kanesa ma mua o kona ulu ʻana a me ka laha ʻana. | Ke kahe ʻana o ke koko: Aia paha kekahi kahe koko liʻiliʻi mai kahi i wehe ʻia ai nā ʻiʻo. Hoʻomalu pinepine ʻia kēia i ka wā o ka endoscopy. |
| ʻAʻole ia e ʻoki i ka ʻōpū e like me ke ʻoki kino nui. | Ka puka ʻana o ka ʻōpū: He mea kākaʻikahi loa, hiki i kahi paipu a mea hana paha ke hou i ka paia. He pilikia kēia. |
| He ʻoluʻolu loa ka ʻeha. | Nā koʻikoʻi Esophageal: Inā wehe ʻia kahi nui o nā ʻiʻo mai ka esophagus, hiki ke lilo ka ʻāina i mea e wili ai ma muli o ka ʻeha e kū mai ana i ka wā e ho'ōla ai. |
| E ola koke ʻoe a hiki iā ʻoe ke hoʻi i ka hana i hoʻokahi a ʻelua paha lā. | |
| ʻAʻohe ʻōpala i waiho ʻia ma waho o ke kino. |
He mea maʻamau ke makaʻu i ka lohe ʻana i ka huaʻōlelo "maʻi ʻaʻai." Akā me nā ʻenehana hou e like me EMR, hiki ke mālama i kēia mau mea i ko lākou wā mua me ka ʻole o ka hana ʻoki kino nui.
ʻEhia ka lōʻihi e ho'ōla ai a he aha kaʻu e hana ai ma hope?
ʻO kekahi o nā pono nui o ke ʻano EMR ka hoʻōla wikiwiki ʻana.
- Ke hele nei i ka hana: Hiki i ka hapa nui o ka poʻe ke hoʻi i kā lākou hana maʻamau i ka lā aʻe .
- ʻAi: E paipai paha kāu kauka i kahi ʻai wai no kekahi mau lā a hiki i ka ho'ōla ʻana o kou ʻōpū. Ma hope o kēlā, hiki iā ʻoe ke hoʻi mālie i ka meaʻai maʻamau.
- Hana Hoʻomau: E noi ʻia ʻoe e hoʻi mai e ʻike i kāu kauka ma kahi o 12 mau pule ma hope o kāu mālama ʻana. E hana ʻia kahi endoscopy e nānā inā ua wehe loa ʻia nā ʻiʻo ʻē aʻe a inā ua ho'ōla maikaʻi ʻia ka wahi. Ma muli o ka hōʻike ʻiʻo, e hoʻoholo ʻia inā pono ʻoe i ka mālama hou aʻe a i ʻole.
He aha nā pilikia e pono ai ke kāhea ʻana i ke kauka?
Inā ʻike ʻoe i kekahi o kēia mau hōʻailona ma hope o ka mālama ʻana, mai hoʻowahāwahā iā lākou. E kāhea koke aku i kāu kauka, a i ʻole e hele i ka Emergency Department (ETU) o ka haukapila kokoke loa me ka hoʻokaʻulua ʻole.
- Inā he koko kou i loko o kou noho (ʻeleʻele a ʻulaʻula paha)
- ʻEha nui o ka umauma
- Inā manaʻo ʻoe ua poniuniu a nāwaliwali paha
- Inā loaʻa iā ʻoe ke kuni a i ʻole ke anu a me ka haʻalulu
- Ka paʻakikī o ka hanu ʻana (dyspnea)
He mau hōʻailona paha kēia o nā pilikia a mākou i kūkākūkā ai ma mua, no laila he mea nui e ʻimi koke i ke kōkua lapaʻau.
ʻAʻole ʻo EMR kahi hana ʻoki kino nui, he hana ia e hoʻopilikia iki ana. Hiki i nā ʻenehana hou e like me kēia ke kōkua i ka hōʻemi ʻana i ka makaʻu a me ka hopohopo e hele mai me ka ʻike ʻana he maʻi kanesa kou a i ʻole he pilikia paha i ka maʻi kanesa. Ke hoʻohālikelike ʻia me ka manawa hoʻōla a me ka ʻeha ma hope o ke ʻoki kino nui, hiki iā EMR ke hoʻi koke i kahi ola olakino.
Leka Lawe-Home
- ʻAʻole he ʻoki kino nui ka Endoscopic Mucosal Resection (EMR). He lāʻau ia e hana ʻia ma o kahi endoscope, me ka ʻoki ʻole ʻana i ka ʻōpū.
- Hiki i kēia kaʻina hana ke wehe i nā maʻi kanesa mua a me nā hunaola ʻē i hiki ke lilo i kanesa i loko o ke ala ʻai.
- Ke hoʻohālikelike ʻia me ke ʻoki kino kuʻuna, ʻoi aku ka ʻeha ʻole o kēia, ʻoi aku ka pōkole o ka manawa hoʻōla , a ʻaʻohe mau ʻeha o waho ma ke kino.
- He mea nui loa ka hahai ʻana i nā ʻōlelo a ke kauka (ka hoʻokē ʻai ʻana, ka hoʻomaʻemaʻe ʻana i ka ʻōpū, ka papaʻai) ma mua pono a ma hope o ka lāʻau lapaʻau.
- Inā ʻike ʻoe i kekahi mau hōʻailona ma hope o ka mālama ʻana, e like me ke kuni, ka ʻeha nui, a i ʻole ke koko i loko o kou ʻōpala, e hoʻomaopopo koke i kāu kauka a i ʻole e hele i ka haukapila.
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