I-ESDimisebenzi ayivumelekanga ukuba yenziwe ngokungacwangciswanga okanye ngokungacwangciswanga.
Iindlela ezahlukeneyo zisetyenziswa kwiindawo ezahlukeneyo. Iindawo eziphambili yi-esophagus, isisu, kunye ne-colorectum. Isisu sahlulwe saba yi-antrum, indawo ye-prepyloric, i-angle yesisu, i-gastric fundus, kunye nokugoba okukhulu komzimba wesisu. I-colorectum yahlulwe yaba yi-colon kunye ne-rectum. Phakathi kwazo,I-ESD yezilonda ze-antrum greater curvatureyinxalenye eqalayo, ngelixa i-ESD ye-engile yesisu, i-cardia, kunye nezilonda zekoloni yasekunene inzima ngakumbi.
Umgaqo oqhelekileyo kukuqwalasela i-low gravity factor uze uqale ngenxalenye enzima uze emva koko ube nenxalenye elula. Qala ukusika kunye nokukrazula ukusuka kwindawo ephantsi gravity. Ngexesha lokukrazula, ukukrazula kufuneka kuqale nakwinxalenye enzima kakhulu. I-Esophageal ESD ingenziwa ngokukrazula uhlobo lokutyhala. Indlela yokukrazula kunye nokukrazula izilonda zesisu kufuneka yenziwe kwangaphambili. Izilonda kwi-engile yesisu, ukugoba okuncinci komzimba wesisu, kunye nendawo ye-prepyloric zinokuvezwa ngokutsalwa. Itekhnoloji ye-tunnel kunye nendlela yepokotho zombini ziyinxalenye yesicwangciso se-ESD. Iitekhnoloji ezithathwe kwi-ESD ziquka i-ESTD, i-EFTR, i-ESE, i-POEM, njl. Ezi tekhnoloji nazo ziitekhnoloji ezivela ngokwemvelo emva kokuba izakhono ze-ESD ziqondwe kakuhle. Ngoko ke i-ESD sisiseko.
2. Iinkcukacha zokusebenza kwe-ESD
I-ESDIinkcukacha zokusebenza ziinkcukacha eziphantsi kwesikhokelo secebo elikhulu.
Iinkcukacha Zokusebenza
Iinkcukacha zotyando ziquka ukuphawulwa, ukutofwa, ukuxotyulwa, njl.njl.
Kukho amaqhinga amabini: elinye kukukhetha iimela ngendlela elawulekayo phantsi kombono othe ngqo (sebenzisa ukukhetha iimela ezingaboniyo kancinci kangangoko), elinye kukusebenzisa imida kunye nemibutho emincinci ngendlela elawulwayo.
Ukulebhelisha kunye nokufaka inaliti
Ukuphawula nge-electrocoagulation kusetyenziswa xa kubhalwa. Ngokubanzi, umda wesilonda (2-5 mm ngaphandle) usetyenziswa njengophawu. Ukuphawula kungenziwa ngomgca ngomgca okanye ukusuka kwinkulu ukuya kwincinci. Ekugqibeleni, isithuba esiphakathi kwamanqaku amabini kufuneka sibe ngaphakathi kwe-5 mm, kwaye kufuneka sibonakale xa i-endoscope ikufutshane nendawo yokubona.
Kwinqaku elilandelayo eliphawulweyo. Inaliti isekelwe kwimikhwa yomntu. Emva kokufaka inaliti kwi-submucosal layer, inaliti kufuneka irhoxiswe kancinci ize ijojwe kwakhona ukuqinisekisa ukuba isilonda siphakanyisiwe saya kufikelela kubude obaneleyo bokusikwa nokuxobuka okulandelayo.
Sika
Ukusikwa, ezinye iindawo zisikwa ukusuka kude ukuya kufutshane okanye ukusuka kufutshane ukuya kude (ukusikwa kokutyhala), ngokwemikhwa yomntu kunye neendawo ezithile, kuyimfuneko ukusika ukusuka kwinqanaba eliphantsi lomxhuzulane kuqala. Ukusikwa kuquka ukusika okungaphantsi kunye nokusika okunzulu kwangaphambili. Ukusikwa kwangaphambili kufuneka kube "ngokuchanekileyo" kwaye "kwanele". Ubunzulu bokusika kufuneka bube banele ngaphambi kokuba kwenziwe umsebenzi olandelayo wokuxobula. Njengokuthatha imela kunye nokuseta ifestile yengelosi. Nje ukuba ungene kwifestile yengelosi,
I-ESD ithetha ukufikelela kwindlela esebenzayo. Kodwa eneneni, ayizizo zonke ii-ESD ezinokungena kwiFestile yeNgelosi. Izilonda ezininzi ezincinci kunye nezilonda ezikhethekileyo i-ESD ayinakungena kwiFestile yeNgelosi. Okwangoku, kuxhomekeke kakhulu ekusebenzeni kwemela ecociweyo.
Susa: Susa kuqala indawo enzima ukuyiphatha. Xa ususa inxalenye engaphantsi kwesisu, kufuneka yenziwe ukusuka kumacala omabini ukuya embindini, wenze "isitshixo" esimile njengo-V. Ubunzulu bokusika kwangaphambili kwe-peripheral kufuneka banele, kungenjalo kulula ukukrazula ngaphaya komda. Okukhona izicubu eziseleyo zincinci, kokukhona inqanaba lenkululeko liphezulu. Kubalulekile ukulawula imela ukuze usike izicubu ngokuthe ngqo, ingakumbi izicubu zokugqibela. Ukuba ulawulo alulunganga, kulula ukusika kakhulu okanye kancinci kakhulu.
Indlela yokubamba isibuko
Kukho iindlela ezimbini zokubamba i-scope ye-ESD, zombini ezilawula umzimba we-scope, amaqhosha, kunye nezixhobo eziphumayo neziphumayo. Kukho iindlela ezimbini: "ulwalathiso lwesandla sasekhohlo + izixhobo" kunye "nezandla ezibini ukuya kwezine". Umgaqo ophambili wokubamba i-scope kukugcina intsimi yokusebenza izinzile kwaye ilawuleka. Okwangoku, indlela yezandla ezibini ukuya kwezine inozinzo olungcono lolawulo lwe-scope kwaye isetyenziswa kakhulu. Kuphela xa i-scope izinzile apho ukusebenza kokuvezwa kwezicubu ezincinci + ii-flaps kungaphathwa ngcono.
Kuphela yindlela efanelekileyo yokubamba isipili apho imela ingalawulwa ngcono. Indlela yokukha imela inokulawula ngcono icala, injongo kukuhlala kude nongqimba lwemisipha nokusika izicubu ekujoliswe kuzo. Xa usenza i-I-ESDXa kusikwa i-submucosal, kuyimfuneko ukusika kufutshane nomaleko wemisipha, ubunzulu bokusika kwezicubu buyanele, kwaye kulula ukuyeka ukopha. Eyona nto ibalulekileyo kukuqinisekisa ukuba ukusika akunzulu kakhulu okanye akuphumeleli, kwaye indlela yokukha iimela yeyona nto iphambili ngeli xesha.
Ulawulo lombono
Ulawulo lwendlela lukwabonakala ekutyhilekeni nasekulawuleni indawo yokujonga. Ukongeza ekujikeleziseni iqhina kunye nomzimba welensi, ii-caps ezicacileyo kunye nezixhobo zikwasetyenziswa ukutyhila indawo yokujonga okanye izicubu ekujoliswe kuzo, ingakumbi amandla amancinci asetyenziselwa ukutyhila nokuphakamisa izicubu ezincinci, oku kukuguquka kwezicubu ezincinci kakhulu.
Lawula umgama wentsimi yombono. Kuphela xa intsimi yombono igcinwe kumgama ofanelekileyo apho ingasetyenziswa kwaye ilawulwe khona. Ukuba ikude kakhulu okanye ikufutshane kakhulu, kuya kuba nzima ukulawula imela ngokuzinzileyo. Iintshukumo ezingabonakaliyo zinokubonakala ngathi azishukumi, kodwa izicubu sele zinamandla okuguquka. Yiyo loo nto i-ESD kufuneka isebenzise umgama ofanelekileyo kunye nokuguquka okufanelekileyo.
Iinkcukacha ezingentla, ukubamba ilensi, kunye nolawulo lokujonga indawo zezona zinto ziphambiliI-ESD"Ulawulo lwelensi".
Thina, Jiangxi Zhuoruihua Medical Instrument Co.,Ltd., singumvelisi eTshayina ogxile kwizinto ezisetyenziswayo ze-endoscopic, ezifanai-biopsy forceps, i-hemoclip, umgibe we-polyp, inaliti ye-sclerotherapy, i-catheter yokutshiza, iibhrashi ze-cytology, ucingo lwesikhokelo, ibhaskithi yokuqokelela amatye, i-catheter yokukhupha amanzi empumlweni,isingxobo sokufikelela kwi-ureteralkwayeisingxobo sokufikelela kwi-ureteral esinokufunxanjl. ezisetyenziswa kakhulu kwiI-EMR, I-ESD, I-ERCPIimveliso zethu ziqinisekisiwe yi-CE, kwaye izityalo zethu ziqinisekisiwe yi-ISO. Iimpahla zethu zithunyelwe eYurophu, eMntla Melika, eMbindi Mpuma nakwinxalenye ye-Asia, kwaye zifumana umthengi udumo nodumo ngokubanzi!
Ixesha leposi: Julayi-14-2025