Iziguli eziningi eminyangweni ye-gastroenterology noma ezikhungweni ze-endoscopy ziyanconywa ukuthi zihlinzwe i-endoscopic mucosal resection (I-EMRIsetshenziswa kaningi, kodwa uyazi yini ngezinkomba zayo, imikhawulo, kanye nezinyathelo zokuphepha ngemva kokuhlinzwa?
Lesi sihloko sizokuqondisa ngendlela ehlelekile ngolwazi olubalulekile lwe-EMR ukuze sikusize wenze isinqumo esinolwazi nokuqiniseka.
Ngakho-ke, iyini i-EMR? Ake siyidwebe kuqala bese sibona…
❋Zithini iziqondiso ezigunyaziwe ngezinkomba ze-EMR? Ngokweziqondiso Zokwelashwa Komdlavuza Wesisu WaseJapane, i-Chinese Expert Consensus, kanye neziqondiso ze-European Society of Endoscopy (ESGE), izinkomba ezinconywayo njengamanje ze-EMR zifaka okulandelayo:
Ⅰ. Ama-polyp noma ama-adenoma angewona awemvelo
● Izilonda ≤ 20 mm ezinemingcele ecacile
● Azikho izimpawu ezicacile zokuhlasela kwe-submucosal
● Isimila Esisakazeka Ngasohlangothini (LST-G)
Ⅱ. I-focal high-grade intraepithelial neoplasia (HGIN)
● Kunqunyelwe amafinyila, akukho ukudumba
● Izilonda ezincane kune-10 mm
● Kuhlukaniswe kahle
Ⅲ. I-dysplasia encane noma izilonda ezisezingeni eliphansi ezine-pathology ecacile kanye nokukhula kancane
◆ Iziguli ezibhekwa njengezifanele ukuhlinzwa ngemva kokuhlolwa okulandelayo
⚠Qaphela: Nakuba iziqondiso zithi i-EMR iyamukeleka kumdlavuza wesigaba sokuqala uma isilonda sincane, singanamanxeba, futhi sivaleleke ku-mucosa, empeleni, i-ESD (endoscopic submucosal dissection) ngokuvamile iyathandwa ukuqinisekisa ukususwa okuphelele, ukuphepha, kanye nokuhlolwa okunembile kwezifo.
I-ESD inikeza izinzuzo eziningana ezibalulekile:
Ukususwa kwesilonda nge-en bloc kungenzeka
Kwenza kube lula ukuhlola umkhawulo, kunciphisa ingozi yokuphinda kwenzeke
Ilungele izilonda ezinkulu noma eziyinkimbinkimbi kakhulu
Ngakho-ke, i-EMR okwamanje isetshenziswa kakhulu emitholampilo ye:
1. Izilonda ezingembi kangako ezingenayo ingozi yomdlavuza
2. Ama-polyp amancane, alula ukuwasusa noma ama-LST e-colorectal
⚠Izinyathelo Zokuqapha Ngemva Kokuhlinzwa
1. Ukuphathwa Kokudla: Emahoreni okuqala angu-24 ngemva kokuhlinzwa, gwema ukudla noma uphuze uketshezi olucacile, bese ushintshela kancane kancane ekudleni okuthambile. Gwema ukudla okunongwe kakhulu, okune-astringent, nokucasulayo.
2. Ukusetshenziswa Kwemithi: Ama-proton pump inhibitors (PPIs) avame ukusetshenziswa ngemva kokuhlinzwa kwezilonda zesisu ukukhuthaza ukuphulukiswa kwezilonda nokuvimbela ukuphuma kwegazi.
3. Ukuqapha Izinkinga: Qaphela izimpawu zokopha noma ukubhoboka ngemva kokuhlinzwa, njenge-melena, i-hematemesis, kanye nobuhlungu besisu. Funa usizo lwezokwelapha ngokushesha uma kwenzeka noma yikuphi ukukhubazeka.
4. Uhlelo Lokubuyekeza: Hlela ukuvakasha kokulandelela bese uphinda ama-endoscopy ngokusekelwe kokutholakele kwezifo.
Ngakho-ke, i-EMR iyindlela ebalulekile yokususa izilonda zesisu. Kodwa-ke, kubalulekile ukuqonda kahle izinkomba zayo nokugwema ukusetshenziswa ngokweqile noma ukusetshenziswa kabi. Kodokotela, lokhu kudinga ukwahlulela kanye nekhono; ezigulini, kudinga ukwethenjwa nokuqonda.
Ake sibone ukuthi yini esingayinikeza nge-EMR.
Nazi izinto zethu ezisetshenziswayo ze-endoscopic ezihlobene ne-EMR ezifaka phakathiIziqeshana ze-Hemostatic,Ugibe Lokususwa Kwe-Polypectomy,Inaliti YomjovofuthiAma-Forceps e-Biopsy.
Isikhathi sokuthunyelwe: Septhemba-01-2025