Ngaba ugqirha wakho ukuxelele ukuba unezicubu ezincinci ezingaqhelekanga, ithumba, okanye i-polyp kwinkqubo yakho yokugaya ukutya, oko kukuthi, esiswini sakho okanye emophagus? Xa sisiva oko, uloyiko oluza engqondweni yethu kukuba, "Owu, ngaba kuya kufuneka ndenze utyando olukhulu ngoku?" Kodwa ngesayensi yezonyango yanamhlanje ephucukileyo, akukho mfuneko yokwenza utyando olubangela ukunqunyulwa okukhulu kuyo yonke into. Yiyo loo nto siza kuthetha ngendlela yonyango emangalisayo enokubangela umonakalo omncinci emzimbeni kwaye iphiliswe ngokukhawuleza.
Ngamafutshane, yintoni i-Endoscopic Submucosal Dissection?
Nangona igama lisenokuvakala liyinkimbinkimbi kancinci, le nkqubo ilula kakhulu. I-Endoscopic Submucosal Dissection , okanye i-ESD ngamafutshane, yinkqubo engangenisi ntsholongwane esusa izicubu ezingaqhelekanga, amaqhuma eeseli anokuba ngumhlaza, okanye amaqhuma amancinci ngaphakathi kwindlela yakho yokugaya ukutya.
Khawuthelekelele oku kwenziwa yingcali yezifo zamathumbu. Usebenzisa ityhubhu ende, eguquguqukayo enekhamera ekupheleni. Oku sikubiza ngokuba yi-endoscope.
- Ukuba ingxaki ikwinkqubo yakho yokugaya engasentla (umzekelo, umphimbo, isisu), le endoscope ifakwa ngomlomo wakho.
- Ukuba ingxaki ikwindlela yakho yamathumbu esezantsi (amathumbu amakhulu, i-rectum), ifakwa nge-anus.
Oku kwenziwa kusetyenziswa isixhobo sotyando esincinci esifakwa kwityhubhu, kwaye phantsi kwesikhokelo sekhamera, sisetyenziselwa ukusika nokususa ngononophelo izicubu ezingaqhelekanga. Eyona nto ingcono kukuba, konke oku kwenzeka ngaphakathi emzimbeni. Ekubeni kungekho mingxunya yangaphandle, ungaphila ngokukhawuleza, ube neentlungu ezimbalwa, kwaye uphephe amanxeba.
Zeziphi iintlobo zeemeko zonyango ezisetyenziselwa i-ESD?
Olu nyango lwe-ESD ludla ngokusetyenziselwa ukususa umhlaza ongaphambi komhlaza okanye okwinqanaba lokuqala kwinkqubo yokugaya ukutya. Makhe sijonge ukuba ziintoni.
| Imeko yezonyango | Ingcaciso elula |
|---|---|
| Umphimbo kaBarrett | Imeko apho ulwelo lwe-esophagus (umbhobho wokutya) lutshintsha khona, kwaye ekuhambeni kwexesha, kukho umngcipheko wokuba nomhlaza. |
| Umhlaza weColoral | Iithumba zomhlaza ezikwinqanaba lokuqala ezikhula kwikholoni okanye kwi-rectum. |
| Umhlaza wesisu | Umhlaza wesigaba sokuqala somqala. |
| Umhlaza wamathumbu amancinci | Umhlaza okhula emathunjini amancinci, ingakumbi i-duodenum, inxalenye yayo yokuqala. |
| Umhlaza wesisu | Iimeko zomhlaza zesigaba sokuqala ezenzeka eludongeni lwesisu. |
Yintoni umahluko phakathi kwe-ESD kunye ne-EMR?
Usenokuba ukhe weva ngenye inkqubo efanayo, ebizwa ngokuba yi -Endoscopic Mucosal Resection (EMR) . Nangona zombini ezi nkqubo zingangenisi kakhulu, kukho umahluko omncinci.
Udonga lwenkqubo yethu yokugaya ukutya lwenziwe ngamaleko aliqela. Inwebu ebhityileyo engaphakathi ibizwa ngokuba yi-mucosa.
- Indlela ye-EMR: Oku kususa ikakhulu iithumba ezikwindawo engaphakathi ebizwa ngokuba yi-mucosa. Oku kuquka ukufaka ulwelo phantsi kwethumba, ukuliphakamisa, nokulisika ngento efana neluphu yesinyithi.
- Indlela ye-ESD: Le yindlela ephucuke kancinci kune-EMR. Ingasusa iithumba ezikwi-mucosa, kunye neethumba ezisasazeke kumaleko angaphantsi kwayo. Eyona nzuzo inkulu yoku kukuba izicubu ezingaqhelekanga, nokuba zinkulu kangakanani na, zinokususwa zibe yingcezu enye . Emva koko kulula ukuyithumela kwilebhu kwaye uqinisekise ngokuchanekileyo ukuba umhlaza ususiwe ngokupheleleyo na.
Ngamafutshane, indlela ye-EMR ilungele kakhulu iithumba ezincinci ezingaphezulu. Indlela ye-ESD isetyenziselwa ukususa iithumba ezinkulu okanye ezinzulu kwiqhekeza elinye.
Ndingazilungiselela njani ngaphambi kolu nyango?
Ugqirha wakho uza kukunika imiyalelo ecacileyo ngaphambi kolu nyango. Kubaluleke kakhulu ukuyilandela ngokuchanekileyo.
- Ukuba unyangwa kwindlela ephezulu yesisu: (umphimbo, isisu) kuya kufuneka uyeke ngokupheleleyo ukutya nokusela kangangeeyure ezimbalwa ngaphambi konyango. Oku kuthetha ukuba isisu sakho kufuneka singabi nanto.
- Ukuba unyangwa indlela yakho esezantsi yokugaya ukutya: (amathumbu amakhulu), uya kucelwa ukuba wenze "ulungiselelo lwamathumbu." Oku kuquka ukukhupha amathumbu akho amakhulu ngokupheleleyo ngokusela ulwelo olukhethekileyo ( i-laxative ). Oku kuvumela ugqirha ukuba abone ngaphakathi ngokucacileyo nge-endoscope.
Kwenzeka ntoni ngexesha lonyango?
Awuyi kuva ntlungu okanye ukungonwabi ngexesha lonyango. Oku kungenxa yokuba uza kufakwa i-anesthesia. Usenokulaliswa ngokupheleleyo (i-General Anesthesia), okanye unganikwa uhlobo lwe-anesthesia olukwenza uzive ulele kwaye ukhululekile (i-Monitored Anesthesia Care).
Ngexesha lonyango, ugqirha wakho uza kulandela la manyathelo:
1. I-endoscope ifakwa ngomlomo okanye kwi-rectum.
2. Ngokusebenzisa ikhamera, i-endoscope ithunyelwa apho kukho izicubu ezingaqhelekanga.
3. Kusetyenziswa isixhobo esidluliswa kwi-endoscope, kwenziwa uphawu olujikeleze ithumba ukuze lisuswe.
4. Okulandelayo, kufakwa ulwelo olukhethekileyo kwi-membrane engaphantsi kwethumba. Oku kudala umqamelo ongaphantsi kwethumba, uliphakamise kwizicubu eziphilileyo ezijikelezileyo. Oku kwenza kube lula ukulihlula nokulisika.
5. Okokugqibela, kusetyenziswa isixhobo esikhethekileyo esifana nemela yombane esetyenziswa rhoqo, ithumba liyasikwa ngononophelo kumgca ophawulweyo lize lisuswe.
Lonke olu tyando ludla ngokuthatha iyure enye ukuya kwezintathu , kuxhomekeke kubukhulu nendawo ekuyo izicubu ezisusiweyo.
Kwenzeka ntoni emva konyango?
Emva kokuba unyango lugqityiwe, izicubu ezisusiweyo zithunyelwa kwilebhu apho ingcali yezifo izihlola khona ukuze ibone ukuba zinazo na iiseli zomhlaza kwaye nokuba zisusiwe ngokupheleleyo na.
Uza kusiwa kwigumbi lokuchacha ixesha elifutshane emva konyango. Xa iziphumo ze-anesthesia ziphelile ngokupheleleyo, unokukwazi ukuya ekhaya ngaloo mini inye, okanye unokufuna ukuhlala esibhedlele ubusuku bonke. Ngokuqinisekileyo kufuneka ukhatshwe ngumntu oza kuhamba naye ekhaya , njengoko kungathatha ukuya kuthi ga kwiiyure ezingama-24 ukuba iziphumo ze-anesthesia ziphele ngokupheleleyo.
Ngaba kukho iziphumo ebezingalindelekanga kunye neengozi?
Njengakwezinye iindlela zonyango, kukho iziphumo ebezingalindelekanga ezincinci kunye neengozi ezingaqhelekanga.
Iziphumo ebezingalindelekanga ezincinci ezinokubakho
Ezi zifo zihlala ziphela ngokupheleleyo kungekapheli usuku okanye ezimbini.
- Ukuzalisa isisu
- Isisu esibuhlungu
- Igesi kunye nentlungu ebangela yona
- Isicaphucaphu okanye ukuhlanza
- Umphimbo obuhlungu (ukuba i-endoscope ifakwe ngomlomo)
Kusenokuba yinto eqhelekileyo ukuba negazi elincinci kakhulu esitulweni sakho, kodwa kufuneka liphele zingadlulanga iiyure ezingama-24.
Iingxaki ezingaqhelekanga
Amathuba okuba ezi zinto zenzeke mancinci kakhulu, kodwa kubalulekile ukuba uzazi.
- Ukopha: Ukopha kwindawo yokususwa kwezicubu.
- Ukugqobhoka kwamathumbu: Ukugqobhoka kodonga lwendlela yokugaya ukutya nge-endoscope okanye isixhobo.
- Amanxeba: Ingakumbi xa kunyangwa umphimbo, amanxeba ayenzeka ngexesha lokuphiliswa anokubangela ukuba umphimbo unciphe (ii-esophageal strictures).
Zithini iingenelo zale ndlela?
Indlela ye-ESD ineengenelo ezininzi xa ithelekiswa notyando oluvulekileyo.
- Iintlungu ezingaphantsi: Iintlungu zincinci kakhulu kuba akukho zisikwe.
- Ukuchacha ngokukhawuleza: Ungabuyela kubomi obuqhelekileyo kwaye usebenze ngokukhawuleza.
- Akukho zikrweqe: Akukho zikrweqe zibonakalayo ngaphandle komzimba.
- Iingxaki ezimbalwa: Kukho umngcipheko omncinci weengxaki kunotyando oluvulekileyo.
- Ukugcinwa kwamalungu omzimba: Le ndlela ingaziphepha izinto ezifana nokususa inxalenye yesisu okanye yamathumbu ebezinokwenziwa ngexesha lotyando olukhulu.
Ufanele uye nini kugqirha ngoko nangoko?
Xa ubuyela ekhaya emva konyango, ukuba ufumana naziphi na iimpawu ezilumkisayo, kubaluleke kakhulu ukufowunela ugqirha wakho okanye uye kwiSebe lezeMpilo eziNgxamisekileyo (ETU) elikufutshane ngaphandle kokulibazisa .
| Iimpawu zesilumkiso - qaphela ngokukhawuleza! | |
|---|---|
| Uphawu | Inkcazo |
| Igazi esitulweni | Ukuba kukho igazi elininzi esitulweni, kunokubakho ibala elincinci kwiphepha langasese. |
| Iintlungu zesifuba | Intlungu yesifuba eqatha ngequbuliso. |
| Isiyezi okanye ukuba nentloko ebuhlungu | Ukuba uziva unesizungu okanye utyhafile. |
| Umkhuhlane okanye ukubanda | Ukuba uziva ngathi unomkhuhlane okanye uyangcangcazela. |
| Ubunzima bokuphefumla (i-Dyspnea) | Ukuba unengxaki yokuphefumla okanye uziva ufuthanisekile. |
| Ukuhlanza igazi | Ukuba uhlanza igazi. |
Kuthatha ixesha elingakanani ukuphiliswa?
Uninzi lwabantu lunokubuyela emsebenzini emva kweentsuku ezintlanu. Nangona kunjalo, ukuba wenza umsebenzi onzima kakhulu, njengokuphakamisa izinto ezinzima, ugqirha wakho unokukucebisa ukuba uphumle ixesha elide. Kunokubakho utshintsho oluncinci kwindlela osebenza ngayo esiswini kangangeveki emva konyango.
Uza kuphinda ubonane nogqirha wakho emva kweeveki ezimbini. Ngelo xesha, baza kukuchazela iziphumo zengxelo yelabhoratri baze bagqibe kwelokuba kufuneka unyango olongezelelweyo okanye hayi.
I-ESD lunyango oluphumelele kakhulu. Ezinye izifundo zibonise ukuba umngcipheko wokuba ithumba liphinde libuye kwindawo enye kubantu abaye balufumana olu nyango uphantsi njenge-1%.
Umyalezo Wokuya Ekhaya
- I-Endoscopic Submucosal Dissection (ESD) yindlela yonyango ephucukileyo nengenabungozi kangako esusa izicubu ezingaqhelekanga kwindlela yokugaya ukutya.
- Ekubeni oku kungabandakanyi ukugruzuka okukhulu, iintlungu azinciphi, ixesha lokuphola alincinci, kwaye akukho zikrweqe.
- Oku kususa izicubu ezingaqhelekanga zibe yinxalenye enye, ukuze kuqinisekiswe ngokuchanekileyo ukuba umhlaza ususiwe ngokupheleleyo na.
- Ukuba kukho naziphi na iimpawu ezilumkisayo (umz., ukopha kakhulu, umkhuhlane, iintlungu zesifuba) emva konyango, funa ingcebiso kagqirha ngokukhawuleza.
- Ukuba uneminye imibuzo malunga noku, ungoyiki ukuthetha nogqirha wakho ukuze ufumane yonke into ecacileyo.
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