Pono ʻoe i kahi ʻoki nui e wehe i nā puʻupuʻu i loko o ka ʻōpū? E kamaʻilio kākou e pili ana i ka Endoscopic Submucosal Dissection

Ua haʻi aku anei kāu kauka iā ʻoe he ʻiʻo liʻiliʻi ʻē, he puʻupuʻu, a he polyp paha kou i loko o kāu ʻōnaehana hoʻoheheʻe, ʻo ia hoʻi, i loko o kou ʻōpū a i ʻole esophagus? Ke lohe mākou i kēlā, ʻo ka makaʻu e hiki mai ana i ko mākou manaʻo, "Auē, pono anei au e hana i kahi ʻoki nui i kēia manawa?" Akā me ka ʻepekema lapaʻau holomua o kēia lā, ʻaʻohe pono e hana i nā ʻoki e hana ai i nā ʻoki nui no nā mea āpau. ʻO ia ke kumu e kamaʻilio ai mākou e pili ana i kahi ʻano lapaʻau kupaianaha e hiki ke hōʻeha iki i ke kino a ho'ōla koke.

I ka ʻōlelo maʻalahi, he aha ka Endoscopic Submucosal Dissection?

ʻOiai paha e kani iki ka inoa i kahi paʻakikī, he maʻalahi loa ke kaʻina hana. ʻO ka Endoscopic Submucosal Dissection , a i ʻole ESD no ka pōkole, he kaʻina hana invasive ʻole ia e wehe ana i nā ʻiʻo ʻē, nā puʻupuʻu o nā cell i hiki ke lilo i maʻi kanesa, a i ʻole nā ​​​​pūpū liʻiliʻi mai loko mai o kou ʻōpū gastrointestinal.

E noʻonoʻo ua hana ʻia kēia e kahi gastroenterologist. Hoʻohana ʻo ia i kahi ʻōmole lōʻihi a palupalu me kahi kāmela ma ka hopena. Kāhea mākou i kēia he endoscope.

• Inā aia ka pilikia ma kāu ʻōnaehana hoʻoheheʻe o luna (no ka laʻana, esophagus, ʻōpū), e hoʻokomo ʻia kēia endoscope ma kou waha.
• Inā aia ka pilikia ma kou ʻōpū haʻahaʻa (ʻōpū nui, rectum), ua hoʻokomo ʻia ma ka anus.

Hana ʻia kēia me ka hoʻohana ʻana i kahi mea hana ʻoki liʻiliʻi i hoʻokomo ʻia i loko o ka ʻōmole a, ma lalo o ke alakaʻi ʻana o kahi kāmela, hoʻohana ʻia e ʻoki pono a wehe i nā ʻiʻo ʻē. ʻO ka mea maikaʻi loa, hana ʻia kēia mau mea a pau i loko o ke kino. No ka mea, ʻaʻohe ʻoki waho, hiki iā ʻoe ke ho'ōla wikiwiki, loaʻa ka ʻeha liʻiliʻi, a pale i ka ʻeha.

He aha nā ʻano kūlana e hoʻohana ʻia ai ʻo ESD?

Hoʻohana pinepine ʻia kēia lāʻau ESD e wehe i nā maʻi kanesa precancerous a i ʻole nā ​​​​maʻi kanesa mua i loko o ka ʻōnaehana hoʻoheheʻe. E nānā kākou i ke ʻano o lākou.

He aha ka ʻokoʻa ma waena o ESD a me EMR?

Ua lohe paha ʻoe i kekahi kaʻina hana like ʻē aʻe, i kapa ʻia ʻo Endoscopic Mucosal Resection (EMR) . ʻOiai ʻaʻole i komo nui nā kaʻina hana ʻelua, aia kahi ʻokoʻa iki.

Ua hana ʻia ka paia o kā mākou ʻōnaehana hoʻoheheʻe ʻai me kekahi mau papa. ʻO ka membrane lahilahi o loko loa i kapa ʻia ʻo ka mucosa.

• Ke ʻano EMR: Hoʻopau nui kēia i nā puʻupuʻu i loko o ka papa o loko loa i kapa ʻia ʻo ka mucosa. Pili kēia i ka hoʻokomo ʻana i kahi wai ma lalo o ka puʻupuʻu, hāpai iā ia, a ʻokiʻoki iā ia me kahi mea e like me ke apo hao.
• Ke ʻano hana ESD: He ʻano hana holomua iki kēia ma mua o EMR. Hiki iā ia ke wehe i nā puʻupuʻu i loko o ka mucosa, a me nā puʻupuʻu i pālahalaha i ka papa ma lalo pono . ʻO ka pōmaikaʻi nui o kēia, ʻo ia ka hiki ke wehe ʻia nā ʻiʻo ʻē, ʻaʻohe mea nui, i hoʻokahi ʻāpana . A laila maʻalahi ke hoʻouna iā ia i ka hale hana a hōʻoia pololei inā ua wehe loa ʻia ke kanesa.

Pehea e hoʻomākaukau ai ma mua o kēia lāʻau lapaʻau?

E hāʻawi aku kāu kauka iā ʻoe i kahi hoʻonohonoho maopopo o nā kuhikuhi ma mua o kēia lāʻau lapaʻau. He mea nui loa ia e hahai pololei iā lākou.

• Inā ʻoe e mālama ʻia ana ma ke ala ʻōpū o luna: (esophagus, ʻōpū) pono ʻoe e hōʻole loa i ka ʻai ʻana a me ka inu ʻana no kekahi mau hola ma mua o ka mālama ʻana. ʻO ke ʻano kēia, pono e hakahaka kou ʻōpū.
• Inā ʻoe e mālama ʻia nei no kou ʻōpū gastrointestinal haʻahaʻa: (ʻōpū nui), e noi ʻia ʻoe e hana i kahi "hoʻomākaukau ʻōpū." Pili kēia i ka hoʻokahe ʻana i kou ʻōpū nui ma ka inu ʻana i kahi wai kūikawā ( laxative ). Hiki i kēia i ke kauka ke ʻike maopopo i loko me ka endoscope.

He aha ka mea e hana ʻia i ka wā o ka mālama ʻana?

ʻAʻole ʻoe e ʻike i kekahi ʻeha a ʻoluʻolu ʻole paha i ka wā o kēia mālama ʻana. ʻO kēia no ka mea e hoʻomaʻamaʻa ʻia ʻoe. Hiki ke hoʻomoe loa ʻia ʻoe (General Anesthesia), a i ʻole e hāʻawi ʻia paha ʻoe i kahi ʻano anesthesia e hoʻohiamoe ai a hoʻomaha iā ʻoe (Monitored Anesthesia Care).

I ka wā o ka mālama ʻana, e hahai kāu kauka i kēia mau hana:

1. Hoʻokomo ʻia ka endoscope ma o ka waha a i ʻole ka rectum.

2. Me ka hoʻohana ʻana i ke kāmela, hoʻouna ʻia ka endoscope i kahi i loaʻa ai nā ʻiʻo ʻē.

3. Me ka hoʻohana ʻana i kahi hāmeʻa i hoʻokomo ʻia ma o ka endoscope, ua hana ʻia kahi māka a puni ka puʻupuʻu e wehe ʻia.

4. A laila, hoʻokomo ʻia kahi wai kūikawā i loko o ka membrane ma lalo o ka puʻupuʻu. Hoʻokumu kēia i kahi uluna ma lalo o ka puʻupuʻu, e hāpai ana iā ia mai nā ʻiʻo olakino a puni. ʻOi aku ka maʻalahi o ka hoʻokaʻawale ʻana a me ke ʻoki ʻana.

5. ʻO ka mea hope loa, me ka hoʻohana ʻana i kahi mea kūikawā e like me ka pahi uila alapine kiʻekiʻe, ʻoki pono ʻia ka puʻupuʻu ma ka laina i hōʻailona ʻia a wehe ʻia.

Hiki i ke kaʻina hana holoʻokoʻa ke hala ma waena o hoʻokahi a ʻekolu mau hola , ma muli o ka nui a me kahi o ka ʻiʻo e wehe ʻia ana.

He aha ka mea e hana ʻia ma hope o ka lāʻau lapaʻau?

Ma hope o ka pau ʻana o ka lāʻau lapaʻau, hoʻouna ʻia ka ʻiʻo i wehe ʻia i kahi keʻena hoʻokolohua kahi e nānā ai kahi pathologist e ʻike inā he mau hunaola kanesa a inā ua wehe loa ʻia.

E lawe ʻia ʻoe i kahi lumi hoʻōla no kekahi manawa pōkole ma hope o ka mālama ʻana. Ke pau loa nā hopena o ka anesthesia, hiki paha iā ʻoe ke hoʻi i ka home i ka lā hoʻokahi, a i ʻole pono ʻoe e noho i ka haukapila i ka pō. Pono ʻoe e hele pū me kekahi i ka home , no ka mea, hiki ke hala a hiki i 24 mau hola no ka pau loa ʻana o nā hopena o ka anesthesia.

Aia kekahi mau hopena ʻaoʻao a me nā pilikia?

E like me nā lāʻau lapaʻau āpau, aia nā hopena ʻaoʻao liʻiliʻi a me nā pilikia kakaikahi loa.

Nā hopena ʻaoʻao liʻiliʻi paha

ʻO ka maʻamau, nalo loa kēia mau mea i loko o hoʻokahi a ʻelua paha lā.

• Hoʻopiha i ka ʻōpū
• ʻeha ka ʻōpū
• ʻO ke kinoea a me ka ʻeha e hoʻoulu ai
• Ka luaʻi a i ʻole ka luaʻi
• ʻEha ka ʻāʻī (inā ua hoʻokomo ʻia ka endoscope ma ka waha)

He mea maʻamau paha ke loaʻa ʻana o ke koko liʻiliʻi loa i loko o kou ʻōpala, akā pono e pau i loko o 24 mau hola.

Nā pilikia kakaikahi

He haʻahaʻa loa ka likelika o kēia mau mea, akā he mea nui e ʻike iā lākou.

• Ke kahe ʻana o ke koko: Ke kahe ʻana o ke koko mai kahi i wehe ʻia ai nā ʻiʻo.
• Ka puka ʻana o ka ʻōpū: Ka puka ʻana o ka paia o ke ala ʻōpū e kahi endoscope a mea hana paha.
• ʻO ka ʻōpala: ʻOi loa aku i ka mālama ʻana i ka esophagus, ʻo ka ʻōpala e kū mai ana i ka wā e ho'ōla ai hiki ke alakaʻi i ka hāiki ʻana o ka esophagus (esophageal strictures).

He aha nā pono o kēia ʻano hana?

He nui nā pono o ke ʻano ESD i hoʻohālikelike ʻia me ke ʻoki kino hāmama.

• ʻEha iki: ʻEha iki ka ʻeha no ka mea ʻaʻohe ʻoki ʻia.
• Hoʻōla wikiwiki: Hiki iā ʻoe ke hoʻi i ke ola maʻamau a hana koke.
• ʻAʻohe ʻeha: ʻAʻohe ʻeha e ʻike ʻia ma waho o ke kino.
• Nā pilikia liʻiliʻi: Aia ka haʻahaʻa o ka pilikia o nā pilikia ma mua o ke ʻoki kino hāmama.
• Mālama ʻana i nā kino: Hiki i kēia ʻano hana ke pale aku i nā mea e like me ka wehe ʻana i kahi ʻāpana o ka ʻōpū a i ʻole ka naʻau i hana ʻia i ka wā o ke ʻoki kino nui.

Āhea ʻoe e ʻike koke ai i ke kauka?

Ke hoʻi ʻoe i ka home ma hope o ka mālama ʻana, inā ʻike ʻoe i kekahi mau hōʻailona hōʻailona, ​​​​he mea nui loa e kāhea aku i kāu kauka a hele paha i ka haukapila kokoke loa i ka Emergency Department (ETU) me ka hoʻokaʻulua ʻole .

ʻEhia ka lōʻihi e ho'ōla ai?

Hiki i ka hapa nui o ka poʻe ke hoʻi i ka hana ma hope o ʻelima mau lā. Eia nō naʻe, inā hana ʻoe i kahi hana luhi loa, e like me ka hāpai ʻana i nā mea kaumaha, hiki i kāu kauka ke aʻo iā ʻoe e hoʻomaha no kahi manawa lōʻihi. Aia paha he mau loli iki i nā ʻano hana ʻōpū no hoʻokahi pule ma hope o ka mālama ʻana.

ʻO ka maʻamau, e ʻike hou ʻoe i kāu kauka ma kahi o ʻelua pule. I kēlā manawa, e wehewehe lākou i nā hopena o ka hōʻike lab iā ʻoe a hoʻoholo inā pono a ʻaʻole paha he lāʻau lapaʻau hou aʻe.

He lāʻau lapaʻau holomua loa ka ESD. Ua hōʻike kekahi mau noiʻi he haʻahaʻa ka pilikia o ka hoʻi hou ʻana o kahi puʻupuʻu ma kahi like i ka poʻe i hana ʻia i kēia lāʻau lapaʻau e like me 1%.