Yintoni i-EMR? Masiyizobe!

Izigulane ezininzi kumasebe e-gastroenterology okanye kumaziko e-endoscopy ziyacetyiswa ukuba zisuswe i-endoscopic mucosal resection (I-EMRIsetyenziswa rhoqo, kodwa ngaba uyazi ukuba izalathiso, imida, kunye namanyathelo okhuseleko emva kotyando?

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

Ngoko ke, yintoni i-EMR? Masiyizobe kuqala size sibone…

❋Zithini izikhokelo ezigunyazisiweyo malunga neempawu ze-EMR? Ngokwezikhokelo zoNyango loMhlaza weSisu saseJapan, i-Chinese Expert Consensus, kunye nezikhokelo ze-European Society of Endoscopy (ESGE), izibonakaliso ezicetyiswayo ngoku ze-EMR ziquka oku kulandelayo:

Ⅰ. Iipolyps okanye ii-adenomas ezingengobungozi

● Izilonda ≤ 20 mm kunye nemida ecacileyo

● Akukho zimpawu zicacileyo zokuhlaselwa yi-submucosal

● Ithumba Elisasaza Ngasecaleni (LST-G)

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

● Ayinazo izihlunu, ayinazilonda

● Izilonda ezincinci kune-10 mm

● Yahluke kakuhle

Ⅲ. I-dysplasia ebuthathaka okanye izilonda ezikumgangatho ophantsi ezine-pathology ecacileyo kunye nokukhula kancinci

◆ Izigulana ezithathwa njengezifanelekileyo ukususwa emva kokuhlolwa okulandelayo

⚠Qaphela: Nangona izikhokelo zisithi i-EMR iyamkeleka kumhlaza wesigaba sokuqala ukuba isilonda sincinci, asinazilonda, kwaye sivaleleke kwi-mucosa, kwindlela yokwenyani yeklinikhi, i-ESD (endoscopic submucosal dissection) ikhethwa ngokubanzi ukuqinisekisa ukususwa ngokupheleleyo, ukhuseleko, kunye novavanyo oluchanekileyo lwe-pathological.

I-ESD ineenzuzo ezininzi ezibalulekileyo:

Ukususwa kwesilonda nge-en bloc kunokwenzeka

Iququzelela uvavanyo lomda, inciphisa umngcipheko wokuphinda ubuye

Ifanelekile kwizilonda ezinkulu okanye ezinzima ngakumbi

Ngoko ke, i-EMR okwangoku isetyenziswa kakhulu kwizonyango xa kuziwa kwezi zinto zilandelayo:

1. Izilonda ezingalunganga ezingenabungozi bomhlaza

2. Iipolyps ezincinci, ezinokususwa lula okanye ii-LST ze-colorectal

⚠Amanyathelo okhuseleko emva kotyando

1. Ulawulo Lokutya: Kwiiyure ezingama-24 zokuqala emva kotyando, kuphephe ukutya okanye usele ulwelo olucacileyo, uze emva koko utshintshele kancinci kancinci kwisidlo esithambileyo. Kuphephe ukutya okuneziqholo, okunencasa, nokucaphukisayo.

2. Ukusetyenziswa Kwamayeza: Izithinteli zeProton pump (PPIs) zihlala zisetyenziswa emva kotyando kwizilonda zesisu ukukhuthaza ukuphiliswa kwezilonda nokuthintela ukopha.

3. Ukubeka esweni iingxaki: Lumka xa ubona iimpawu zokopha okanye ukugqobhoka emva kotyando, ezifana ne-melena, i-hematemesis, kunye nentlungu yesisu. Funa uncedo lwezonyango ngokukhawuleza ukuba kukho naziphi na iingxaki ezenzekayo.

4. Isicwangciso soHlolo: Lungiselela utyelelo olulandelayo kunye nokuphinda ii-endoscopy ngokusekelwe kwiziphumo zesifo.

Ngoko ke, i-EMR yindlela ebalulekileyo yokususa izilonda zesisu. Nangona kunjalo, kubalulekile ukuqonda ngokuchanekileyo imiqondiso yayo kwaye uphephe ukuyisebenzisa ngokugqithisileyo okanye ukusetyenziswa gwenxa. Kugqirha, oku kufuna ugwebo kunye nobuchule; kwizigulana, kufuna ukuthembana nokuqonda.

Makhe sibone ukuba singanikela ntoni nge-EMR.

Nazi izinto zethu ezisetyenziswayo ze-endoscopic ezinxulumene ne-EMR ezibandakanyaIikliphu zeHemostatic,Umgibe we-Polypectomy,Inaliti YokujovakwayeIiForceps zeBiopsy.