He mea maʻamau ka makaʻu i ka wā e haʻi aku ai kāu kauka iā ʻoe he puʻupuʻu kou ma kou rectum, ʻo ia ka ʻaoʻao haʻahaʻa o kou ʻōpū nui. Ke noʻonoʻo nei paha ʻoe, "Auē, pono wau e ʻoki i kou ʻōpū, pono wau e noho i ka haukapila no kekahi mau lā, e ʻeha nui ia," ʻeā? Akā, mai hopohopo. Ua holomua loa ka ʻenehana i kēia lā. I kēia lā, ke kamaʻilio nei mākou e pili ana i ka Transanal Endoscopic Microsurgery (TEMS) , kahi hana ʻoki kūikawā e wehe i nā puʻupuʻu e like me kēia me ka ʻole o ka hana ʻana i kekahi ʻoki i loko o kou ʻōpū, me ka hoʻohana ʻana i nā mea hana liʻiliʻi i hoʻokomo ʻia ma o kou rectum.
I ka ʻōlelo maʻalahi, he aha ka TEMS?
He hana ʻoki kino minimally invasive ka TEMS i hoʻohana ʻia e wehe i nā puʻupuʻu a me nā maʻi ʻaʻai liʻiliʻi mai kou rectum. I ka wā ma mua, ʻo ka wehe ʻana i kahi puʻupuʻu mai kou rectum e pono ai kahi ʻoki ʻōpū nui. Ma kēia kaʻina hana TEMS, hoʻokomo ke kauka ʻoki i kahi mea hana kūikawā ma o kou anus a hoʻohana i kahi kāmela liʻiliʻi a me nā mea hana ʻoki e wehe i ka puʻupuʻu.
ʻO ka pōmaikaʻi nui o kēia, ʻoiai ʻaʻohe ʻoki ma waho o ke kino , e emi ana ka ʻeha, e ho'ōla wikiwiki, a e emi ana nā pilikia ma mua o ka hana ʻoki nui.
He aha ka ʻokoʻa ma waena o TEM a me TAMIS?
Ua lohe paha ʻoe iā TAMIS. Ua like iki kēia mau ʻano hana ʻelua, akā aia kahi ʻokoʻa iki.
- TEMS (Transanal Endoscopic Microsurgery): Hoʻohana kēia i kahi mea hana lōʻihi a mānoanoa e like me ka paipu i kapa ʻia ʻo "Rectoscope." Hoʻokomo ʻia ke kāmela a me nā mea hana ʻē aʻe ma o kēia paipu.
- TAMIS (Transanal Minimally Invasive Surgery): Hoʻohana kēia i kahi puka liʻiliʻi, poepoe, palupalu, e like me ka gel. Hoʻokomo ʻia ia ma o ka anus a wehe ʻia ka puʻupuʻu me ka hoʻohana ʻana i nā mea hana like i hoʻohana ʻia no nā ʻoki laparoscopic.
E loiloi ke kauka i kou kūlana a koho i ke ʻano hana kūpono loa iā ʻoe ma muli o ka wahi o ka puʻupuʻu.
No wai ke ʻoki kino TEMS i kūpono loa?
ʻAʻole no nā kānaka a pau kēia ʻoki kino, akā i kekahi mau hihia he koho maikaʻi loa ia.
- No ka poʻe i pilikia i ke ʻoki kino nui ma muli o nā pilikia olakino ʻē aʻe (e like me ka maʻi puʻuwai, ka maʻi diabetes).
- No ka poʻe me ke kanesa rectal i ke kahua mua.
- No nā poʻe ʻōpio me nā puʻupuʻu ʻaʻole maʻi kanesa (benign).
- No kekahi mea makemake e pale i ke ʻoki kino nui, inā hoʻoholo ke kauka he kūpono ia.
Eia nō naʻe, inā paʻakikī ke kūlana o kou iwi kuamoʻo no ka mea hana e hiki aku i ka puʻupuʻu, a inā ua haiki kou rectum (stenosis), ʻaʻole paha e hiki kēia kaʻina hana. Hoʻoholo ʻia kēia a pau e kāu kauka lapaʻau.
Nā kūlana i mālama ʻia me ke ʻoki ʻana o TEMS
Hana pinepine ʻia kēia ʻoki kino e wehe i nā puʻupuʻu i loko o ka rectum. Hoʻohana ʻia ia e mālama i nā kūlana ma lalo nei:
| Kūlana olakino | He wehewehe maʻalahi |
|---|---|
| Nā puʻupuʻu rectal maikaʻi | Nā puʻupuʻu maʻamau ʻaʻole e lilo i maʻi ʻaʻai. |
| Ka maʻi ʻaʻai rectum | ʻOi aku hoʻi nā puʻupuʻu kanesa i nā wā mua. |
| Nā polyps rectal | Nā cysts liʻiliʻi e ulu ana ma ka uhi o ka rectum. |
| Nā Fistula | Nā wahi liʻiliʻi i loaʻa i ka maʻi i hana ʻia ma waena o ka anus a me ka ʻili a puni. |
| ʻO ka prolapse rectal | ʻĀpana o ka rectum e puka mai ana mai ka puka anal. |
| Ka hāiki ʻana o ka rectum (Strictures) | Ua haiki ka ʻōpū no kekahi kumu. |
Pehea ʻoe e hoʻomākaukau ai ma mua o ke ʻoki kino?
ʻO ka hoʻomākaukau ʻana no kēia ua like ia me ka hoʻomākaukau ʻana no ka colonoscopy. ʻO ka mea nui, ʻo ia ka hoʻomaʻemaʻe loa ʻana i kou ʻōpū . E ʻae kēia i ke kauka e ʻike maopopo i loko o kou rectum. No kēia, e hāʻawi kāu kauka iā ʻoe i kahi laxative kūikawā.
ʻO ka maʻamau, e loaʻa iā ʻoe nā ʻōlelo aʻoaʻo e like me kēia:
- E pale i ka ʻai ʻana i nā meaʻai paʻa i ka lā ma mua o ke ʻoki ʻana.
- E inu wale i nā wai maopopo (wai, wai paʻakai, Jeevani) 12-24 mau hola ma mua o ke ʻoki ʻana.
- Mai ʻai a inu paha i kekahi mea mai ke aumoe o ka lā o ke ʻoki kino.
- Inā ʻoe e lawe ana i kekahi mea e like me nā lāʻau hoʻokahe koko, e hoʻomaopopo pono e haʻi i kāu kauka e pili ana i ia mea a hoʻōki i ka lawe ʻana iā lākou i kekahi mau lā ma mua, e like me kāna ʻōlelo aʻo.
ʻO ka mea nui loa, ʻo ia ka hahai pono ʻana i nā kuhikuhi a pau a ke kauka i hāʻawi ai. He mea nui loa kēia no ka holomua o ke ʻoki kino.
He aha ka mea e hana ʻia i ka wā o ke ʻoki kino?
ʻAʻole ʻoe e manaʻo i kekahi mea i ka wā o kēia kaʻina hana no ka mea e hana ʻia ke ʻoki ʻana ma lalo o ka anesthesia laulā, ʻo ia hoʻi e hiamoe loa ʻoe. Eia ka mea e hana ʻia i ka wā o ke ʻoki ʻana:
1. Hoʻokomo ke kauka lapaʻau i ka mea hana "Rectoscope" ma o ka puka anal i loko o ka rectum.
2. Ua hoʻopiha iki ʻia ka rectum me ke kinoea e ʻike maikaʻi aku ai i ka ʻāpana a puni ka puʻupuʻu.
3. Hoʻokomo ʻia kahi kāmela a me nā mea hana ʻoki palupalu ma o ka rectoscope a ʻoki ʻia a wehe ʻia ka puʻupuʻu a polyp paha, me kekahi mau ʻiʻo olakino e hoʻopuni ana.
4. A laila pani ʻia ka ʻoki me nā humuhumu hiki ke hoʻoheheʻe ʻia a i ʻole nā ʻūmi metala liʻiliʻi.
Pehea ke ʻano ma hope o ke ʻoki kino?
Hiki paha iā ʻoe ke loaʻa i kahi ʻoluʻolu ʻole ma hope o ke ʻoki ʻana. I loko o nā hola 24 mua, hiki paha iā ʻoe ke loaʻa:
- He ʻōmole (`catheter`) i hoʻokomo ʻia i loko o kou ʻōpū mimi e hoʻokahe i ka mimi.
- E hāʻawi i ke kino i nā wai e pono ai ma o ka hoʻokomo ʻana i ka saline (kahi 'IV line') i loko o kahi aa koko ma kou lima.
- Nā lāʻau ʻaʻai antibiotic (IV antibiotics) i hāʻawi ʻia ma o ka saline no kahi o 24 mau hola e pale aku ai i ka maʻi.
Hiki iā ʻoe ke hoʻomaka e ʻai a inu ma kahi o hoʻokahi lā ma hope o ke ʻoki kino. Hiki iā ʻoe ke hoʻi i ka home ma hope o hoʻokahi a ʻelua paha lā ma ka haukapila .
He aha nā pono o kēia ʻano hana?
He nui nā pono o ke ʻano TEMS ma mua o ka laparotomy. Hiki i ke ʻoki kino nui ke alakaʻi i nā pilikia kaohi mimi, ka hana pono ʻole o ka moekolohe, a me ka pono no kahi colostomy mau loa. Hoʻemi ke ʻano TEMS i nā pilikia he nui.
| Pōmaikaʻi | Wehewehena |
|---|---|
| Ka emi ʻana o ke kahe koko | He kakaikahi loa ke kahe ʻana o ke koko no ka mea ʻaʻohe ʻoki ʻia. |
| Nā pilikia liʻiliʻi | Haʻahaʻa ka pilikia o ka maʻi a me ke ālai ʻana o ka ʻōpū. |
| Hoʻōla wikiwiki | Hiki ke hoʻomaka nā hana maʻamau i hoʻokahi a ʻelua paha lā. |
| Noho pōkole ma ka haukapila | ʻO ka maʻamau, hiki iā ʻoe ke hoʻi i ka home i loko o 1-2 mau lā. |
ʻAʻole anei he pilikia i loko o kēia?
E like me nā ʻoki kino āpau, aia kahi pilikia liʻiliʻi, akā ʻoi aku ka haʻahaʻa o ka pilikia ma mua o ka tummy tuck.
- Ke kahe ʻana o ke koko
- Loaʻa i kahi maʻi
- ʻEha rectal a ʻōpū paha
- Paʻakikī i ka mimi ʻana ('Paʻa ʻana o ka mimi')
- Pono koke e hoʻokahe i ka ʻōpū ('Fecal urgency')
Inā kū mai kekahi mea e like me kēia, ua mākaukau nā kauka e mālama iā ia.
Inā loaʻa iā ʻoe kēia mau hōʻailona, e ʻike koke i ke kauka.
Inā ʻike ʻoe i kekahi o kēia mau hōʻailona ma hope o ka hoʻi ʻana i ka home, e kāhea koke aku i kāu kauka a i ʻole e hele i ka Emergency Department (ETU) o ka haukapila.
- Ke kahe koko nui
- Kuni a i ʻole ke anu
- Paʻakikī ke mimi
- ʻEha ʻōpū a ʻeha paha i ka rectum
Inā he maʻi kanesa, ʻo kēia wale nō anei ka lāʻau lapaʻau?
Inā ʻike ʻia ka maʻi ʻaʻai rectal i kona mau pae mua, a ua wehe loa ʻia ka puʻupuʻu me ke ʻoki ʻana TEMS, ʻaʻole pono paha nā lāʻau ʻē aʻe. Eia nō naʻe, no kekahi poʻe, ma muli o ke ʻano o ka puʻupuʻu, hiki i kāu kauka ke ʻōlelo aku i ka chemotherapy a i ʻole ka radiation therapy ma waho aʻe o kēia ʻoki ʻana. E hoʻoholo ʻia kēia mau mea a pau ma hope o ka nānā ʻana i kou kūlana.
Leka Lawe-Home
- He hana ʻoki kino hou, palekana, a ʻaʻole invasive ka TEMS i hoʻohana ʻia e wehe i nā ʻōpū rectal.
- ʻO ka hopena, ʻoi aku ka liʻiliʻi o ka ʻeha, ka wikiwiki o ka ho'ōla ʻana, a me ka noho pōkole ʻana i ka haukapila.
- ʻAʻole kūpono kēia no nā kānaka a pau. Na kāu kauka e hoʻoholo inā kūpono kēia iā ʻoe a ʻaʻole paha.
- He mea nui loa e hahai pono i nā kuhikuhi i hāʻawi ʻia ma mua o ke ʻoki kino (ka hoʻomaʻemaʻe ʻōpū, ka ʻai).
- ʻOiai inā wikiwiki ka ho'ōla ʻana, e makaʻala i nā hōʻailona e like me ke kuni, ka ʻeha nui, a i ʻole ke kahe ʻana o ke koko. Inā ʻike ʻoe i kekahi o kēia mau mea, e ʻimi koke i ke kōkua lapaʻau.
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