Zvakajairika kuti unzwe kutya kana chiremba wako akakuudza kuti une bundu mu rectum yako, chikamu chezasi cheura hwako hukuru. Ungave uchifunga kuti, "Oh, ndichafanira kucheka dumbu rako, ndichafanira kugara muchipatara kwemazuva mashoma, zvicharwadza zvikuru," handiti? Asi usazvidya moyo. Tekinoroji yafambira mberi zvikuru nhasi. Nhasi, tiri kutaura nezveTransanal Endoscopic Microsurgery (TEMS) , nzira yekuvhiya yakakosha inobvisa bundu rakadai pasina kucheka mudumbu mako, uchishandisa zvishandiso zvidiki zvinoiswa mu rectum yako.
Zvichitaurwa zviri nyore, chii chinonzi TEMS?
TEMS inzira yekuvhiya isinganyanyi kupindira inoshandiswa kubvisa bundu nekenza diki kubva mudumbu rako. Kare, kubvisa bundu kubva mudumbu rako kwaida kuvhiyiwa kukuru mudumbu. Munzira iyi yeTEMS, chiremba anoisa chinhu chakakosha kuburikidza nedumbu rako uye anoshandisa kamera diki nezvishandiso zvekuvhiya kubvisa bundu.
Chinhu chikuru cheizvi ndechekuti sezvo pasina mavanga kunze kwemuviri , hauzonzwi kurwadziwa kwakanyanya, uchapora nekukurumidza, uye hauzove nematambudziko akawanda pane mushure mekuvhiyiwa kukuru.
Chii chiri musiyano uripo pakati peTEM neTAMIS?
Ungave wakambonzwawo nezveTAMIS. Nzira idzi dzese dzakafanana, asi pane musiyano mudiki.
- TEMS (Transanal Endoscopic Microsurgery): Izvi zvinoshandisa chishandiso chakareba, chakakora chakaita sechubhu chinonzi ``Rectoscope.'' Kamera nezvimwe zvinoshandiswa zvinopfuudzwa nechubhu iyi.
- TAMIS (Transanal Minimally Invasive Surgery): Izvi zvinoshandisa chidimbu chidiki, chakatenderera, chinochinjika, chakaita sejeli. Chinopinzwa nepaburi remusana uye bundu rinobviswa uchishandisa zvishandiso zvakafanana zvinoshandiswa pakuvhiya kwe laparoscopic.
Chiremba achaongorora mamiriro ako ezvinhu uye osarudza nzira inokukodzera zvichienderana nenzvimbo yebundu racho.
Ndiani anonyanya kukodzera kuvhiyiwa kweTEMS?
Kuvhiyiwa uku hakusi kwemunhu wese, asi mune dzimwe nguva isarudzo yakanaka kwazvo.
- Kune avo vanoomerwa nekuvhiyiwa kukuru nekuda kwemamwe matambudziko ehutano (semuenzaniso chirwere chemwoyo, chirwere cheshuga).
- Kune avo vane kenza yemudumbu iri padanho rekutanga.
- Kune vechidiki vane bundu risiri rekenza (risina kuipa).
- Kune chero ani zvake anoda kudzivisa kuvhiyiwa kukuru, kana chiremba akasarudza kuti zvakakodzera.
Zvisinei, kana nzvimbo yemusana wako ichiita kuti zviomere kuti mudziyo usvike pabundu, kana kuti rectum yako yakatetepa (stenosis), nzira iyi ingasakwanisika. Izvi zvese zvinosarudzwa nachiremba wako.
Mamiriro ezvinhu anorapwa nekuvhiyiwa kweTEMS
Kuvhiyiwa uku kunowanzoitwa kubvisa bundu riri mu rectum. Kunoshandiswa kurapa zvirwere zvinotevera:
| Dambudziko rehutano | Tsananguro iri nyore |
|---|---|
| Matumbu asina kunaka emudumbu | Mabundu akajairwa asingazove kenza. |
| Kenza yemudumbu | Kunyanya kenza yemabundu ari mumatanho ekutanga. |
| Maporipu emudumbu | Matumbu madiki anokura pamucheto werectum. |
| Fistula | Nzira diki dzine utachiona dzinoumba pakati pe anus neganda rakatenderedza. |
| Kupera kwemusana | Chikamu cherectum chinobuda paburi rekumashure. |
| Kutetepa kwerectum (Strictures) | Dumbu rave rakatetepa nekuda kwechimwe chikonzero. |
Unogadzirira sei usati wavhiyiwa?
Kugadzirira izvi kwakafanana nekugadzirira colonoscopy. Chinhu chikuru ndechekuchenesa ura hwako zvachose . Izvi zvichaita kuti chiremba aone zviri mukati me rectum yako zvakajeka. Kuti izvi zviitike, chiremba wako achakupa mushonga wekubvisa dumbu wakakosha.
Kazhinji uchawana mirairo yakaita seiyi:
- Dzivisa kudya chikafu chakasimba zuva risati rasvika rekuvhiyiwa.
- Inwa mvura yakachena chete (mvura, mvura ine munyu, Jeevani) maawa 12-24 usati wavhiyiwa.
- Dzivisa kudya kana kunwa chero chinhu kubva pakati pehusiku pazuva rekuvhiyiwa.
- Kana uri kutora mishonga yakaita seye blood thinners, iva nechokwadi chekuudza chiremba wako nezvazvo uye rega kuitora mazuva mashoma pachine nguva, sekureva kwezano rake.
Chinhu chinonyanya kukosha ndechekutevedzera mirairo yese yakapihwa nachiremba nemazvo. Izvi zvakakosha zvikuru kuti kuvhiyiwa kubudirire.
Chii chinoitika panguva yekuvhiyiwa?
Hauzonzwi chero chinhu panguva yekuvhiyiwa uku nekuti kuvhiyiwa uku kuchaitwa pasi peanesthesia, zvinoreva kuti uchange wakarara zvachose. Hezvino zvinoitika panguva yekuvhiyiwa:
1. Chiremba anoisa mudziyo wekuti "Rectoscope" kuburikidza nepaburi rekumashure rinopinda murectum.
2. Mudumbu munobva maburi makazara gasi kuti zvinyatsoonekwa nzvimbo yakatenderedza bundu.
3. Kamera nezvishandiso zvekuvhiya zvinoiswa kuburikidza ne rectoscope uye bundu kana kuti polyp, pamwe chete nedzimwe nyama dzakapoteredzwa dzine hutano, zvinochekwa zvobviswa.
4. Kucheka kunozovharwa nemasitichi anonyungudika kana zvipikiri zvidiki zvesimbi.
Zvakaita sei mushure mekuvhiyiwa?
Unganzwa kusagadzikana mushure mekuvhiyiwa. Mumaawa makumi maviri nemana ekutanga, unogona kunzwa zvinotevera:
- Chubhu (`catheter`) inoiswa mudundira rako kuti ibudise weti.
- Ipa muviri mvura yaunoda kuburikidza nekuiswa munyu ('IV line') mutsinga iri muruoko rwako.
- Mishonga inorwisa mabhakitiriya (mushonga unorwisa mabhakitiriya wemudumbu) inopihwa nemushonga wemunyu kwemaawa angangoita makumi maviri nemana kudzivirira hutachiona.
Unogona kutanga kudya nekunwa zuva rimwe chete mushure mekuvhiyiwa. Kazhinji unokwanisa kudzokera kumba mushure mezuva rimwe kana maviri uri muchipatara .
Ndezvipi zvakanakira nzira iyi?
Nzira yeTEMS ine zvakanakira zvakawanda kupfuura laparotomy. Kuvhiyiwa kukuru dzimwe nguva kunogona kukonzera matambudziko ekugadzirisa weti, kusagadzikana pabonde, uye kutoda colostomy inogara iripo. Nzira yeTEMS inoderedza njodzi dzakawanda idzi.
| Zvakanakira | Tsananguro |
|---|---|
| Kubuda ropa kushoma | Kubuda ropa kushoma nekuti hapana cheni. |
| Matambudziko mashoma | Njodzi dzekutapukirwa nehutachiona uye kuvharika kweura dzakaderera. |
| Kupora nekukurumidza | Mabasa akajairika anogona kutanga mukati mezuva rimwe kusvika maviri. |
| Kugara kwenguva pfupi muchipatara | Unogona kudzokera kumba mumazuva 1-2. |
Hapana njodzi here mune izvi?
Sekunge kune chero kuvhiyiwa kupi zvako, pane njodzi diki, asi njodzi yacho yakaderera pane kuvhiyiwa kwedumbu.
- Kubuda ropa
- Kuva nehutachiona
- Kurwadziwa kwepadumbu kana padumbu
- Kuoma kwekuita weti ('Kuchengeta weti')
- Kuda kamwe kamwe kuita tsvina (`Fecal urgent`)
Kana chimwe chinhu chakadai chikaitika, vanachiremba vakagadzirira kuchirapa.
Kana uine zviratidzo izvi, enda kuna chiremba nekukasika.
Mushure mekudzokera kumba, kana ukaona chimwe chezviratidzo zvinotevera, fonera chiremba wako nekukasika kana kuenda kuEmergency Department (ETU) yechipatara.
- Kubuda ropa zvakanyanya
- Fivha kana kunzwa kutonhora
- Kuoma kwekuita weti
- Marwadzo asingatsungiririki mudumbu kana muhuro
Kana iri kenza, iyi ndiyo nzira chete yekurapa here?
Kana kenza yemudumbu ikaonekwa ichiri kutanga, uye bundu racho rikabviswa zvachose nekuvhiyiwa kweTEMS, mamwe marapirwo angasave akakosha. Zvisinei, kune vamwe vanhu, zvichienderana nerudzi rwebundu iri, chiremba wenyu anogona kukurudzira kurapwa nechemotherapy kana radiation pamusoro pekuvhiyiwa uku. Izvi zvese zvichaonekwa mushure mekuongorora mamiriro ako.
Mharidzo Yekuenda Nayo Kumba
- TEMS inzira yekuvhiya yemazuva ano, yakachengeteka, uye isingapindi muropa inoshandiswa kubvisa bundu remudumbu.
- Izvi zvinoita kuti kurwadziwa kushoma, kupora kukuru, uye kugara muchipatara kwenguva pfupi.
- Izvi hazvikodzeri munhu wese. Chiremba wako ndiye achasarudza kana zvichikukodzera iwe kana kwete.
- Zvakakosha kutevedzera mirairo yakapihwa usati wavhiyiwa (kuchenesa dumbu, kudya zvakanaka) nemazvo.
- Kunyangwe kana kupora kuchikurumidza, tarisa zviratidzo zvinonyevera zvakaita sefivha, kurwadziwa kwakanyanya, kana kubuda ropa. Kana ukaona chimwe cheizvi, tsvaga rubatsiro rwechiremba nekukasika.
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