Yintoni i-EMR? Masiyizobe!

Izigulana ezininzi kumasebe e-gastroenterology okanye kumaziko e-endoscopy zinconywa ukuba zifakwe kwi-endoscopic mucosal resection.I-EMR). Isetyenziswa rhoqo, kodwa ngaba uyazazi izalathiso zayo, imida, kunye nezilumkiso zasemva kotyando?

Eli nqaku liza kukukhokela ngolwazi oluphambili lwe-EMR ukukunceda wenze isigqibo esinolwazi kunye nokuzithemba.

Ke, yintoni i-EMR? Masiyizobe kuqala sibone...

❋Zithini izikhokelo ezigunyazisiweyo malunga nezalathisi zeEMR? Ngokutsho kweJapan Gastric Cancer Treatment Guidelines, i-Chinese Expert Consensus, kunye ne-European Society of Endoscopy (ESGE) izikhokelo, izikhombisi ezicetyiswayo ngoku ze-EMR ziquka ezi zilandelayo:

Ⅰ. Iipolyps ezintle okanye i-adenomas

● Izilonda ≤ 20 mm kunye nemida ecacileyo

● Akukho zimpawu zicacileyo zohlaselo lwe-submucosal

● Laterally Spreading Tumor (LST-G)

Ⅱ. I-Focal high-grade intraepithelial neoplasia (HGIN)

● I-Mucosal-limited, akukho zilonda

● Izilonda ezincinci kune-10 mm

● Yahlulwe kakuhle

Ⅲ. I-dysplasia ethambileyo okanye izilonda eziphantsi kunye ne-pathology ecacileyo kunye nokukhula okucothayo

◆ Izigulane zibonwa zifanelekile ukutshatyalaliswa emva kokuqwalaselwa kokulandelela

⚠Qaphela: Nangona izikhokelo zichaza ukuba i-EMR iyamkeleka kwi-cancer yasekuqaleni ukuba i-lesion incinci, ayinayo i-ulcerated, kwaye ivalelwe kwi-mucosa, kwi-extra practice yeklinikhi, i-ESD (i-endoscopic submucosal dissection) ikhethwa ngokubanzi ukuqinisekisa ukutshatyalaliswa okupheleleyo, ukhuseleko, kunye novavanyo oluchanekileyo lwe-pathological.

I-ESD ibonelela ngeenzuzo ezininzi ezibalulekileyo:

I-En bloc resection yesilonda sinokwenzeka

Iququzelela uvavanyo lomda, ukunciphisa umngcipheko wokuphindaphinda

Ifanelekile izilonda ezinkulu okanye ezinzima

Ke ngoko, i-EMR okwangoku isetyenziswa ngokuyintloko kwiiklinikhi zoku:

1. Izilonda ezingenabungozi zomhlaza

2. Iipolyps ezincinci, ezikwazi ukuphinda ziphinde zivele okanye ii-LST ezinemibala

⚠Amanyathelo okhuseleko emva kotyando

Ulawulo lwe-1.Dietary: Kwiiyure zokuqala ze-24 emva kokuhlinzwa, kunqande ukutya okanye udle ulwelo olucacileyo, emva koko ngokuthe ngcembe utshintshele kwisidlo esithambileyo. Kuphephe ukutya okuneziqholo, okuthambisayo, nokucaphukisayo.

2.Ukusetyenziswa kweMithi: I-Proton pump inhibitors (PPIs) isetyenziswa ngokuqhelekileyo emva kokuhlinzwa kwizilonda zesisu ukukhuthaza ukuphulukiswa kwesilonda kunye nokukhusela ukuphuma kwegazi.

I-3.I-Complication Monitoring: Qaphela iimpawu ze-postoperative zokuphuma kwegazi okanye i-perforation, njenge-melena, i-hematemesis, kunye nentlungu yesisu. Funa unyango ngokukhawuleza ukuba kukho naziphi na izinto ezingaqhelekanga.

4. Isicwangciso sokuphonononga: Lungiselela ukutyelelwa okulandelayo kunye nokuphinda i-endoscopies ngokusekelwe kwiziphumo ze-pathological.

Ngaloo ndlela, i-EMR yindlela efunekayo yokubuyisela kwakhona izilonda zesisu. Nangona kunjalo, kubalulekile ukuqonda ngokuchanekileyo izibonakaliso zayo kwaye ugweme ukusetyenziswa ngokugqithiseleyo okanye ukusetyenziswa kakubi. Kumagqirha, oku kufuna isigwebo kunye nobuchule; kwizigulana, kufuna ukuthenjwa nokuqonda.

Makhe sibone ukuba yintoni esinokunikela ngayo kwi-EMR.

Nazi izinto zethu ze-EMR ezinxulumene ne-endoscopic ezibandakanyaIikliphu zeHemostatic,Polypectomy Umgibe,Inaliti yokutofakwayeBiopsy Forceps.