Kuqhelekile ukuba noloyiko xa ugqirha wakho ekuxelela ukuba unethumba kwi-rectum yakho, inxalenye esezantsi yamathumbu akho amakhulu. Usenokuba ucinga, "Owu, kuza kufuneka ndisike isisu sakho, kuza kufuneka ndihlale esibhedlele iintsuku ezimbalwa, kuza kuba buhlungu kakhulu," akunjalo? Kodwa ungakhathazeki. Ubuchwepheshe buhambele phambili kakhulu namhlanje. Namhlanje, sithetha nge- Transanal Endoscopic Microsurgery (TEMS) , inkqubo ekhethekileyo yotyando esusa iithumba ezinje ngaphandle kokwenza naziphi na iziqwenga esiswini sakho, kusetyenziswa izixhobo ezincinci ezifakwe kwi-rectum yakho.
Ngamafutshane, yintoni i-TEMS?
I-TEMS yindlela yotyando engangenisi mandla kangako esetyenziselwa ukususa iithumba kunye nomhlaza omncinci kwi-rectum yakho. Ngaphambili, ukususa ithumba kwi-rectum yakho bekuya kufuna utyando olukhulu lwesisu. Kule nkqubo ye-TEMS, ugqirha wotyando ufaka isixhobo esikhethekileyo nge-anus yakho aze asebenzise ikhamera encinci kunye nezixhobo zotyando ukususa ithumba.
Eyona nzuzo inkulu yoku kukuba ekubeni kungekho ziqaqa ngaphandle komzimba , akuyi kuva iintlungu zingako, uphole ngokukhawuleza, kwaye uya kuba neengxaki ezimbalwa kunasemva kotyando olukhulu.
Yintoni umahluko phakathi kwe-TEM kunye ne-TAMIS?
Usenokuba ukhe weva ngeTAMIS. Zombini ezi ndlela ziyafana kancinci, kodwa kukho umahluko omncinci.
- I-TEMS (i-Transanal Endoscopic Microsurgery): Le sixhobo sisebenzisa isixhobo eside, esityebileyo esifana netyhubhu ebizwa ngokuba yi-"Rectoscope." Ikhamera kunye nezinye izixhobo zidluliselwa kule tyhubhu.
- I-TAMIS (Utyando oluNcinci oluNgcwabayo ngeTransanal): Olu tyando lusebenzisa i-port encinci, engqukuva, eguquguqukayo, efana nejeli. Lufakwa nge-anus kwaye i-tumor isuswe kusetyenziswa izixhobo ezifanayo ezisetyenziswa kutyando lwe-laparoscopic.
Ugqirha uza kuvavanya imeko yakho aze akhethe indlela ekufaneleyo ngokusekwe kwindawo ekuyo ithumba.
Ngubani ongcono kakhulu utyando lwe-TEMS?
Olu tyando alulungelanga wonke umntu, kodwa kwezinye iimeko lukhetho oluhle kakhulu.
- Kwabo banengxaki yokunyamezela utyando olukhulu ngenxa yezinye iingxaki zempilo (umz. isifo sentliziyo, isifo seswekile).
- Kwabo banomhlaza wamathumbu okwinqanaba lokuqala.
- Kubantu abancinci abanezimila ezingengomhlaza (ezingenobungozi).
- Nabani na ofuna ukuphepha utyando olukhulu, ukuba ugqirha ugqiba kwelokuba kufanelekile.
Nangona kunjalo, ukuba indawo yomqolo wakho yenza kube nzima ukuba isixhobo sifikelele kwithumba, okanye ukuba i-rectum yakho inciphile (stenosis), le nkqubo isenokungenzeki. Konke oku kumiselwa ngugqirha wakho.
Iimeko ezinyangwa ngotyando lwe-TEMS
Olu tyando ludla ngokwenziwa ukususa iithumba kwi-rectum. Lusetyenziswa ukunyanga ezi meko zilandelayo:
| Imeko yezonyango | Ingcaciso elula |
|---|---|
| Izimila ezingengobungozi emathunjini | Iithumba eziqhelekileyo ezingabi ngumhlaza. |
| Umhlaza wamathumbu | Ingakumbi iithumba ezinomhlaza kwizigaba zokuqala. |
| Iipolyps ezisemacaleni | Ii-cysts ezincinci ezikhula kwi-membrane ye-rectum. |
| I-Fistula | Iipaseji ezincinci ezinentsholongwane ezithi zibe phakathi kwempundu nolusu olujikelezileyo. |
| Ukuhla kwe-rectal | Inxalenye ye-rectum ephuma emngxunyeni wempundu. |
| Ukuncitshiswa kwe-rectum (iiStrictures) | I-rectum iye yaba mxinwa ngesizathu esithile. |
Uzilungiselela njani ngaphambi kotyando?
Ukulungiselela oku kufana nokulungiselela i-colonoscopy. Eyona nto iphambili kukucoca amathumbu akho ngokupheleleyo . Oku kuya kuvumela ugqirha ukuba abone kakuhle ingaphakathi le-rectum yakho. Ngenxa yesi sizathu, ugqirha wakho uya kukunika i-laxative ekhethekileyo.
Ngokwesiqhelo uza kufumana imiyalelo efana nale:
- Kuphephe ukutya ukutya okuqinileyo ngosuku olungaphambi kotyando.
- Sela kuphela ulwelo olucacileyo (amanzi, amanzi anetyuwa, iJeevani) iiyure ezili-12-24 ngaphambi kotyando.
- Kuphephe ukutya okanye ukusela nantoni na ukususela ezinzulwini zobusuku ngomhla wotyando.
- Ukuba uthatha nantoni na efana ne-blood thinners, qiniseka ukuba uxelela ugqirha wakho ngayo kwaye uyeke ukuyithatha kwiintsuku ezimbalwa ngaphambi kwexesha, ngokwecebiso lakhe.
Eyona nto ibalulekileyo kukulandela yonke imiyalelo enikwe ngugqirha ngokuchanekileyo. Oku kubaluleke kakhulu ukuze utyando luphumelele.
Kwenzeka ntoni ngexesha lotyando?
Awuyi kuva nto ngeli xesha lenkqubo kuba utyando luza kwenziwa phantsi kwe-anesthesia eqhelekileyo, oko kuthetha ukuba uza kube ulele ngokupheleleyo. Nantsi into eyenzekayo ngexesha lotyando:
1. Ugqirha ufaka isixhobo esithi ``Rectoscope``` ngomngxuma wempundu ukuya kwi-rectum.
2. I-rectum igcwele igesi kancinci ukuze ibone kakuhle indawo ejikeleze ithumba.
3. Ikhamera kunye nezixhobo zotyando ezithambileyo zifakwa nge-rectoscope kwaye ithumba okanye i-polyp, kunye nezinye izicwili eziphilileyo ezijikelezileyo, ziyasikwa zize zisuswe.
4. Emva koko isikrweqe siyavalwa ngezititshi ezinyibilikayo okanye ngezikliphu ezincinci zesinyithi.
Kunjani emva kotyando?
Usenokungakhululeki emva kotyando. Kwiiyure ezingama-24 zokuqala, unokufumana oku kulandelayo:
- Ityhubhu (`catheter`) efakwe kwisinyi sakho ukuze ikhuphe umchamo.
- Nika umzimba ulwelo olufunekayo nge-saline infusion (umgca we-IV) emthanjeni osengalweni yakho.
- Ii-antibiotics (ii-antibiotics ezine-IV) ezinikwa nge-saline kangangeeyure ezingama-24 ukuthintela usulelo.
Ungaqala ukutya nokusela malunga nosuku emva kotyando. Ngokwesiqhelo uya kukwazi ukuya ekhaya emva kosuku okanye ezimbini esibhedlele .
Zithini iingenelo zale ndlela?
Indlela ye-TEMS ineengenelo ezininzi kune-laparotomy. Utyando olukhulu ngamanye amaxesha lunokubangela iingxaki zokulawula umchamo, ukungasebenzi kakuhle ngokwesondo, kwanokufuneka kwe-colostomy esisigxina. Indlela ye-TEMS inciphisa uninzi lwale mingcipheko.
| Inzuzo | Ingcaciso |
|---|---|
| Ukopha kancinci | Ukopha kuncinci kakhulu kuba akukho kusikwa. |
| Iingxaki ezimbalwa | Iingozi zosulelo kunye nokuvaleka kwamathumbu ziphantsi. |
| Ukubuyela umva ngokukhawuleza | Imisebenzi eqhelekileyo ingaqala ngosuku olunye ukuya kwezimbini. |
| Ukuhlala ixesha elifutshane esibhedlele | Ngokwesiqhelo ungabuyela ekhaya kwiintsuku ezi-1-2. |
Akukho mngcipheko na koku?
Njengakwezinye iintlobo zotyando, kukho umngcipheko omncinci, kodwa umngcipheko uphantsi kakhulu kunowokugoba isisu.
- Ukopha
- Ukuba nosulelo
- Intlungu emqolo okanye esiswini
- Ubunzima bokuchama (`Ukugcinwa komchamo`)
- Ukufuna ukuya ngasese ngequbuliso (`ungxamiseko lwendle`)
Ukuba kwenzeka into efana nale, oogqirha bakulungele ukuyinyanga.
Ukuba unale mpawu, bonana nogqirha ngokukhawuleza.
Emva kokubuyela ekhaya, ukuba ufumana naziphi na kwezi mpawu zilandelayo, fowunela ugqirha wakho ngoko nangoko okanye uye kwiSebe lezeMpilo eziNgxamisekileyo (ETU) lesibhedlele.
- Ukopha kakhulu
- Umkhuhlane okanye ukuziva ubanda
- Ubunzima bokuchama
- Intlungu yesisu okanye ye-rectal enganyamezelekiyo
Ukuba ngumhlaza, ngaba lo kuphela unyango olu?
Ukuba umhlaza wesisu ufunyenwe kwisigaba sawo sokuqala, kwaye ithumba lisuswe ngokupheleleyo ngotyando lwe-TEMS, olunye unyango lusenokungabi yimfuneko. Nangona kunjalo, kwabanye abantu, kuxhomekeke kuhlobo lwethumba, ugqirha wakho unokucebisa unyango lwe-chemotherapy okanye i-radiation ukongeza kolu tyando. Konke oku kuya kugqitywa emva kokuhlola imeko yakho.
Umyalezo Wokuya Ekhaya
- I-TEMS yinkqubo yotyando yanamhlanje, ekhuselekileyo, nengangenisi ntsholongwane esetyenziselwa ukususa iithumba ezisemathunjini.
- Oku kubangela ukuba iintlungu zingabi ninzi, kukhawuleze ukuchacha, kwaye umntu ahlale ixesha elifutshane esibhedlele.
- Oku akufanelekanga kuwo wonke umntu. Ugqirha wakho uya kugqiba ukuba oku kufanelekile na kuwe okanye akunjalo.
- Kubaluleke kakhulu ukulandela imiyalelo enikiweyo ngaphambi kotyando (ukucoca isisu, ukutya okunesondlo) ngokuchanekileyo.
- Nokuba uphola ngokukhawuleza, khangela iimpawu ezilumkisayo ezinje ngomkhuhlane, iintlungu ezigqithisileyo, okanye ukopha. Ukuba ubona nayiphi na kwezi, funa ingcebiso kagqirha ngokukhawuleza.
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