Kodi mukuopa opaleshoni ya m'chiuno? Tiyeni tiphunzire za njira yatsopano yosavulaza (TEMS)!

Ndizachilendo kuchita mantha dokotala wanu akakuuzani kuti muli ndi chotupa m'matumbo anu, m'munsi mwa matumbo anu akuluakulu. Mwina mukuganiza kuti, "O, ndiyenera kudula m'mimba mwanu, ndiyenera kukhala m'chipatala kwa masiku angapo, zidzandipweteka kwambiri," sichoncho? Koma musadandaule. Ukadaulo wapita patsogolo kwambiri masiku ano. Lero, tikulankhula za Transanal Endoscopic Microsurgery (TEMS) , njira yapadera yochitira opaleshoni yomwe imachotsa zotupa ngati izi popanda kudula m'mimba mwanu, pogwiritsa ntchito zida zazing'ono zomwe zimayikidwa kudzera m'matumbo mwanu.

Mwachidule, kodi TEMS ndi chiyani?

TEMS ndi opaleshoni yochepa kwambiri yomwe imagwiritsidwa ntchito kuchotsa zotupa ndi khansa zazing'ono m'matumbo mwanu. Kale, kuchotsa chotupa m'matumbo mwanu kukanafunika opaleshoni yayikulu ya m'mimba. Mu njira iyi ya TEMS, dokotalayo amaika chida chapadera kudzera mu anus yanu ndipo amagwiritsa ntchito kamera yaying'ono ndi zida zochitira opaleshoni kuti achotse chotupacho.

Ubwino waukulu wa izi ndi wakuti popeza palibe mabala kunja kwa thupi , mudzamva kupweteka kochepa, mudzachira msanga, komanso mudzakhala ndi mavuto ochepa kuposa opaleshoni yayikulu.

Kodi kusiyana pakati pa TEM ndi TAMIS ndi kotani?

Mwina munamvapo za TAMIS. Njira zonsezi ndi zofanana pang'ono, koma pali kusiyana pang'ono.

• TEMS (Transanal Endoscopic Microsurgery): Izi zimagwiritsa ntchito chida chachitali, chokhuthala ngati chubu chotchedwa ``Rectoscope.'' Kamera ndi zida zina zimadutsa mu chubuchi.
• TAMIS (Opaleshoni Yochepa Yowononga Matumbo): Iyi imagwiritsa ntchito doko laling'ono, lozungulira, losinthasintha, lofanana ndi gel. Limayikidwa kudzera mu anus ndipo chotupacho chimachotsedwa pogwiritsa ntchito zida zomwezo zomwe zimagwiritsidwa ntchito pa opaleshoni ya laparoscopic.

Dokotala adzayesa vuto lanu ndikusankha njira yoyenera kwambiri kutengera komwe chotupacho chili.

Kodi opaleshoni ya TEMS ndi yoyenera kwa ndani?

Opaleshoni iyi si ya aliyense, koma nthawi zina ndi njira yabwino kwambiri.

• Kwa iwo omwe akuvutika kuchitidwa opaleshoni yayikulu chifukwa cha mavuto ena azaumoyo (monga matenda a mtima, matenda a shuga).
• Kwa iwo omwe ali ndi khansa ya m'matumbo yoyambirira.
• Kwa achinyamata omwe ali ndi zotupa zopanda khansa (zosavulaza).
• Kwa aliyense amene akufuna kupewa opaleshoni yaikulu, ngati dokotala akuona kuti ndi koyenera.

Komabe, ngati malo a msana wanu akupangitsa kuti chipangizocho chikhale chovuta kufika pa chotupacho, kapena ngati rectum yanu yachepa (stenosis), njirayi singatheke. Zonsezi zimatsimikiziridwa ndi dokotala wanu.

Matenda omwe amachiritsidwa ndi opaleshoni ya TEMS

Opaleshoni iyi nthawi zambiri imachitika kuti ichotse zotupa mu rectum. Imagwiritsidwa ntchito pochiza matenda awa:

Kodi mumakonzekera bwanji musanachite opaleshoni?

Kukonzekera izi kuli ngati kukonzekera colonoscopy. Chofunika kwambiri ndikutsuka matumbo anu mokwanira . Izi zithandiza dokotala kuwona bwino mkati mwa rectum yanu. Pachifukwa ichi, dokotala wanu adzakupatsani mankhwala apadera otsekula m'mimba.

Kawirikawiri mudzalandira malangizo monga awa:

• Pewani kudya zakudya zolimba tsiku lisanafike opaleshoni.
• Imwani zakumwa zoyera zokha (madzi, madzi amchere, Jeevani) maola 12-24 musanachite opaleshoni.
• Pewani kudya kapena kumwa chilichonse kuyambira pakati pausiku patsiku la opaleshoni.
• Ngati mukumwa mankhwala ena monga ochepetsa magazi, onetsetsani kuti mwauza dokotala wanu za izi ndipo siyani kumwa mankhwalawa pasadakhale masiku angapo, monga momwe akulangizira.

Kodi chimachitika ndi chiyani panthawi ya opaleshoni?

Simudzamva chilichonse panthawi ya opaleshoniyi chifukwa opaleshoniyi idzachitika pansi pa anesthesia, zomwe zikutanthauza kuti mudzakhala mutulo tofa nato. Izi ndi zomwe zimachitika panthawi ya opaleshoniyi:

1. Dokotala wa opaleshoni amalowetsa chida chotchedwa ``Rectoscope`` kudzera m'malo otulukira maliseche kupita ku rectum.

2. M'mimba mwa rectum mumakhala mpweya pang'ono kuti muwone bwino malo ozungulira chotupacho.

3. Kamera ndi zida zofewa zochitira opaleshoni zimayikidwa kudzera mu rectoscope ndipo chotupa kapena polyp, pamodzi ndi minofu ina yozungulira yathanzi, zimadulidwa ndikuchotsedwa.

4. Kenako chochekacho chimatsekedwa ndi zosokera zosungunuka kapena zomangira zazing'ono zachitsulo.

Kodi zimakhala bwanji pambuyo pa opaleshoni?

Mungakhale ndi vuto linalake mukatha opaleshoni. Mu maola 24 oyambirira, mutha kukhala ndi:

• Chubu (`catheter`) choyikidwa mu chikhodzodzo chanu kuti chitulutse mkodzo.
• Perekani thupi madzi omwe limafunikira kudzera mu saline infusion ('IV line') mu mtsempha womwe uli m'dzanja lanu.
• Mankhwala opha tizilombo toyambitsa matenda (IV antibiotics) amaperekedwa kudzera mu saline kwa maola pafupifupi 24 kuti apewe matenda.

Mukhoza kuyamba kudya ndi kumwa pafupifupi tsiku limodzi pambuyo pa opaleshoni. Nthawi zambiri mudzatha kupita kunyumba mutatha tsiku limodzi kapena awiri kuchipatala .

Kodi ubwino wa njira iyi ndi wotani?

Njira ya TEMS ili ndi ubwino wambiri kuposa laparotomy. Opaleshoni yayikulu nthawi zina ingayambitse mavuto oletsa mkodzo, kusagwira bwino ntchito kwa kugonana, komanso kufunikira kwa colostomy yokhazikika. Njira ya TEMS imachepetsa zoopsa zambirizi.

Kodi palibe chiopsezo mu izi?

Monga momwe zimakhalira ndi opaleshoni iliyonse, pali chiopsezo chochepa, koma chiopsezocho n'chochepa kwambiri kuposa kutsekeka kwa mimba.

• Kutuluka magazi
• Kukhala ndi matenda
• Kupweteka kwa m'mimba kapena m'mimba
• Kuvuta kukodza ('Kusunga mkodzo')
• Kufunika kodzichitira chimbudzi mwadzidzidzi (`fecal urgency`)

Ngati chinthu chonga ichi chichitika, madokotala ali okonzeka kuchichiza.

Ngati muli ndi zizindikiro izi, pitani kwa dokotala nthawi yomweyo.

Ngati mukukumana ndi zizindikiro zotsatirazi mutabwerera kunyumba, imbani dokotala wanu nthawi yomweyo kapena pitani ku Dipatimenti Yoona za Zadzidzidzi (ETU) ya chipatalacho.

• Kutuluka magazi kwambiri
• Malungo kapena kumva kuzizira
• Kuvuta kukodza
• Kupweteka kosapiririka m'mimba kapena m'matumbo

Ngati ndi khansa, kodi iyi ndiyo njira yokhayo yochiritsira?

Ngati khansa ya m'matumbo yapezeka pachiyambi chake, ndipo chotupacho chachotsedwa kwathunthu ndi opaleshoni ya TEMS, mankhwala ena sangakhale ofunikira. Komabe, kwa anthu ena, kutengera mtundu wa chotupacho, dokotala wanu angakulimbikitseni chithandizo cha chemotherapy kapena radiation kuwonjezera pa opaleshoniyi. Zonsezi zidzadziwika mutafufuza momwe mulili.