Ingabe udokotela wakho ukutshelile ukuthi unezicubu ezincane ezingavamile, isimila, noma i-polyp ohlelweni lwakho lokugaya ukudla, okungukuthi, esiswini sakho noma emhubheni? Uma sizwa lokho, ukwesaba okufika engqondweni yethu ukuthi, "O, kuzomele ngenze ukuhlinzwa okukhulu manje?" Kodwa ngesayensi yezokwelapha ethuthukisiwe yanamuhla, asikho isidingo sokwenza ukuhlinzwa okubangela ukusikwa okukhulu kukho konke. Yingakho sizokhuluma ngendlela yokwelapha emangalisayo engabangela umonakalo omncane emzimbeni futhi iphole ngokushesha.
Kalula nje, kuyini i-Endoscopic Submucosal Dissection?
Nakuba igama lingase lizwakale liyinkimbinkimbi kancane, inqubo empeleni ilula kakhulu. I-Endoscopic Submucosal Dissection , noma i-ESD ngamafuphi, inqubo engahlaseli esusa izicubu ezingavamile, izigaxa zamaseli ezingaba umdlavuza, noma izimila ezincane ngaphakathi kwendlela yakho yokugaya ukudla.
Cabanga ngalokhu kwenziwa udokotela wezifo zamathumbu. Usebenzisa ipayipi elide neliguquguqukayo elinekhamera ekugcineni. Lokhu sikubiza ngokuthi i-endoscope.
- Uma inkinga isesimisweni sakho sokugaya ukudla esingaphezulu (isibonelo, umphimbo, isisu), le endoscope ifakwa ngomlomo wakho.
- Uma inkinga isemgudwini wakho wamathumbu angaphansi (amathumbu amakhulu, i-rectum), ifakwa nge-anus.
Lokhu kwenziwa kusetshenziswa ithuluzi elincane lokuhlinza elifakwa epayipini, futhi ngaphansi kwesiqondiso sekhamera, lisetshenziselwa ukusika nokususa ngokucophelela izicubu ezingavamile. Ingxenye engcono kakhulu ukuthi, konke lokhu kwenzeka ngaphakathi emzimbeni. Njengoba kungekho ukusikwa kwangaphandle, ungalulama ngokushesha, ube nobuhlungu obuncane, futhi ugweme ukuba nezibazi.
Yiziphi izinhlobo zezimo zezokwelapha i-ESD esetshenziselwa zona?
Lokhu kwelashwa kwe-ESD kuvame ukusetshenziselwa ukususa umdlavuza ongaphambi komdlavuza noma osesigabeni sokuqala ohlelweni lokugaya ukudla. Ake sibheke ukuthi uyini.
| Isimo sezokwelapha | Incazelo elula |
|---|---|
| Umphimbo kaBarrett | Isimo lapho ulwelwesi lwe-esophagus (ipayipi lokudla) lushintsha khona, futhi ngokuhamba kwesikhathi, kunengozi yokuba nomdlavuza. |
| Umdlavuza we-Colorectal | Izimila zomdlavuza eziqala esigabeni sokuqala ezakheka emathunjini noma emathunjini. |
| Umdlavuza we-Esophageal | Umdlavuza wesigaba sokuqala somqala. |
| Umdlavuza wamathumbu amancane | Umdlavuza okhula emathunjini amancane, ikakhulukazi i-duodenum, ingxenye yawo yokuqala. |
| Umdlavuza wesisu | Izimo zomdlavuza zesigaba sokuqala ezenzeka odongeni lwesisu. |
Uyini umehluko phakathi kwe-ESD ne-EMR?
Kungenzeka ukuthi uke wezwa ngenye inqubo efanayo, ebizwa ngokuthi i-Endoscopic Mucosal Resection (EMR) . Nakuba zombili lezi zinqubo zingangenisi kakhulu, kunomehluko omncane.
Udonga lohlelo lwethu lokugaya ukudla lwakhiwe ngezingqimba eziningana. Ulwelwesi oluncane olungaphakathi lubizwa ngokuthi i-mucosa.
- Indlela ye-EMR: Lokhu kususa kakhulu izimila ezisesendlaleloni esingaphakathi esibizwa ngokuthi i-mucosa. Lokhu kuhilela ukufaka uketshezi ngaphansi kwesimila, ukusiphakamisa, nokusinquma ngento efana neluphu yensimbi.
- Indlela ye-ESD: Lena indlela ethuthuke kancane kune-EMR. Ingasusa izimila ezise-mucosa, kanye nezimila ezisakazeke kuze kube ungqimba olungaphansi kwayo. Inzuzo enkulu yalokhu ukuthi izicubu ezingavamile, kungakhathaliseki ukuthi zinkulu kangakanani, zingasuswa zibe yingcezu eyodwa . Ngemuva kwalokho kulula ukuyithumela elabhorethri futhi uqinisekise ngokunembile ukuthi umdlavuza usususiwe ngokuphelele.
Kalula nje, indlela ye-EMR ifaneleka kakhulu ezimila ezincane ezingajulile. Indlela ye-ESD isetshenziselwa ukususa izimila ezinkulu noma ezijulile ngengxenye eyodwa.
Ngingalungiselela kanjani ngaphambi kwalokhu kwelashwa?
Udokotela wakho uzokunikeza imiyalelo ecacile ngaphambi kwalokhu kwelashwa. Kubaluleke kakhulu ukuyilandela kahle.
- Uma welashwa ngendlela yokugaya ukudla engenhla: (umphimbo, isisu) kuzodingeka uyeke ngokuphelele ukudla nokuphuza amahora amaningana ngaphambi kokwelashwa. Lokhu kusho ukuthi isisu sakho kumele singabi nalutho.
- Uma welashwa umgudu wakho ongezansi wokugaya ukudla: (amathumbu amakhulu), uzocelwa ukuba "ulungiselele amathumbu." Lokhu kuhilela ukukhipha amathumbu akho amakhulu ngokuphelele ngokuphuza uketshezi olukhethekile ( i-laxative ). Lokhu kuvumela udokotela ukuthi abone ingaphakathi ngokucacile nge-endoscope.
Kwenzekani ngesikhathi sokwelashwa?
Ngeke uzizwe ungakhululekile noma ubuhlungu phakathi nalokhu kwelashwa. Lokhu kungenxa yokuthi uzolaliswa ngokuphelele (i-General Anesthesia), noma unganikwa uhlobo lwe-anesthesia olukwenza uzizwe ulele futhi ukhululekile (i-Monitored Anesthesia Care).
Ngesikhathi sokwelashwa, udokotela wakho uzolandela lezi zinyathelo:
1. I-endoscope ifakwa ngomlomo noma nge-rectum.
2. Kusetshenziswa ikhamera, i-endoscope ithunyelwa lapho kukhona khona izicubu ezingavamile.
3. Kusetshenziswa idivayisi edluliswa nge-endoscope, kwenziwa uphawu oluzungeze isimila ukuze sisuswe.
4. Okulandelayo, kufakwa uketshezi olukhethekile olwelwesini olungaphansi kwesimila. Lokhu kudala umcamelo ngaphansi kwesimila, kusiphakamisela phezulu ezicutshini eziphilile ezizungezile. Lokhu kwenza kube lula ukusihlukanisa nokusisika.
5. Ekugcineni, kusetshenziswa idivayisi ekhethekile njengommese kagesi osebenza kakhulu, isimila sinqunywa ngokucophelela emgqeni ophawuliwe bese sisuswa.
Yonke inqubo ingathatha phakathi kwehora elilodwa nelesithathu , kuye ngobukhulu nendawo yezicubu ezisusiwe.
Kwenzekani ngemva kokwelashwa?
Ngemva kokwelashwa sekuqediwe, izicubu ezisusiwe zithunyelwa elabhorethri lapho udokotela wezifo ezihlola khona ukuze abone ukuthi zinamaseli omdlavuza nokuthi zisusiwe ngokuphelele yini.
Uzoyiswa ekamelweni lokululama isikhashana ngemuva kokwelashwa. Uma imiphumela ye-anesthesia isiphelile ngokuphelele, ungase ukwazi ukuya ekhaya ngalolo suku, noma kungadingeka uhlale esibhedlela ubusuku bonke. Kufanele nakanjani uphelekezelwe othile ekhaya , njengoba kungathatha amahora angama-24 ukuthi imiphumela ye-anesthesia iphele ngokuphelele.
Ingabe kukhona imiphumela emibi kanye nezingozi?
Njenganoma yikuphi ukwelashwa kwezokwelapha, kunemiphumela emibi emincane kanye nezingozi ezingavamile kakhulu.
Imiphumela emibi emincane engaba khona
Lokhu kuvame ukunyamalala ngokuphelele phakathi nosuku noma ezimbili.
- Ukugcwalisa isisu
- Isisu esibuhlungu
- Igesi kanye nobuhlungu obuyibangelayo
- Isicanucanu noma ukuhlanza
- Umphimbo obuhlungu (uma i-endoscope ifakiwe ngomlomo)
Kungase kube yinto evamile ukuba negazi elincane kakhulu esitulweni sakho, kodwa kufanele liphele zingakapheli amahora angu-24.
Izinkinga ezingavamile
Amathuba okuthi lokhu kwenzeke mancane kakhulu, kodwa kubalulekile ukuzazi.
- Ukopha: Ukopha endaweni lapho kususwa khona izicubu.
- Ukubhoboza kwamathumbu: Ukubhoboza udonga lomgudu wokugaya ukudla nge-endoscope noma ithuluzi.
- Izibazi: Ikakhulukazi lapho welapha umphimbo, izibazi ezenzeka ngesikhathi sokuphulukiswa zingaholela ekuncipheni komphimbo (ukuqina komphimbo).
Yiziphi izinzuzo zale ndlela?
Indlela ye-ESD inezinzuzo eziningi uma iqhathaniswa nokuhlinzwa okuvulekile.
- Ubuhlungu obuncane: Ubuhlungu buncane kakhulu ngoba azikho izimbobo.
- Ukululama okusheshayo: Ungabuyela empilweni evamile futhi usebenze ngokushesha.
- Akukho zibazi: Akukho zibazi ezibonakala ngaphandle komzimba.
- Izinkinga ezimbalwa: Kukhona ingozi ephansi yezinkinga kunokuhlinzwa okuvulekile.
- Ukulondolozwa kwezitho zomzimba: Le ndlela ingagwema izinto ezifana nokususa ingxenye yesisu noma yamathumbu ebeyizokwenziwa ngesikhathi sokuhlinzwa okukhulu.
Kufanele ubonane nodokotela ngokushesha nini?
Uma ubuyela ekhaya ngemva kokwelashwa, uma uhlangabezana nanoma yiziphi izimpawu eziyisixwayiso, kubaluleke kakhulu ukushayela udokotela wakho ucingo noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze ngokushesha .
| Izimpawu eziyisixwayiso - qaphela ngokushesha! | |
|---|---|
| Isibonakaliso | Incazelo |
| Igazi esitulweni | Uma kukhona igazi eliningi eliphuma ngendle, kunokuthi kube nechashaza elincane ephepheni lendlu yangasese. |
| Ubuhlungu besifuba | Ubuhlungu besifuba obungazelelwe, obukhulu. |
| Isiyezi noma ikhanda elibuthakathaka | Uma uzizwa unesizungu noma uphelelwa amandla. |
| Umkhuhlane noma ukubanda | Uma uzizwa sengathi unomkhuhlane noma uyathuthumela. |
| Ubunzima bokuphefumula (i-Dyspnea) | Uma unenkinga yokuphefumula noma uzizwa ucindezekile. |
| Ukuhlanza igazi | Uma uhlanza igazi. |
Kuthatha isikhathi esingakanani ukuphulukiswa?
Iningi labantu lingabuyela emsebenzini ngemva kwezinsuku ezinhlanu. Kodwa-ke, uma wenza umsebenzi onzima kakhulu, njengokuphakamisa izinto ezisindayo, udokotela wakho angakweluleka ukuthi uphumule isikhashana. Kungase kube nezinguquko ezincane emikhubeni yamathumbu cishe isonto elilodwa ngemva kokwelashwa.
Ngokuvamile uzophinde ubonane nodokotela wakho cishe emavikini amabili. Ngaleso sikhathi, bazochaza imiphumela yombiko webhubhu bese benquma ukuthi kuyadingeka yini ukwelashwa okwengeziwe noma cha.
I-ESD iyindlela yokwelapha ephumelela kakhulu. Ezinye izifundo zibonise ukuthi ingozi yokuthi isimila siphinde sivele endaweni efanayo kubantu abaye baphathwa ngale ndlela yokwelashwa iphansi kakhulu njenge-1%.
Umlayezo Wokuya Nawe Ekhaya
- I-Endoscopic Submucosal Dissection (ESD) iyindlela yokwelapha ethuthukisiwe, engangenisi kakhulu esusa izicubu ezingavamile endleleni yokugaya ukudla.
- Njengoba lokhu kungahileli ukusikwa okukhulu, ubuhlungu buyancipha, isikhathi sokuphola sincane, futhi akukho zibazi.
- Lokhu kususa izicubu ezingavamile zibe yingcezu eyodwa, ukuze kutholakale ngokunembile ukuthi umdlavuza usususiwe ngokuphelele yini.
- Uma kuvela izimpawu eziyisixwayiso (isib. ukopha okukhulu, umkhuhlane, ubuhlungu besifuba) ngemva kokwelashwa, funa iseluleko sezokwelapha ngokushesha.
- Uma uneminye imibuzo mayelana nalokhu, ungesabi ukukhuluma nodokotela wakho ukuze uthole konke okucacisiwe.
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