ʻOi aku ka kapu o nā hana ESD ke hana ʻole ʻia a i ʻole ka manaʻo.
Hoʻohana ʻia nā hoʻolālā like ʻole no nā ʻāpana like ʻole. ʻO nā ʻāpana nui he esophagus, ʻōpū, a me ka colorectum. Hoʻokaʻawale ʻia ka ʻōpū i antrum, prepyloric area, gastric angle, gastric fundus, a me ka curvature nui o ke kino ʻōpū. Hoʻokaʻawale ʻia ka colorectum i ke kolon a me ka rectum. Ma waena o lākou, ʻo ESD o nā ʻeha curvature ʻoi aku ka nui o ka antrum he ʻāpana komo, ʻoiai ʻoi aku ka paʻakikī o ka ESD o ka ʻāʻī o ka ʻōpū, cardia, a me nā ʻeha kolone ʻākau.
ʻO ke kumu maʻamau ka noʻonoʻo ʻana i ka helu haʻahaʻa haʻahaʻa a hoʻomaka me ka ʻāpana paʻakikī a laila ka ʻāpana maʻalahi. E hoʻomaka i ka ʻoki a me ka wehe ʻana mai ke kūlana haʻahaʻa haʻahaʻa. I ka wā o ka wehe ʻana, pono e hoʻomaka ka wehe ʻana mai ka ʻāpana paʻakikī loa. Hiki ke hana ʻia ʻo Esophageal ESD e ka ʻoki ʻano pana. Pono e hoʻolālā mua ʻia ke kuhikuhi o ka ʻoki ʻana a me ka wehe ʻana i nā ʻeha ʻōpū. Hiki ke ʻike ʻia nā ʻeha ma ka ʻāʻī o ka ʻōpū, ka liʻiliʻi o ka curvature o ke kino ʻōpū, a me ka wahi prepyloric e ka huki ʻana. ʻO ka ʻenehana Tunnel a me ke ʻano pocket ʻelua ʻāpana o ka hoʻolālā ESD. ʻO nā ʻenehana i loaʻa mai i ka ESD, ʻo ia ka ESTD, EFTR, ESE, POEM, a pēlā aku. No laila ʻo ESD ke kumu.
2. Nā kikoʻī hana ESD
ʻO nā kikoʻī hana ESD nā kikoʻī ma lalo o ke alakaʻi o ka hoʻolālā nui.
Nā kikoʻī hana
ʻO nā kikoʻī hana e pili ana i ka hōʻailona ʻana, injection, peeling, etc.
ʻElua mau hoʻopunipuni: ʻo ka ʻohi pahi hiki ke hoʻomalu ʻia ma lalo o ka ʻike maka (e hoʻohana i ka ʻohi pahi makapō i ka liʻiliʻi e hiki ai), a ʻo kekahi ʻo ka hoʻoponopono ʻana i nā palena a me nā hui liʻiliʻi.
Lepili a me ka injection
Hoʻohana ʻia ka hōʻailona electrocoagulation no ka mākaʻikaʻi ʻana. ʻO ka maʻamau, hoʻohana ʻia ka palena lesion (2-5 mm ma waho) e like me ka māka. Hiki ke hōʻailona ʻia ma kahi kikoʻī a i ʻole mai ka nui a i ka liʻiliʻi. I ka hopena, ʻo ka wā ma waena o nā mākaʻikaʻi ʻelua i loko o 5 mm, a pono e ʻike ʻia ke kokoke ka endoscope i ke kahua o ka ʻike.
I ka lae i kaha hou ia. Hoʻokumu ʻia ka injection i nā maʻamau pilikino. Ma hope o ka hoʻokomo ʻana i loko o ka papa submucosal, pono e hoʻihoʻi iki ʻia ka nila a laila e hoʻopiʻi hou ʻia e hōʻoia i ka piʻi ʻana o ka ʻeha i kahi kiʻekiʻe kūpono no ka ʻoki ʻana a me ka ʻili ʻana.
ʻOki
ʻO ka ʻoki ʻana, ua ʻoki ʻia kekahi mau ʻāpana mai kahi mamao a kokoke a i ʻole mai kahi kokoke i kahi mamao (push cutting), e like me nā maʻamau pilikino a me nā ʻāpana kikoʻī, pono nō hoʻi e ʻoki ʻia mai kahi haʻahaʻa o ka umekaumaha ma mua. ʻO ka ʻoki ʻana e pili ana i ka ʻoki mua ʻana a me ka ʻoki mua ʻana. Pono ka "pololei" a "pono" ka pre-cutting. Pono e lawa ka hohonu o ka ʻoki ʻana ma mua o ka hoʻokō ʻana i ka hana peeling ma hope. E like me ka ʻohi ʻana i ka pahi a hoʻokumu i ka puka aniani ʻānela. I ke komo ʻana i ka puka aniani ʻānela,
ʻO ka ESD ke ʻano o ka hoʻokō ʻana i kahi ala kūpono. Akā ʻo ka ʻoiaʻiʻo, ʻaʻole hiki i kēlā me kēia ESD ke komo i ka Window Angel. ʻAʻole hiki i ka ESD ke komo i ka puka makani ʻānela he nui nā liona liʻiliʻi a me nā ʻeha kūikawā. I kēia manawa, hilinaʻi nui ia i ka hana pahi hoʻomaʻemaʻe.
Peel off: E ʻoki mua i ka ʻāpana paʻakikī. I ka ʻili ʻana i ka ʻāpana submucosal, pono e hana ʻia mai nā ʻaoʻao ʻelua a i ke kikowaena, e hana i kahi "kī" V-shaped. Pono e lawa ka hohonu o ka peripheral pre-cut, i ʻole e maʻalahi ke peel ma waho o ka palena. ʻO ka liʻiliʻi o ke koena o ke kino, ʻoi aku ka nui o ke kūʻokoʻa. Pono e hoʻomalu i ka pahi e ʻoki pololei i ka ʻiʻo, ʻoi aku ka hope. Inā maikaʻi ʻole ka mana, maʻalahi ke ʻoki nui a liʻiliʻi paha.
Pehea e paa ai i ke aniani
ʻElua ala e hoʻopaʻa ai i ka scope ESD, ʻo ia mau mea ʻelua e hoʻomalu i ke kino kiko, nā kī, a me nā mea komo i loko a i waho. ʻElua mau ala: "ʻaoʻao hema + nā mea hana" a "ʻelua lima i ʻehā mau lima". ʻO ke kumu nui o ka hoʻopaʻa ʻana i ka laulā ʻo ia ka mālama ʻana i ke kahua hana paʻa a hiki ke kāohi. I kēia manawa, ʻoi aku ka maikaʻi o ke ʻano o ka lima ʻelua i ka lima ʻehā a ʻoi aku ka nui o ka hoʻohana ʻana. Aia wale nō ka paʻa o ka laulā hiki ke hoʻohana maikaʻi ʻia ka hana hoʻolaha o nā ʻiʻo liʻiliʻi + flaps.
Me ke ʻano paʻa aniani maikaʻi wale nō e hiki ke hoʻomalu maikaʻi ʻia ka pahi. Hiki i ka ʻenehana ʻohi pahi ke ʻoi aku ka maikaʻi o ka hoʻokele ʻana i ke kuhikuhi, ʻo ke kumu ka haʻalele ʻana mai ka papa ʻiʻo a ʻoki i ka ʻiʻo i hoʻopaʻa ʻia. I ka hana ʻana i kahi ʻoki submucosal ESD, pono e ʻoki kokoke i ka ʻāpana ʻiʻo, ua lawa ka hohonu o ka ʻoki kino, a ʻoi aku ka maʻalahi o ka hoʻopau ʻana i ke koko. ʻO ka mea nui, ʻo ia ka hōʻoia ʻana ʻaʻole hohonu loa ka ʻoki ʻana, a ʻo ka ʻenehana ʻohi pahi ke akamai nui i kēia manawa.
Ka hoomalu ana i ka ike
Hōʻike ʻia ka mana kuhikuhi i ka ʻike a me ka hoʻomalu ʻana i ke kahua o ka ʻike. Ma waho aʻe o ka hoʻololi ʻana i ka puʻupuʻu a me ke kino o ka lens, hoʻohana ʻia nā pāpale aniani a me nā mea pono e hōʻike i ke kahua o ka ʻike a i ʻole ka ʻiʻo i hoʻopaʻa ʻia, ʻoi aku ka ikaika liʻiliʻi i hoʻohana ʻia e hōʻike a hāpai i nā ʻiʻo liʻiliʻi, ʻo ia ka liʻiliʻi liʻiliʻi.
E mālama i ka mamao o ke kahua o ka ʻike. Aia wale nō ke mālama ʻia ke kahua o ka hihiʻo i kahi mamao kūpono e hiki ai ke hoʻohana ʻia a mālama ʻia. Inā lōʻihi a kokoke paha, he paʻakikī ke hoʻomalu i ka pahi. Me he mea lā ʻaʻohe neʻe ka neʻe ʻana o ka maʻalahi, akā ua loaʻa i ka ʻiʻo ka ikaika deformation maoli. ʻO ia ke kumu e hoʻohana ai ʻo ESD i ka mamao kūpono a me ka deformation kūpono.
ʻO nā kikoʻī ma luna, ka paʻa ʻana o ka lens, a me ka mana o ka nānā ʻana ʻo ia nā mea nui o ESD "ka mana lens".
ʻO mākou, ʻo Jiangxi Zhuoruihua Medical Instrument Co., Ltd., he mea hana ma Kina i mea kūikawā i ka endoscopic consumables, e like me biopsy forceps, hemoclip, polyp snare, sclerotherapy needle, spray catheter, cytology brushes, guidewire, stone retrieval basket, nasal biliary drainage sheath accesser etc. i hoʻohana nui ʻia ma EMR, ESD, ERCP. ʻO kā mākou huahana i hōʻoia ʻia ʻo CE, a ua hōʻoia ʻia kā mākou mea kanu. Ua lawe ʻia kā mākou waiwai i ʻEulopa, ʻAmelika ʻAmelika, Middle East a me kahi hapa o Asia, a loaʻa nui i ka mea kūʻai aku o ka ʻike a me ka hoʻomaikaʻi!
Ka manawa hoʻouna: Jul-14-2025