Ua ʻōlelo ʻia nā maʻi he nui ma nā keʻena gastroenterology a i ʻole nā kikowaena endoscopy no ka endoscopic mucosal resection (EMR). Hoʻohana pinepine ʻia ia, akā ua ʻike anei ʻoe i kona mau hōʻailona, nā palena, a me nā hana palekana ma hope o ke ʻoki ʻana?
E alakaʻi pono kēia ʻatikala iā ʻoe ma o ka ʻike EMR koʻikoʻi e kōkua iā ʻoe e hana i kahi hoʻoholo ʻike a hilinaʻi hoʻi.
No laila, he aha ka EMR? E kahakiʻi mua kākou a ʻike…
❋He aha ka ʻōlelo a nā alakaʻi i manaʻo ʻia e pili ana i nā hōʻailona no EMR? Wahi a nā Alakaʻi Lapaʻau Kanesa ʻŌpū Kepanī, ka Chinese Expert Consensus, a me nā alakaʻi o ka European Society of Endoscopy (ESGE), ʻo nā hōʻailona i ʻōlelo ʻia no EMR e like me kēia:
Ⅰ. Nā polyps maikaʻi a i ʻole adenomas
● Nā ʻeha ≤ 20 mm me nā palena maopopo
● ʻAʻohe hōʻailona maopopo o ka hoʻouka kaua ʻana ma lalo o ka mucosa
● ʻO ka puʻupuʻu pālahalaha ʻaoʻao (LST-G)
II. ʻO ka neoplasia intraepithelial kiʻekiʻe kiʻekiʻe (HGIN)
● Palena ʻia ka mucosal, ʻaʻohe ʻeha
● Nā ʻeha liʻiliʻi ma mua o 10 mm
● Hoʻokaʻawale maikaʻi ʻia
ʻO ka dysplasia liʻiliʻi a i ʻole nā ʻeha haʻahaʻa me ka pathology maopopo a me ka ulu lohi
◆ Ua manaʻo ʻia nā maʻi kūpono no ka ʻoki ʻana ma hope o ka nānā ʻana
⚠Nānā: ʻOiai ke ʻōlelo nei nā alakaʻi ua ʻae ʻia ka EMR no nā maʻi ʻaʻai mua inā he liʻiliʻi ka lesion, ʻaʻole ulcerated, a ua kaupalena ʻia i ka mucosa, i ka hana lapaʻau maoli, ʻoi aku ka makemake ʻia o ka ESD (endoscopic submucosal dissection) e hōʻoia i ka resection piha, palekana, a me ka loiloi pathological pololei.
Hāʻawi ʻo ESD i kekahi mau pono koʻikoʻi:
Hiki ke ʻoki ʻia ka lesion en bloc
Hoʻomaʻalahi i ka loiloi margin, e hōʻemi ana i ka pilikia o ka hana hou ʻana
Kūpono no nā ʻeha nui a paʻakikī paha
No laila, hoʻohana nui ʻia ʻo EMR i ka hana lapaʻau no:
1. Nā ʻeha maikaʻi ʻole me ka pilikia ʻole o ka maʻi kanesa
2. Nā polyps liʻiliʻi a maʻalahi hoʻi e wehe ʻia a i ʻole nā LST colorectal
⚠Nā Mālama Ma hope o ke ʻoki ʻana
1. Ka Hoʻokele ʻAi: No nā hola 24 mua ma hope o ke ʻoki ʻana, e pale i ka ʻai ʻana a i ʻole ka inu ʻana i nā wai maopopo, a laila e neʻe mālie i kahi ʻai palupalu. E pale i nā mea ʻala, astringent, a me nā mea hoʻonāukiuki.
2. Hoʻohana Lāʻau Lapaʻau: Hoʻohana pinepine ʻia nā mea hoʻopaʻa pamu proton (PPI) ma hope o ke ʻoki ʻana no nā ʻeha ʻōpū e hoʻolaha i ka ho'ōla ʻana o ka ʻōpū a pale i ke kahe ʻana o ke koko.
3. Ka Nānā ʻana i nā pilikia: E makaʻala no nā hōʻailona postoperative o ke kahe ʻana o ke koko a i ʻole ka perforation, e like me ka melena, hematemesis, a me ka ʻeha o ka ʻōpū. E ʻimi koke i ke kōkua lapaʻau inā loaʻa kekahi mau mea ʻē.
4. Hoʻolālā Loiloi: E hoʻonohonoho i nā kipa hahai a hana hou i nā endoscopies ma muli o nā ʻike pathological.
No laila, he ʻano hana koʻikoʻi ʻo EMR no ka ʻoki ʻana i nā ʻeha gastrointestinal. Eia nō naʻe, he mea nui e hoʻomaopopo pono i kāna mau hōʻailona a pale i ka hoʻohana nui ʻana a i ʻole ka hoʻohana hewa ʻana. No nā kauka, pono kēia i ka noʻonoʻo a me ke akamai; no nā mea maʻi, pono ka hilinaʻi a me ka hoʻomaopopo ʻana.
E nānā kākou i ka mea hiki iā mākou ke hāʻawi aku no EMR.
Eia kā mākou mau mea hoʻopau endoscopic e pili ana i ka EMR e komo pū ana meNā ʻūpā hemostatic,ʻO ka pahele Polypectomy,Nila Hoʻokomoa meNā Forceps Biopsy.
Ka manawa hoʻouna: Sep-01-2025