Ibikorwa bya ESD birabujijwe gukorwa kubushake cyangwa uko bishakiye.
Ingamba zitandukanye zikoreshwa mubice bitandukanye. Ibice nyamukuru ni esofagusi, igifu, na colorectum. Igifu kigabanyijemo antrum, agace ka preyloric, inguni ya gastric, fund gastric fund, hamwe no kugabanuka kwumubiri wa gastric. Ibara ryigabanyijemo ibice na rectum. Muri byo, ESD ya antrum nini igoramye ni igice cyinjira-urwego, mugihe ESD yinguni ya gastric, cardia, hamwe nibikomere byiburyo biragoye.
Ihame rusange ni ukuzirikana imbaraga nkeya hanyuma ugatangirana nigice kitoroshye hanyuma igice cyoroshye. Tangira gutemagura no kwiyambura umwanya muto. Mugihe cyo kwiyambura, kwiyambura bigomba no guhera kubice bigoye cyane. Esophageal ESD irashobora gukorwa no gusunika ubwoko. Icyerekezo cyo gutemagura no gukuramo ibisebe byo mu gifu bigomba gutegurwa hakiri kare. Ibibyimba mu mfuruka ya gastrici, kugabanuka gake k'umubiri wa gastric, hamwe na preyloric birashobora kugaragara no gukwega. Tekinoroji ya tekinoroji nuburyo bwo mu mufuka byombi bigize ingamba za ESD. Ikoranabuhanga rikomoka kuri ESD ririmo ESTD, EFTR, ESE, POEM, nibindi .Ikoranabuhanga naryo ni tekinoroji isanzwe igaragara nyuma yubuhanga bwa ESD bumaze kumenya. ESD rero niyo shingiro.
2. Ibisobanuro birambuye bya ESD
Ibikorwa bya ESD birambuye birambuye iyobowe ningamba nini.
Ibisobanuro birambuye
Ibisobanuro birambuye birimo gushyiramo ikimenyetso, gutera inshinge, gukuramo, nibindi.
Hano hari amayeri abiri: imwe niyo igenzurwa nicyuma gishobora gutwarwa muburyo butaziguye (koresha icyuma gihumye gutora bike bishoboka), naho ubundi ni ukugenzura gutunganya imipaka nimiryango mito.
Kwandika no gutera inshinge
Ikimenyetso cya Electrocoagulation gikoreshwa mukumenyekanisha. Mubisanzwe, imbibi za lesion (2-5 mm hanze) zikoreshwa nkikimenyetso. Ikimenyetso gishobora gukorwa ingingo ku ngingo cyangwa kuva kinini kugeza kuri gito. Mu kurangiza, intera iri hagati yibi bimenyetso byombi igomba kuba muri mm 5, kandi igomba kugaragara mugihe endoscope yegereye umurima wo kureba.
Ku ngingo ikurikira. Gutera inshinge bishingiye ku ngeso zawe bwite. Nyuma yo gutera inshinge za subucosal, urushinge rugomba gukurwaho gato hanyuma rukongera guterwa inshinge kugirango ibisebe bizamuke muburebure buhagije kugirango bikurikiranwe hanyuma bikure.
Kata
Gutemagura, ibice bimwe byaciwe kuva kure kugera hafi cyangwa kuva hafi kugera kure (gusunika gukata), ukurikije ingeso bwite nibice byihariye, birakenewe kandi guca kumurongo muto wo hasi. Gukata birimo kubanziriza gukata mbere no gukata byimbitse. Mbere yo gukata bigomba kuba "byukuri" kandi "bihagije". Ubujyakuzimu bwo gutema bugomba kuba buhagije mbere yuko igikorwa gikurikiraho gishobora gukorwa. Nko gufata icyuma no gushiraho idirishya ryabamarayika. Umaze kwinjira mu idirishya rya malayika,
ESD bisobanura kugera ku nzira nziza. Ariko mubyukuri, ntabwo buri ESD ishobora kwinjira muri Window ya Malayika. Ibice byinshi bito-byangiritse nibisanzwe bidasanzwe ESD ntishobora kwinjira mwidirishya rya Malayika. Muri iki gihe, biterwa ahanini nigikorwa cyicyuma gitunganijwe.
Kuramo: Kuramo igice kitoroshye-gukemura igice. Iyo ukuyemo igice cya subucosal, bigomba gukorwa kuva kumpande zombi kugera hagati, bigakora “urufunguzo” rwa V. Ubujyakuzimu bwa peripheri mbere yo gukata bugomba kuba buhagije, naho ubundi biroroshye gukuramo kurenga imbibi. Nibice bike bisigaye, niko urwego rwubwisanzure. Birakenewe kugenzura icyuma kugirango ugabanye ingirangingo, cyane cyane tissue yanyuma. Niba kugenzura atari byiza, biroroshye guca byinshi cyangwa bike.
Uburyo bwo gufata indorerwamo
Hariho uburyo bubiri bwo gufata urugero rwa ESD, byombi bigenzura igipimo cyumubiri, ipfundo, hamwe nibikoresho-byinjira. Hariho uburyo bubiri: "icyerekezo cyibumoso + ibikoresho" n "" amaboko abiri kugeza kumaboko ane ". Ihame ryingenzi ryo gufata intera nugukomeza umurima wimikorere uhamye kandi ugenzurwa. Kugeza ubu, uburyo bwamaboko abiri kugeza kumaboko ane afite uburyo bwiza bwo kugenzura umutekano kandi burakoreshwa cyane. Gusa iyo igipimo gihamye gishobora kwerekana imikorere yimyenda mito + flaps ikemurwa neza.
Gusa hamwe nuburyo bwiza bwo gufata indorerwamo irashobora gucungwa neza. Tekinike yo gutoranya icyuma irashobora kugenzura neza icyerekezo, ikigamijwe nukuguma kure yimitsi no kugabanya ingirangingo. Iyo ukora ESD subucosal, birakenewe guca hafi yimitsi, ubujyakuzimu bwimitsi irahagije, kandi biroroshye guhagarika kuva amaraso. Icy'ingenzi ni ukureba niba gutemagura bitaba byimbitse cyangwa kunyuramo, kandi tekinike yo gutora icyuma nubuhanga bwingenzi muri iki gihe.
Kugenzura iyerekwa
Kugenzura icyerekezo bigaragarira no mu kwerekana no kugenzura umurima wo kureba. Usibye kuzenguruka ipfundo n'umubiri wa lens, imipira ibonerana hamwe nibindi bikoresho bikoreshwa muguhishura umurima wo kureba cyangwa ingirabuzimafatizo, cyane cyane imbaraga nto zikoreshwa muguhishura no kuzamura uduce duto, ari déforme ntoya cyane.
Igenzura intera yumurima wo kureba. Gusa iyo umurima wicyerekezo ubitswe intera ikwiye irashobora gukoreshwa no kugenzurwa. Niba ari kure cyane cyangwa yegeranye cyane, bizagorana kugenzura icyuma neza. Imyitwarire yoroheje irashobora gusa nkaho itagenda, ariko urugingo rumaze kugira imbaraga zo guhindura ibintu. Niyo mpamvu ESD igomba gukoresha intera ikwiye no guhindura ibintu.
Ibisobanuro byavuzwe haruguru, gufata lens, hamwe n'umwanya wo kugenzura ni ibintu by'ingenzi bigize ESD “kugenzura”.
Twebwe, Jiangxi Zhuoruihua Medical Instrument Co., Ltd. ESD, ERCP. Ibicuruzwa byacu byemewe na CE, kandi ibihingwa byacu byemewe na ISO. Ibicuruzwa byacu byoherejwe mu Burayi, Amerika y'Amajyaruguru, Uburasirazuba bwo hagati ndetse no muri Aziya, kandi bigera ku bakiriya bamenyekana kandi bashimwe!
Igihe cyo kohereza: Nyakanga-14-2025