He mea noa te mataku ina kī mai tō tākuta he pukupuku tōu kei roto i tō pūkahukahu, te wāhanga o raro o tō whekau nui. Tērā pea kei te whakaaro koe, "Āe, me tapahi e au tō puku, me noho ahau ki te hōhipera mō ētahi rā, ka tino mamae," tika? Engari kaua e manukanuka. He tino matatau te hangarau i ēnei rā. I tēnei rā, kei te kōrero tātou mō te Transanal Endoscopic Microsurgery (TEMS) , he tikanga pokanga motuhake e tango ana i ngā pukupuku pēnei me te kore e tapahia tō puku, mā te whakamahi i ngā taputapu iti e whakaurua ana mā roto i tō pūkahukahu.
He aha te TEMS?
He tikanga pokanga iti rawa te whakaekenga a te TEMS hei tango i ngā pukupuku me ngā matepukupuku iti mai i tō pūkahukahu. I mua, ko te tango i te pukupuku mai i tō pūkahukahu me mahi he pokanga puku nui. I roto i tēnei tikanga TEMS, ka whakauruhia e te taote pokanga he taputapu motuhake mā roto i tō pūkahukahu, ā, ka whakamahia he kāmera iti me ngā taputapu pokanga hei tango i te pukupuku.
Ko te painga nui o tēnei ko te korenga o ngā tapahi i waho o te tinana , ka iti ake te mamae, ka tere ake te ora, ā, ka iti ake ngā raruraru i tērā i muri i te pokanga nui.
He aha te rerekētanga i waenganui i a TEM me TAMIS?
Kua rongo pea koe i ngā TAMIS. He āhua ōrite ēnei tikanga e rua, engari he iti noa te rerekētanga.
- TEMS (Pokanga Maikoro Endoscopic Transanal): Ka whakamahia he taputapu roa, matotoru, rite tonu ki te ngongo e kiia nei ko te "Rectoscope." Ka tukuna te kāmera me ētahi atu taputapu mā roto i tēnei ngongo.
- TAMIS (Pokanga Whakaiti i te Urunga-ā-Waewae): He pokanga iti, porowhita, ngāwari, rite ki te tiēre tēnei e whakamahia ana. Ka whakaurua mā te nono, ā, ka tangohia te pukupuku mā te whakamahi i ngā taputapu e whakamahia ana mō ngā pokanga laparoscopic.
Ka arotakehia e te tākuta tō āhua, ka whiriwhiri i te tikanga e pai ana ki a koe i runga i te wāhi o te pukupuku.
Ko wai te hunga e tino pai ana te pokanga TEMS?
Ehara tēnei pokanga i te mea mā te katoa, engari i ētahi wā he kōwhiringa tino pai.
- Mō te hunga e uaua ana ki te whakamanawanui i ngā pokanga nui nā ētahi atu raruraru hauora (hei tauira, te mate manawa, te mate huka).
- Mō te hunga e pāngia ana e te mate pukupuku o te kōpū i te wā tōmua.
- Mō ngā taiohi he pukupuku kore-matepukupuku (pai).
- Mō te hunga e hiahia ana ki te karo i ngā pokanga nui, mēnā ka whakatau te tākuta he tika.
Heoi, ki te mea he uaua te tūnga o tō tuaiwi ki te toro atu ki te pukupuku, ki te whaiti rānei tō pūkahukahu (stenosis), kāore pea e taea tēnei tikanga. Mā tō taote pokanga tēnei katoa e whakatau.
Ngā āhuatanga e rongoatia ana e te pokanga TEMS
He maha ngā wā ka mahia tēnei pokanga hei tango i ngā pukupuku i roto i te pūkahukahu. Ka whakamahia hei rongoā i ngā āhuatanga e whai ake nei:
| Āhuatanga hauora | He whakamārama māmā |
|---|---|
| Ngā pukupuku rectum pai | Ngā pukupuku noa kāore e huri hei matepukupuku. |
| Matepukupuku rectum | Ina koa ko ngā pukupuku matepukupuku i ngā wāhanga tōmua. |
| Ngā polyp rectum | He pūkahukahu iti e puta ana i te arai o te tō. |
| Ngā Fistula | Ngā ara iti kua pangia e hanga ana i waenganui i te nono me te kiri e karapoti ana. |
| Te hekenga o te rectum | Wāhanga o te tō e pū ake ana i te pūaha o te ana. |
| Te whaiti o te rectum (Strictures) | Kua whaiti te tōku hope mō tētahi take. |
Me pēhea te whakarite i mua i te pokanga?
He rite te whakarite mō tēnei ki te whakarite mō te colonoscopy. Ko te mea nui ko te horoi katoa i ō whekau . Mā tēnei ka taea e te tākuta te kite mārama i te roto o tō pūkahukahu. Mō tēnei, ka hoatu e tō tākuta he rongoā whakamāmā motuhake ki a koe.
Ko te tikanga ka whiwhi koe i ngā tohutohu penei:
- Kaua e kai i ngā kai mārō i te rā i mua i te pokanga.
- Inumia he wai mārama anake (wai, wai tote, Jeevani) 12-24 hāora i mua i te pokanga.
- Kaua e kai, e inu rānei i tetahi mea mai i waenganui pō o te rā o te pokanga.
- Ki te mea kei te tango koe i tētahi mea pēnei i te whakaiti toto, me kōrero ki tō tākuta mō tēnei mea, ā, kati te tango i ētahi rā i mua atu, e ai ki āna tohutohu.
Ko te mea nui ko te whai i ngā tohutohu katoa a te tākuta. He mea tino nui tēnei mō te angitu o te pokanga.
He aha ngā mea ka tupu i te wā o te pokanga?
Kāore koe e rongo i tetahi mea i te wā o tēnei mahi nā te mea ka mahia te pokanga i raro i te mate whakamoe whānui, arā, ka moe rawa koe. Anei ngā mea ka tupu i te wā o te pokanga:
1. Ka whakaurua e te taote pokanga te taputapu "Rectoscope" mā te pūaha o te ihu ki roto i te tō.
2. Ka pupuhihia te pūkahukahu ki te hau kia pai ake ai te tiro atu ki te wāhi e karapoti ana i te puku.
3. Ka whakauruhia he kāmera me ngā taputapu pokanga ngāwari mā roto i te rectoscope, ā, ka tapahia te pukupuku, te polyp rānei, me ētahi kiko hauora e karapoti ana, ka tangohia.
4. Kātahi ka katia te tapahi ki ngā tuitui wairewa, ki ngā topenga whakarewa iti rānei.
He aha te āhua i muri i te pokanga?
Tērā pea ka pāngia koe e te mamae i muri i te pokanga. I roto i ngā haora 24 tuatahi, tērā pea ka pāngia koe e:
- He ngongo (‘catheter’) e whakanohoia ana ki roto i tō pūkahukahu hei tango i te mimi.
- Hoatu te wai e hiahiatia ana e te tinana mā te werohanga tote (he 'raina IV') ki roto i tētahi uaua i tō ringa.
- Ngā paturopi (ngā paturopi IV) e hoatu ana mā te tote mō te 24 hāora hei ārai i te mate.
Ka taea e koe te tīmata ki te kai me te inu i te rā kotahi i muri i te pokanga. I te nuinga o te wā ka taea e koe te hoki ki te kāinga i muri i te rā kotahi, e rua rānei i te hōhipera .
He aha ngā painga o tēnei tikanga?
He maha ngā painga o te tikanga TEMS i te laparotomy. I ētahi wā, ka raru pea te whakahaere mimi i te mate pāwera o te ira tangata, ka pāngia hoki e te pokanga nui, tae atu ki te hiahiatanga o te colostomy tuturu. Ka whakaitihia e te tikanga TEMS te nuinga o ēnei mōrearea.
| Painga | Whakamārama |
|---|---|
| He iti ake te toto | He iti noa te toto e puta mai ana nā te mea kāore he tapahi. |
| He iti ake ngā raruraru | He iti te mōrearea o te mate urutā me te aukati o te puku. |
| Whakaora tere | Ka taea te tīmata i ngā mahi noa i roto i te kotahi ki te rua rā. |
| He poto ake te noho hōhipera | I te nuinga o te wā ka taea e koe te hoki ki te kāinga i roto i te 1-2 rā. |
Kāore ianei he mōrearea kei roto i tēnei?
Pērā i ngā pokanga katoa, he iti noa te mōrearea, engari he iti iho te mōrearea i te pokanga puku.
- Te toto
- He mate pāwera
- Mamae o te rectum, o te puku rānei
- Te uaua ki te mimi ('Te pupuri mimi')
- Te hiahia ohorere ki te tūtae ('Te hiahia nui ki te tūtae')
Ki te puta mai tētahi mea pēnei, kua rite ngā tākuta ki te rongoā.
Ki te pā mai ēnei tohu ki a koe, me toro atu ki te tākuta tonu.
I muri i te hokinga ki te kāinga, ki te pāngia koe e tētahi o ngā tohu e whai ake nei, waea atu ki tō tākuta tonu atu , haere rānei ki te Tari Ohotata (ETU) o te hōhipera.
- Te toto nui rawa
- Te kirika, te mātao rānei
- Te uaua ki te mimi
- Te mamae o te puku, o te rectum rānei e kore e taea te whakamanawanui
Mena he mate pukupuku, koinei anake te rongoā?
Mena ka kitea te mate pukupuku o te kōpū i tōna tīmatanga, ā, ka tangohia katoatia te pukupuku mā te pokanga TEMS, kāore pea e hiahiatia ētahi atu maimoatanga. Heoi, mō ētahi tāngata, i runga i te āhua o te pukupuku, ka tūtohu pea tō tākuta i te chemotherapy, i te radiation therapy rānei hei tāpiri atu ki tēnei pokanga. Ka whakatauhia katoatia tēnei i muri i te tirotiro i tō āhua.
Karere Tangohia ki te Kāinga
- He tikanga pokanga hou, haumaru, kāore hoki e pokanga te TEMS e whakamahia ana hei tango i ngā pukupuku o te rectum.
- Ko te hua o tēnei ka iti ake te mamae, ka tere ake te ora, ā, ka poto ake te noho hōhipera.
- Kāore tēnei e pai mō te katoa. Mā tō tākuta e whakatau mēnā he pai tēnei mōu, kāore rānei.
- He mea tino nui kia tino whai i ngā tohutohu i hoatu i mua i te pokanga (te horoi puku, te kai).
- Ahakoa he tere te ora, kia tūpato ki ngā tohu whakatūpato pēnei i te kirika, te mamae nui, te toto rānei. Ki te kite koe i tētahi o ēnei, rapua tonutia he tohutohu hauora.
💬 Comments (0)
Kaore ano kia tukuna he korero. Tāpirihia to korero ki konei mo te wa tuatahi.
Tāpirihia to korero