Ingabe udokotela ukutshelile ukuthi unesimila esincane ku-colon noma umphimbo wakho esidinga ukususwa? Uma uzwa lokho, abaningi bethu bayesaba futhi bakhathazeke, becabanga ukuthi, "O, kuzomele ngihlinzwe kakhulu?" Kodwa ngobuchwepheshe bezokwelapha obuthuthukisiwe obutholakala namuhla, kunezindlela ezimangalisayo zokususa lezi zinto ngaphandle kokwenza i-incision enkulu emzimbeni. Namuhla, sizokhuluma ngenye indlela yokwelapha ekhethekile, engangenisi kakhulu.
Kalula nje, kuyini i-Endoscopic Submucosal Dissection (ESD)?
Lokhu kulula kakhulu ukukuqonda. Cishe uke wezwa ngokuhlolwa kwe- 'endoscopy '. Inqubo lapho kufakwa khona ipayipi eliguquguqukayo elinekhamera ngomlomo noma endunu ukuhlola ipayipi lokudla . Lokhu kuyinto efanayo. Kodwa kuthuthuke kancane.
Ku-ESD, udokotela wezifo zamathumbu usebenzisa i-endoscope ukufaka amathuluzi okuhlinza amahle kakhulu. Ngemuva kwalokho, izicubu ezingavamile odongeni lomgudu wakho wokugaya ukudla, ingxenye efana nesimila , iyasikwa ngokucophelela futhi isuswe. Ingxenye engcono kakhulu ukuthi konke lokhu kwenzeka ngaphandle kokwenza noma yikuphi ukusikwa ngaphandle komzimba wakho. Lokhu kusho ukuthi ubuhlungu buncane kunangemva kokuhlinzwa okukhulu, futhi ungalulama ngokushesha.
Yiziphi izinhlobo zezimo eziwusizo kuzo indlela ye-ESD?
Lokhu kwelashwa kuvame ukusetshenziselwa ukususa izimila ezinomdlavuza noma ezingakabonakali, ama-polyp , noma izilonda endleleni yokugaya ukudla. I-ESD isebenza kahle kakhulu kulezi zimo ezilandelayo:
- Umphimbo kaBarrett : Kulesi simo, amangqamuzana engxenyeni engezansi yomphimbo ashintsha ngendlela engavamile. Lawa angaphenduka umdlavuza kamuva.
- Umdlavuza we-Colorectal
- Umdlavuza we-Esophageal
- Umdlavuza wamathumbu amancane
- Umdlavuza wesisu
Into ebaluleke kakhulu ukuthi le ndlelaAmandla okususa ngokuphelele amangqamuzana omdlavuza noma izicubu ezingavamile engxenyeni eyodwa . Lokhu kwenza kube lula ukuqinisekisa ukuthi isifo sisusiwe ngokuphelele.
Uyini umehluko phakathi kwe-ESD ne-EMR?
Kungenzeka ukuthi uke wezwa ngenye inqubo ebizwa ngokuthi `i-Endoscopic Mucosal Resection (EMR).` Zombili lezi zinqubo ziyindlela yokwelapha engangenisi kakhulu eyenziwa kusetshenziswa i-endoscope. Kodwa-ke, kunomehluko omncane phakathi kwalezi ezimbili. Ake sibheke ukuthi ziyini.
| Isici | Ukususwa Kwama-Mucosal Endoscopic (EMR) | Ukususwa Kwe-Endoscopic Submucosal (ESD) |
|---|---|---|
| Indawo eqondiwe | Izimila ebusweni bolwelwesi lwangaphakathi lomgudu wokugaya ukudla (i-mucosa) ziyasuswa. | Ngaphezu kwezimila ezingaphezulu, izimila ezingene zajula kancane olwelwesini nazo zingasuswa. |
| Indlela esetshenzisiwe | Isimila sisuswa ngokufaka uketshezi ngaphansi kwaso, siphakamise, bese sisika ngento efana ne-metal snare. Ngezinye izikhathi sisuswa sibe yizicucu eziningana. | Kusetshenziswa ummese okhethekile kagesi, izithelo zisikwa kahle kakhulu nxazonke nangaphansi, zisuswe zibe yingcezu eyodwa . |
| Imicimbi efaneleke kakhulu | Kwamantongomane amancane kakhulu, angaphandle. | Kumathumba amakhulu, ayisicaba, noma akhule kancane, ikakhulukazi ezimweni zamathumba anomdlavuza, kunconywa ukuthi kususwe ngokuphelele. |
Uzilungiselela kanjani ngaphambi kokwelashwa?
Lokhu akudingi ukulungiselela okuningi. Udokotela wakho uzokunikeza imiyalelo eqondile oyidingayo.
- Uma kufakwa i-endoscope ngomlomo (isib. isisu, umphimbo): Uzocelwa ukuthi uyeke ukudla noma ukuphuza amahora amaningana ngaphambi kokwelashwa.
- Uma ifakwa nge-rectally (isb., ku-colon): Uzocelwa ukuthi "ulungiselele amathumbu." Lokhu kusho ukuthi kuzodingeka uthathe umuthi wokuhlanza umzimba ozonikezwa udokotela wakho ukuze ahlanze ngokuphelele i-colon yakho. Lokhu kuzovumela udokotela ukuthi abone ingaphakathi le-colon yakho ngokucacile.
Kwenzekani ngesikhathi sokwelashwa?
Asikho isidingo sokukhathazeka ngalokhu. Udokotela wezinzwa uzokulalisa ngokuphelele (`I-General Anesthesia`), noma akunike imithi yokukugcina uphumule futhi ungenabuhlungu. Ngeke uzwe lutho phakathi nalesi sikhathi.
Ngesikhathi sokwelashwa, udokotela uzolandela lezi zinyathelo:
1. Ishubhu le-endoscope lifakwa ngomlomo noma erekthrini.
2. Uma ubheka ngekhamera, yiya lapho kukhona khona leso simila esingavamile.
3. Indawo yesimila imakwe ngedivayisi ekhethekile.
4. Ukuze kugwenywe ukulimaza izicubu ezinempilo ngaphansi kwesimila, kufakwa uketshezi olukhethekile ngaphansi kwesimila. Lokhu kudala "umcamelo" ngaphansi kwesimila, okuphakamisa isimila phezulu.
5. Bese kuthi, kusetshenziswa ummese kagesi osebenza kakhulu, isimila sinqunywe ngokuphelele futhi sisuswe.
Le nqubo yonke ingathatha cishe ihora elilodwa kuya kwamathathu.
Kwenzekani ngemva kokwelashwa? Futhi yiziphi izingozi?
Ngemva kokwelashwa, uzoqashwa egumbini lokululama uze uvuke ekuhlinzweni kwe-anesthesia. Izicubu ezisusiwe zithunyelwa elabhorethri ukuze zixilongwe. Lapho, udokotela wezifo uyayihlola ukuze abone ukuthi kukhona yini amangqamuzana omdlavuza nokuthi wonke umdlavuza usususiwe yini.
Ungase ukwazi ukuya ekhaya ngalolo suku, noma kungase kudingeke uhlale esibhedlela ubusuku bonke. Okubaluleke kakhulu, kuthatha cishe amahora angama-24 ukuthi imiphumela yomuthi wokubulala izinzwa iphele ngokuphelele, ngakho-ke kuzodingeka nakanjani uze nothile bese umshayela ekhaya ngemoto.
Kungase kube nokungakhululeki okuncane usuku olulodwa noma ezimbili ngemva kokwelashwa, kodwa kunezinto ezithile okufanele uziqaphele.
| Imiphumela emibi evamile yesikhashana (ukululama ezinsukwini ezingu-1-2) | Isikhathi sokuya kudokotela wakho noma eMnyangweni Wezimo Eziphuthumayo (i-ETU) wesibhedlela ngokushesha |
|---|---|
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Izinkinga ze-ESD azivamile, kodwa zingafaka phakathi ukopha, ukubhoboka kwamathumbu, noma ukuqina komphimbo. Lokhu akuvamile kakhulu.
Kuthatha isikhathi esingakanani ukululama?
Iningi labantu lingabuyela emisebenzini yalo evamile ngemva kwezinsuku ezi-5. Kodwa-ke, uma unomsebenzi onzima ngokomzimba, udokotela wakho angase akucebise ukuthi uphumule isikhashana. Ukuhamba kwakho kwamathumbu kungase kungabi njalo cishe isonto lonke ngemva kokwelashwa.
Uzocelwa ukuthi ubonane nodokotela futhi cishe emavikini amabili ngemuva kokwelashwa. Ngemuva kwalokho ungaxoxa ngemiphumela yombiko webhubhu nokuthi ngabe udinga ukwelashwa okwengeziwe.
Umlayezo Wokuya Nawe Ekhaya
- I-Endoscopic Submucosal Dissection (ESD) iyindlela yokwelapha esezingeni eliphezulu kakhulu esusa umdlavuza osesigabeni sokuqala noma izimila ezingavamile ohlelweni lokugaya ukudla ngaphandle kokwenza ukusika okukhulu ngaphandle komzimba.
- Lokhu kususa izicubu ezingavamile zibe yingcezu eyodwa, okwenza kube lula ukuqinisekisa ukuthi lesi sifo sisusiwe ngokuphelele.
- Akubuhlungu kangako njengokuhlinzwa kwendabuko, ukululama kuyashesha kakhulu, futhi azikho izibazi ezinkulu.
- Landela imiyalelo kadokotela wakho ngokucophelela ngaphambi nangemva kokwelashwa.
- Uma uhlangabezana nezimpawu ezifana nokopha ngokweqile, ubuhlungu obukhulu, umkhuhlane, noma ubunzima bokuphefumula ngemva kokwelashwa, yazisa udokotela wakho ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze.
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