Wake wahlolwa i-endoscopy udokotela wathi, "Kukhona isimila esincane esiswini sakho, sidinga ukusisusa"? Noma "Kukhona i-polyp encane emathunjini akho, masiyisuse ngaphambi kokuba ibe umdlavuza"? Uma uzwa lokho, cishe ucabanga ukuthi, "O, ukuhlinzwa?". Ungase uzibuze ukuthi kuzodingeka yini usike isisu sakho, uhlale esibhedlela izinsuku ezimbalwa, nokuthi kuzobangela ubuhlungu obungakanani. Kodwa ungajabula, ngoba akusikho konke okudinga ukuhlinzwa okukhulu. Namuhla sizokhuluma ngobuchwepheshe obuthuthukisiwe kakhulu nobuphephile obususa lezi zicubu ezingavamile ngaphakathi kwe-endoscopy tube yakho, ngaphandle kokusika isisu sakho.
Kuyini ukususwa kwe-Endoscopic Mucosal (EMR)?
Leli gama lingase lizwakale liyinkimbinkimbi kancane, kodwa empeleni lilula kakhulu. Ake silibize ngokuthi i-EMR ngamafuphi.
Kalula nje, lokhu akusihlinzwa. Kuyinqubo esusa izicubu ezingavamile ngaphakathi kwendlela yakho yokugaya ukudla, ngaphandle kokwenza noma yikuphi ukusikeka esiswini sakho. Lezi zicubu ezingavamile zingaba amangqamuzana omdlavuza, noma zingaba ukukhula okungaphambi komdlavuza okungaphenduka umdlavuza esikhathini esizayo.
Cabanga ngohlelo lwakho lokugaya ukudla njengepayipi elide. Amaseli angajwayelekile akhula odongeni lwangaphakathi lwaleli payipi (silibiza ngokuthi i-mucosa). Enqubweni ye-EMR, njengoba nje ubungenza nge-endoscopy, ipayipi elide, eliguquguqukayo elinekhamera enamathiselwe kulo (i-endoscope) lifakwa ngomlomo wakho noma e-rectum, endaweni lapho kukhona khona izicubu ezingajwayelekile, futhi esebenzisa amathuluzi amancane adluliselwa ngepayipi, udokotela ohlinzayo usika leso siqephu sezicubu asisuse.
Lokhu kwenziwa ngudokotela wezifo zamathumbu. Inzuzo enkulu yale ndlela ukuthi azikho izimbobo zangaphandle, ngakho-ke uzwa ubuhlungu obuncane kakhulu, futhi ungalulama ngokushesha futhi ubuyele empilweni yakho evamile.
Lolu hlelo lwe-EMR lusetshenziselwa ziphi izinhlobo zezifo?
Le ndlela isetshenziswa kakhulu ekwelapheni umdlavuza kanye nezimo ezingaphambi komdlavuza. Okubalulekile ukuthi le ndlela iphumelela kuphela uma lesi sifo sitholakala kusenesikhathi . Okusho ukuthi, lapho izicubu ezingavamile zingaphakathi kodonga lomphimbo.
Indlela ye-EMR isetshenziswa kakhulu ezimweni ezilandelayo:
- Umdlavuza we-Esophageal: Umdlavuza wesigaba sokuqala se-esophagus (ipayipi esigwinya ngalo ukudla).
- Umphimbo kaBarrett: Yilapho amangqamuzana angaphakathi komphimbo wakho eshintsha khona futhi abe namathuba amaningi okuthuthuka abe umdlavuza. Le nqubo isetshenziselwa ukususa la maseli angajwayelekile.
- Umdlavuza wesisu: Umdlavuza wesigaba sokuqala oqala phezu kodonga lwesisu.
- Umdlavuza we-Coloral:Le ndlela iphumelela kakhulu ekususeni ama-polyp noma umdlavuza wesigaba sokuqala ku-colon noma i-rectum.
- Umdlavuza wamathumbu amancane: Lokhu kusetshenziselwa nomdlavuza owenzeka engxenyeni yokuqala yamathumbu amancane (i-duodenum).
Into ebaluleke kakhulu ukuthola nokususa umdlavuza ngaphambi kokuba ukhule, ungene odongeni, bese usakazeka. I-EMR iyisisombululo esifanele salokho.
Ubani lokwelashwa okufanelekela kangcono?
Udokotela wakho uzonquma ukuthi ukwelashwa kwe-EMR kulungile yini kuwe. Kuncike ezintweni eziningana. Eziyinhloko ubukhulu bezicubu ezingavamile nokuthi zisakazeke kangakanani .
Lokhu kwelashwa ngokuvamile kungakufanelekela:
- Uma izicubu zakho ezingavamile (isimila noma isisindo) zincane ngobukhulu.
- Ngaphandle kokuthi ifinyelele ezingqimbeni ezijulile zodonga lomgudu wokugaya ukudla.
Kodwa-ke, uma isimila sikhulu noma singene sajula odongeni, i-EMR yodwa ingase inganele. Ezimweni ezinjalo, kungadingeka usebenzise ezinye izindlela zokwelapha.
| Indlela yokwelapha | Isimo sokusetshenziswa |
|---|---|
| I-EMR (Ukususwa Kwama-Mucosal Endoscopic) | Kuma-cancer amancane, angabalulekile asesigabeni sokuqala noma amaseli angase abe umdlavuza. |
| Ukususwa Kwe-Endoscopic Submucosal (ESD) | Enye indlela ye-endoscopic enkulu kancane kune-EMR futhi esetshenziselwa umdlavuza osungene wajula odongeni. |
| Ukuhlinzwa | Uma umdlavuza umkhulu, ujulile, noma ususakazekele kuma-lymph node, kwenziwa i-incision esiswini bese leyo ngxenye isuswa. |
| Ukwelashwa ngamakhemikhali / Ukwelashwa ngemisebe | Uma umdlavuza ususakazekele kwezinye izingxenye zomzimba noma njengokwelashwa okungeziwe ngaphambi/ngemva kokuhlinzwa. |
Ulungiselela kanjani le nqubo kusenesikhathi?
Udokotela wakho uzokunikeza imiyalelo ecacile yokuthi ungakulungiselela kanjani lokhu, futhi kubaluleke kakhulu ukuyilandela ngqo.
- Ngomgudu wokugaya ukudla ongaphezulu (umphimbo, isisu): Uzocelwa ukuthi uyeke ngokuphelele ukudla noma ukuphuza amahora amaningana ngaphambi kwenqubo. Lokhu kungenxa yokuthi udokotela angabona ngokucacile nangokuphepha izicubu uma isisu singenalutho.
- Ngamathumbu amakhulu (ikholoni): Ukuze wenze lokhu, kuzodingeka "ulungiselele amathumbu." Udokotela uzokunikeza umuthi okhethekile ( i-laxative ) ozowuphuza. Ngemva kokuphuza lokhu, kuzodingeka uye endlini yangasese njalo. Nakuba lokhu kungakhululeki kancane, kubalulekile ukwenza lokhu ukuze uhlanze kahle ingaphakathi lekholoni lakho. Lokhu kuzovumela udokotela ukuthi abone kahle lapho efaka ipayipi.
Kwenzekani phakathi nenqubo?
Sizothatha izinyathelo ezidingekayo ukuqinisekisa ukuthi awuzizwa ubuhlungu noma ukungakhululeki phakathi nale nqubo.
Uzofakwa ngaphansi kwe-anesthesia ejwayelekile , okusho ukuthi uzobe ulele ngokuphelele. Ngezinye izikhathi uzozizwa sengathi uvukile, kodwa ngeke ukhumbule lutho ngemva kwalokho (ukwelashwa ngokuthula kwengqondo) . Ngakho ngeke uzwe noma ukhumbule lutho.
Udokotela ulandela lezi zinyathelo:
1. Uma umgudu wakho wokugaya ukudla ongaphezulu uthintekile, ukwelashwa kwenziwa ngomlomo . Uma umgudu wakho wokugaya ukudla ongezansi uthintekile, ithubhu le-endoscope lifakwa kancane kancane nge-anus .
2. Kusetshenziswa ikhamera, ithubhu iqondiswa endaweni eqondile yezicubu ezingavamile.
3. Bese kuthi, kudlule amathuluzi amancane okuhlinza ngepayipi bese kususwa izicubu. Kunezindlela eziningana zokwenza lokhu. Ngezinye izikhathi izicubu ziyadonswa phezulu kusetshenziswa ukumunca, noma kufakwe uketshezi ngaphansi kwezicubu bese ziphakanyiswa bese zisikwa, noma zisikwe ngentambo kagesi.
4. Susa ngokucophelela ingcezu yethishu esusiwe.
Le nqubo yonke ivame ukuthatha imizuzu engama-30 kuya kwengama-60 .
Kwenzekani ngemva kwenqubo?
Ngemva kokuphela kokwelashwa, uzodluliselwa ekamelweni lokululama. Kuzodingeka uhlale ngaphansi kokuqashwa kwezokwelapha amahora ambalwa kuze kube yilapho imiphumela yomuthi wokubulala izinzwa iphela.
- Endleleni eya ekhaya:Njengoba kungathatha amahora angama-24 ukuthi imiphumela yomuthi wokubulala izinzwa iphele ngokuphelele, uzodinga umuntu ozokuthatha akuyise ekhaya. Ngeke uvunyelwe ukushayela noma ukuya ekhaya wedwa.
- Ukuhlolwa kwezicubu: Izicubu ezisusiwe zithunyelwa elabhorethri. Lapho, isazi sezifo sizihlola ngaphansi kwe-microscope bese sihlinzeka ngombiko onemininingwane, okuhlanganisa ukuthi zinamangqamuzana omdlavuza yini, ukuthi zisusiwe ngokuphelele yini, nokuthi zinjani.
Ingabe kukhona imiphumela emibi emincane?
Yebo, ungase uzwe ukungakhululeki okuncane usuku olulodwa noma ezimbili. Lokhu kujwayelekile futhi kuzophela ngokushesha.
- Ukuqunjelwa
- Ubuhlungu besisu (Ukuqaqamba kwesisu)
- Ubuhlungu begesi kanye nokuqunjelwa
- Isicanucanu noma ukuhlanza
- Umphimbo obuhlungu kancane uma ipayipi lifakwe ngomlomo
Lokhu kuvame ukuphola ngokuphelele phakathi nosuku noma ezimbili.
Yiziphi izinzuzo nezingozi zalolu hlelo lwe-EMR?
Njenganoma yikuphi ukwelashwa kwezokwelapha, kunezinzuzo kanye nezingozi ezincane kakhulu.
| Izinzuzo | Izingozi - (Akuvamile kakhulu) |
|---|---|
| Umdlavuza ungasuswa ngaphambi kokuba ukhule futhi usabalale. | Ukopha: Kungase kube nokopha okuncane endaweni lapho kususwa khona izicubu. Lokhu kuvame ukulawulwa ngesikhathi se-endoscopy. |
| Akusikeki isisu njengokuhlinzwa okukhulu. | Ukubhoboza kwamathumbu: Akuvamile ukuthi ipayipi noma umshini ubhoboze udonga. Lokhu kuyisimo esiphuthumayo. |
| Ubuhlungu buncane kakhulu. | Ukuqina kwesisu: Uma kususwa inani elikhulu lezicubu emqaleni, indawo ingase inciphe ngenxa yezibazi ezenzeka ngesikhathi sokuphulukiswa. |
| Uzolulama ngokushesha futhi ukwazi ukubuyela emsebenzini ngosuku olulodwa noma ezimbili. | |
| Akukho zibazi ezisele ngaphandle komzimba. |
Kuvamile ukuzizwa wesaba uma uzwa igama elithi “umdlavuza.” Kodwa ngobuchwepheshe obusha njenge-EMR, kungenzeka ukwelapha lezi zinto ezigabeni zazo zokuqala ngaphandle kokuhlinzwa okukhulu.
Kuthatha isikhathi esingakanani ukuphulukiswa futhi yini okufanele ngiyenze ngemva kwalokho?
Enye yezinzuzo ezinkulu zendlela ye-EMR ukululama okusheshayo.
- Ukuya emsebenzini: Iningi labantu lingabuyela emisebenzini yalo evamile ngosuku olulandelayo .
- Ukudla: Udokotela wakho cishe uzoncoma ukudla okumanzi izinsuku ezimbalwa kuze kube yilapho umgudu wakho wokugaya ukudla uphola. Ngemva kwalokho, ungabuyela kancane kancane ekudleni okuvamile.
- Ukulandelela: Uzocelwa ukuthi ubuye uzobona udokotela wakho cishe emavikini ayi-12 ngemuva kokwelashwa kwakho. Kuzokwenziwa i-endoscopy ukuhlola ukuthi zonke izicubu ezingavamile zisusiwe ngokuphelele nokuthi indawo ipholile kahle yini. Ngokusekelwe embikweni wezicubu, kuzothathwa isinqumo sokuthi udinga ukwelashwa okwengeziwe noma cha.
Yiziphi izimo eziphuthumayo ezidinga ukufonela udokotela?
Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo ngemva kokwelashwa, ungazinaki. Shayela udokotela wakho ngokushesha, noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze ngokushesha.
- Uma unegazi esithweni sakho (esimnyama noma esibomvu ngokumnyama)
- Ubuhlungu obukhulu besifuba
- Uma uzizwa unesizungu noma uphelelwa amandla .
- Uma unomkhuhlane noma ukubanda nokuthuthumela
- Ubunzima bokuphefumula (ukuphelelwa umoya)
Lokhu kungaba izimpawu zezinkinga esixoxe ngazo ekuqaleni, ngakho-ke kubalulekile ukufuna usizo lwezokwelapha ngokushesha.
I-EMR akuyona indlela enkulu yokuhlinzwa, inqubo engeyiningi kakhulu. Ubuchwepheshe besimanje obufana nabu bungasiza ekunciphiseni ukwesaba nokukhathazeka okuhambisana nokwazi ukuthi unomdlavuza noma usengozini yokuba nomdlavuza. Uma kuqhathaniswa nesikhathi sokululama kanye nobuhlungu ngemva kokuhlinzwa okukhulu, i-EMR ikuvumela ukuthi ubuyele empilweni enempilo ngokushesha okukhulu.
Umlayezo Wokuya Nawe Ekhaya
- Ukuhlinzwa kwe-Endoscopic Mucosal (EMR) akuyona indlela enkulu yokuhlinzwa. Kuyindlela yokwelapha eyenziwa nge-endoscope, ngaphandle kokusikwa kwesisu.
- Le nqubo ingasusa umdlavuza osesigabeni sokuqala kanye namaseli angajwayelekile angaphenduka umdlavuza endleleni yokugaya ukudla.
- Uma kuqhathaniswa nokuhlinzwa kwendabuko, lokhu akubuhlungu kakhulu, isikhathi sokululama sifushane kakhulu , futhi azikho izibazi zangaphandle emzimbeni.
- Kubaluleke kakhulu ukulandela imiyalelo kadokotela (ukuzila ukudla, ukuhlanza isisu, ukudla okudlayo) ngaphambi nangemva kokwelashwa.
- Uma uhlangabezana nanoma yiziphi izimpawu eziyisixwayiso ngemva kokwelashwa, njengomkhuhlane, ubuhlungu obukhulu, noma igazi esitulweni sakho, yazisa udokotela wakho ngokushesha noma uye esibhedlela.
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