Kodi EMR ndi chiyani? Tiyeni tijambule!

Odwala ambiri m'madipatimenti a gastroenterology kapena m'malo ochitira opaleshoni ya m'mimba amalangizidwa kuti achotsedwe mucosal resection (EMRAmagwiritsidwa ntchito mobwerezabwereza, koma kodi mukudziwa zizindikiro zake, zofooka zake, ndi njira zodzitetezera pambuyo pa opaleshoni?

Nkhaniyi ikutsogolerani mwadongosolo mfundo zazikulu za EMR kuti zikuthandizeni kupanga chisankho chodziwa bwino komanso chodalirika.

Ndiye, kodi EMR ndi chiyani? Tiyeni tijambule kaye kuti tiwone…

❋Kodi malangizo odalirika amanena chiyani za zizindikiro za EMR? Malinga ndi malangizo a Japanese Gastric Cancer Treatment Guidelines, Chinese Expert Consensus, ndi malangizo a European Society of Endoscopy (ESGE), zizindikiro zomwe zikulangizidwa pakali pano za EMR zikuphatikizapo izi:

Ⅰ. Ma polyps kapena adenomas osavulaza

● Zilonda ≤ 20 mm zokhala ndi malire omveka bwino

● Palibe zizindikiro zoonekeratu za kulowa kwa submucosal

● Kufalikira kwa Chotupa M'mbali (LST-G)

Ⅱ. Focal high-grade intraepithelial neoplasia (HGIN)

● Yochepa mucous membranes, palibe zilonda

● Zilonda zazing'ono kuposa 10 mm

● Yosiyana kwambiri

Ⅲ. Dysplasia yofatsa kapena zilonda zochepa zomwe zimakhala ndi matenda omveka bwino komanso kukula pang'onopang'ono

◆ Odwala omwe akuwoneka kuti ndi oyenera kuchitidwa opaleshoni pambuyo poyang'aniridwa ndi dokotala

⚠Dziwani: Ngakhale malangizowa akunena kuti EMR ndi yovomerezeka pa khansa yoyambirira ngati chilondacho chili chaching'ono, chosatupa, ndipo chili pafupi ndi mucosa, m'machitidwe enieni azachipatala, ESD (endoscopic submucosal dissection) nthawi zambiri imakondedwa kuti zitsimikizire kuti kuchotsa kwathunthu, chitetezo, komanso kuwunika kolondola kwa matenda.

ESD ili ndi zabwino zingapo zazikulu:

Kuchotsa chilondacho ndi bloc resection n'kotheka

Zimathandizira kuwunika malire, kuchepetsa chiopsezo chobwereranso

Yoyenera zilonda zazikulu kapena zovuta kwambiri

Chifukwa chake, EMR imagwiritsidwa ntchito makamaka muzochita zachipatala pa:

1. Zilonda zosaopsa popanda chiopsezo cha khansa

2. Ma polyps ang'onoang'ono, osavuta kuchotsa kapena ma LST a colorectal

⚠Malangizo Oyenera Kutsatira Pambuyo pa Opaleshoni

1. Kusamalira Zakudya: Kwa maola 24 oyamba mutatha opaleshoni, pewani kudya kapena kumwa zakumwa zoyera, kenako pang'onopang'ono musinthe kukhala zakudya zofewa. Pewani zakudya zokometsera, zoletsa kupweteka, komanso zokwiyitsa.

2. Kugwiritsa Ntchito Mankhwala: Zoletsa kupopera kwa proton (PPIs) zimagwiritsidwa ntchito kwambiri pambuyo pa opaleshoni ya zilonda zam'mimba kuti zichiritse zilonda ndikuletsa kutuluka magazi.

3. Kuyang'anira Mavuto: Khalani tcheru ngati pali zizindikiro za kutuluka magazi kapena kubowoka pambuyo pa opaleshoni, monga melena, hematemesis, ndi kupweteka m'mimba. Pitani kuchipatala mwachangu ngati pali vuto lililonse.

4. Ndondomeko Yowunikiranso: Konzani maulendo otsatira ndi kubwereza ma endoscopy kutengera zomwe zapezeka pa matenda.

Motero, EMR ndi njira yofunika kwambiri pochotsa zilonda zam'mimba. Komabe, ndikofunikira kumvetsetsa bwino zomwe zikuwonetsa ndikupewa kugwiritsa ntchito mopitirira muyeso kapena kugwiritsa ntchito molakwika. Kwa madokotala, izi zimafuna kuweruza ndi luso; kwa odwala, zimafuna kudalirika ndi kumvetsetsa.

Tiyeni tiwone zomwe tingapereke pa EMR.

Nazi zinthu zathu zokhudzana ndi EMR zomwe zingagwiritsidwe ntchito pofufuza ma endoscopic zomwe zikuphatikizapoMa Clips a Hemostatic,Msampha wa Polypectomy,Singano ya jakisonindiMphamvu za Biopsy.