Kuvamile ukuzizwa wesaba lapho udokotela wakho ekutshela ukuthi unesimila e-rectum yakho, engxenyeni engezansi yamathumbu akho amakhulu. Ungase ucabange, "O, kuzodingeka ngisike isisu sakho, kuzodingeka ngihlale esibhedlela izinsuku ezimbalwa, kuzobuhlungu kakhulu," akunjalo? Kodwa ungakhathazeki. Ubuchwepheshe buthuthuke kakhulu namuhla. Namuhla, sikhuluma nge- Transanal Endoscopic Microsurgery (TEMS) , inqubo ekhethekile yokuhlinzwa esusa izimila ezinjengalezi ngaphandle kokwenza noma yikuphi ukusikwa esiswini sakho, kusetshenziswa amathuluzi amancane afakwe e-rectum yakho.
Kalula nje, iyini i-TEMS?
I-TEMS inqubo yokuhlinzwa engangenisi kakhulu esetshenziselwa ukususa izimila kanye nomdlavuza omncane e-rectum yakho. Esikhathini esidlule, ukususa isimila e-rectum yakho bekuzodinga ukuhlinzwa okukhulu kwesisu. Kule nqubo ye-TEMS, udokotela ohlinzayo ufaka ithuluzi elikhethekile nge-anus yakho bese esebenzisa ikhamera encane kanye nezinsimbi zokuhlinzwa ukususa isimila.
Inzuzo enkulu yalokhu ukuthi njengoba kungekho ukusikwa ngaphandle komzimba , uzozwa ubuhlungu obuncane kakhulu, uphole ngokushesha, futhi ube nezinkinga ezimbalwa kunangemva kokuhlinzwa okukhulu.
Uyini umehluko phakathi kwe-TEM ne-TAMIS?
Kungenzeka ukuthi uke wezwa nge-TAMIS. Lezi zindlela ezimbili zifana kancane, kodwa kunomehluko omncane.
- I-TEMS (Transanal Endoscopic Microsurgery): Lokhu kusebenzisa ithuluzi elide, elijiyile elifana nethubhu elibizwa ngokuthi "i-Rectoscope." Ikhamera nezinye izinsimbi zidluliswa ngaleli thubhu.
- I-TAMIS (Ukuhlinzwa Okuncane Okungena Emathunjini Okudlulela Emuva): Lokhu kusebenzisa imbobo encane, eyindilinga, eguquguqukayo, efana nejeli. Ifakwa nge-anus bese isimila sisuswa kusetshenziswa amathuluzi afanayo asetshenziswa ekuhlinzeni kwe-laparoscopic.
Udokotela uzohlola isimo sakho bese ekhetha indlela ekufanele kakhulu ngokusekelwe endaweni yesimila.
Ubani ofanelekela kakhulu ukuhlinzwa kwe-TEMS?
Lokhu kuhlinzwa akulona olwawo wonke umuntu, kodwa kwezinye izimo kuyindlela enhle kakhulu.
- Kulabo abanobunzima bokubekezelela ukuhlinzwa okukhulu ngenxa yezinye izinkinga zempilo (isib. isifo senhliziyo, isifo sikashukela).
- Kulabo abanomdlavuza we-rectal osesigabeni sokuqala.
- Kwabasha abanezimila ezingewona umdlavuza (ezingenobungozi).
- Noma ubani ofuna ukugwema ukuhlinzwa okukhulu, uma udokotela enquma ukuthi kufanelekile.
Kodwa-ke, uma indawo yomgogodla wakho yenza kube nzima ukuthi ithuluzi lifinyelele esimila, noma uma i-rectum yakho inciphile (stenosis), le nqubo ingase ingenzeki. Konke lokhu kunqunywa udokotela wakho ohlinzayo.
Izimo eziphathwa ngokuhlinzwa kwe-TEMS
Lokhu kuhlinzwa kuvame ukwenziwa ukuze kususwe izimila e-rectum. Kusetshenziselwa ukwelapha izimo ezilandelayo:
| Isimo sezokwelapha | Incazelo elula |
|---|---|
| Izimila ezingembi kakhulu emaqakaleni | Izimila ezivamile ezingabi umdlavuza. |
| Umdlavuza we-rectal | Ikakhulukazi izimila ezinomdlavuza ezigabeni zokuqala. |
| Ama-polyp angaphakathi | Ama-cyst amancane akhula ongqimbeni lwe-rectum. |
| I-Fistula | Imigudu emincane ethelelekile eyakheka phakathi kwe-anus nesikhumba esizungezile. |
| Ukwehla kwe-rectal | Ingxenye ye-rectum ephuma embotsheni yendunu. |
| Ukuncishiswa kwe-rectum (Strictures) | I-rectum isibe mncane ngesizathu esithile. |
Uzilungiselela kanjani ngaphambi kokuhlinzwa?
Ukulungiselela lokhu kufana nokulungiselela i-colonoscopy. Into eyinhloko ukuhlanza amathumbu akho ngokuphelele . Lokhu kuzovumela udokotela ukuthi abone ingaphakathi le-rectum yakho ngokucacile. Ngenxa yalokhu, udokotela wakho uzokunikeza umuthi okhethekile wokuhlanza isisu.
Ngokuvamile uzothola imiyalelo efana nale:
- Gwema ukudla ukudla okuqinile ngosuku olwandulela ukuhlinzwa.
- Phuza kuphela uketshezi olucacile (amanzi, amanzi anosawoti, iJeevani) emahoreni angu-12-24 ngaphambi kokuhlinzwa.
- Gwema ukudla noma ukuphuza noma yini kusukela phakathi kwamabili ngosuku lokuhlinzwa.
- Uma uthatha noma yini efana nemithi yokunciphisa igazi, qiniseka ukuthi utshela udokotela wakho ngayo futhi uyeke ukuyithatha kusasele izinsuku ezimbalwa, ngokweseluleko sakhe.
Into ebaluleke kakhulu ukulandela yonke imiyalelo enikezwe udokotela ngqo. Lokhu kubaluleke kakhulu ukuze ukuhlinzwa kuphumelele.
Kwenzekani ngesikhathi sokuhlinzwa?
Ngeke uzwe lutho phakathi nale nqubo ngoba ukuhlinzwa kuzokwenziwa ngaphansi kwe-anesthesia ejwayelekile, okusho ukuthi uzobe ulele ngokuphelele. Nakhu okwenzekayo ngesikhathi sokuhlinzwa:
1. Udokotela ohlinzayo ufaka ithuluzi elithi ``Rectoscope`` ngembobo yendunu iye e-rectum.
2. I-rectum igcwele igesi kancane ukuze ibone kahle indawo ezungeze isimila.
3. Ikhamera kanye namathuluzi okuhlinza abucayi kufakwa nge-rectoscope bese kuthi isimila noma i-polyp, kanye nezinye izicubu eziphilile ezizungezile, zisikwe bese zisuswa.
4. I-incision ivalwa ngezithungo ezincibilikayo noma ngeziqeshana ezincane zensimbi.
Kunjani ngemva kokuhlinzwa?
Ungase uzizwe ungakhululekile ngemva kokuhlinzwa. Phakathi namahora okuqala angu-24, ungase uzizwe:
- Ipayipi (`i-catheter`) elifakwa esinyeni sakho ukuze likhiphe umchamo.
- Nikeza umzimba uketshezi oludingayo ngokufakwa usawoti (umugqa we-IV) emthanjeni osengalweni yakho.
- Ama-antibiotic (ama-antibiotic e-IV) anikezwa nge-saline cishe amahora angama-24 ukuvimbela ukutheleleka.
Ungaqala ukudla nokuphuza cishe usuku olulodwa ngemuva kokuhlinzwa. Ngokuvamile uzokwazi ukuya ekhaya ngemva kosuku olulodwa noma ezimbili esibhedlela .
Yiziphi izinzuzo zale ndlela?
Indlela ye-TEMS inezinzuzo eziningi kune-laparotomy. Ukuhlinzwa okukhulu ngezinye izikhathi kungaholela ezinkingeni zokulawula umchamo, ukungasebenzi kahle kocansi, ngisho nesidingo sokuhlinzwa okuhlala njalo kwe-colostomy. Indlela ye-TEMS inciphisa eziningi zalezi zingozi.
| Inzuzo | Incazelo |
|---|---|
| Ukopha okuncane | Kuncane kakhulu ukuphuma kwegazi ngoba akukho ukusikwa. |
| Izinkinga ezimbalwa | Izingozi zokutheleleka kanye nokuvaleka kwamathumbu ziphansi. |
| ukululama okusheshayo | Imisebenzi evamile ingaqala ngosuku olulodwa kuya kwezimbili. |
| Ukuhlala esibhedlela okufushane | Ngokuvamile ungaya ekhaya ezinsukwini ezingu-1-2. |
Akukho yini ingozi kulokhu?
Njenganoma yikuphi ukuhlinzwa, kunengozi encane, kodwa ingozi iphansi kakhulu kune-tummy tuck.
- Ukopha
- Ukuba nokutheleleka
- Ubuhlungu besisu noma umphimbo
- Ubunzima bokuchama ('Ukugcinwa komchamo')
- Isidingo sokuzikhulula ngokuzumayo (`Ukudakwa kwendle`)
Uma kwenzeka into efana nale, odokotela sebekulungele ukuyelapha.
Uma unalezi zimpawu, bona udokotela ngokushesha.
Ngemva kokubuyela ekhaya, uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo, shayela udokotela wakho ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela.
- Ukopha ngokweqile
- Umkhuhlane noma ukuzizwa ubanda
- Ubunzima bokuchama
- Ubuhlungu besisu noma be-rectal obungabekezeleleki
Uma kungumdlavuza, ingabe lokhu kuphela kokwelashwa?
Uma umdlavuza we-rectal utholakala ezigabeni zawo zokuqala, futhi isimila sisusiwe ngokuphelele ngokuhlinzwa kwe-TEMS, ezinye izindlela zokwelapha zingase zingadingeki. Kodwa-ke, kwabanye abantu, kuye ngohlobo lwesimila, udokotela wakho angase ancome ukwelashwa ngamakhemikhali noma ngemisebe ngaphezu kwalokhu kuhlinzwa. Konke lokhu kuzonqunywa ngemva kokuhlola isimo sakho.
Umlayezo Wokuya Nawe Ekhaya
- I-TEMS inqubo yokuhlinzwa yesimanje, ephephile, futhi engahlaseli esetshenziselwa ukususa izimila zangemuva.
- Lokhu kuholela ekunciphiseni ubuhlungu, ukululama okusheshayo, kanye nokuhlala esibhedlela isikhathi esifushane.
- Lokhu akufanele wonke umuntu. Udokotela wakho uzonquma ukuthi lokhu kufanele yini kuwe noma cha.
- Kubaluleke kakhulu ukulandela imiyalelo enikezwe ngaphambi kokuhlinzwa (ukuhlanza isisu, ukudla okudlayo) ngqo.
- Ngisho noma ukululama kushesha, qaphela izimpawu eziyisixwayiso ezifana nomkhuhlane, ubuhlungu obukhulu, noma ukopha. Uma ubona noma yikuphi kwalokhu, funa iseluleko sezokwelapha ngokushesha.
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