Nui nā poʻe maʻi ma nā keʻena gastroenterology a i ʻole ke kikowaena endoscopy i manaʻo ʻia no ka ʻoki ʻana o ka mucosal endoscopic (EMR). Hoʻohana pinepine ʻia, akā ʻike anei ʻoe i kāna mau hōʻailona, nā palena, a me nā hana mālama postoperative?
Na kēia ʻatikala e alakaʻi iā ʻoe ma o ka ʻike EMR koʻikoʻi e kōkua iā ʻoe e hoʻoholo i ka ʻike a me ka hilinaʻi.
No laila, he aha ka EMR? E kaha mua kākou a ʻike…
❋He aha ka ʻōlelo a nā alakaʻi mana e pili ana i nā hōʻailona no EMR? Wahi a ka Japanese Gastric Cancer Treatment Guidelines, ka Chinese Expert Consensus, a me ka European Society of Endoscopy (ESGE) alakaʻi, ʻo nā hōʻailona i ʻōlelo ʻia i kēia manawa no EMR e pili ana i kēia:
Ⅰ. ʻO nā polyps maikaʻi a i ʻole nā adenomas
● Lesions ≤ 20 mm me nā ʻaoʻao māmā
● ʻAʻohe hōʻailona maopopo o ke komo ʻana o ka submucosal
● Laterally Spreading Tumor (LST-G)
Ⅱ. ʻO ka neoplasia intraepithelial pae kiʻekiʻe (HGIN)
● Mucosal-limited, ʻaʻohe ulceration
● Liʻiliʻi liʻiliʻi ma mua o 10 mm
● Hoʻokaʻawale maikaʻi
Ⅲ. ʻO ka dysplasia haʻahaʻa a i ʻole nā haʻahaʻa haʻahaʻa me ka pathology maopopo a me ka ulu lohi
◆ ʻO nā maʻi i manaʻo ʻia he kūpono no ka wehe ʻana ma hope o ka nānā ʻana
⚠Note: ʻOiai ke ʻōlelo nei nā alakaʻi e ʻae ʻia ʻo EMR no nā maʻi maʻi maʻi mua inā he liʻiliʻi ka ʻeha, ʻaʻole ʻeha, a paʻa i ka mucosa, ma ka hoʻomaʻamaʻa lapaʻau maoli, makemake ʻia ʻo ESD (endoscopic submucosal dissection) e hōʻoia i ka wehe piha ʻana, palekana, a me ka loiloi pathological pololei.
Hāʻawi ʻo ESD i nā pōmaikaʻi nui:
Hiki ke hoʻokaʻawale ʻia i ka ʻeha
Hoʻomaʻamaʻa i ka loiloi margin, hoʻemi i ka pilikia o ka hoʻi hou ʻana
He kūpono no nā ʻeha nui a paʻakikī paha
No laila, hoʻohana mua ʻia ʻo EMR i ka hana lapaʻau no:
1. ʻO nā ʻeha maikaʻi me ka pilikia ʻole o ka maʻi kanesa
2. Nā polyps li'ili'i a ma'alahi hiki ke wehe 'ia a i 'ole LST colorectal
⚠Ma hope o ka hana ʻana
1. ʻAi Manaʻo: No nā hola 24 mua ma hope o ka ʻoki ʻana, e pale i ka ʻai ʻana a i ʻole ka ʻai ʻana i nā wai maʻemaʻe, a laila e hoʻololi mālie i kahi meaʻai palupalu. Hōʻalo i nā meaʻai ʻala, astringent, a me nā mea hoʻonāukiuki.
2. Hoʻohana i ka lāʻau lapaʻau: Hoʻohana maʻamau ʻia nā mea hoʻopaʻa paʻa Proton (PPI) ma hope o ka ʻoki ʻana no nā maʻi ʻōpū e hoʻoikaika i ka ho'ōla ʻana a me ka pale ʻana i ke koko.
3.Complication Monitoring: E makaʻala no nā hōʻailona postoperative o ke koko a i ʻole ka perforation, e like me melena, hematemesis, a me ka ʻeha ʻōpū. E ʻimi koke i ka lāʻau lapaʻau inā loaʻa nā mea ʻino.
4. Hoʻolālā Hoʻolālā: E hoʻonohonoho i nā kipa ukali a hana hou i nā endoskopi ma muli o nā ʻike pathological.
No laila, ʻo EMR kahi ʻano hana koʻikoʻi no ka wehe ʻana i nā maʻi gastrointestinal. Eia nō naʻe, he mea koʻikoʻi e hoʻomaopopo pono i kāna mau hōʻailona a pale i ka hoʻohana nui ʻana a i ʻole hoʻohana hewa. No nā kauka, pono kēia i ka noʻonoʻo a me ke akamai; no nā maʻi, pono ia i ka hilinaʻi a me ka hoʻomaopopo.
E ʻike i ka mea hiki iā mākou ke hāʻawi no EMR.
Eia kā mākou mau mea hoʻohana endoscopic e pili ana i ka EMRHemostatic Clips,Pahele Polypectomy,Needle InjectionaBiopsy Forceps.
Ka manawa hoʻouna: Sep-01-2025