EMR ni iki? Reka dushushanye!

Abarwayi benshi bo mu mashami ya gastroenterology cyangwa ibigo bya endoskopi basabwa kuvura mucosal endoscopique (EMR). Irakoreshwa cyane, ariko uzi ibimenyetso byayo, aho bigarukira, hamwe nuburinzi bwa nyuma yibikorwa?

Iyi ngingo izakuyobora neza binyuze mumakuru yingenzi ya EMR kugirango igufashe gufata ibyemezo byinshi kandi byizewe.

None, EMR ni iki? Reka tubanze dushushanye turebe…

GuidelinesAmabwiriza yemewe avuga iki kubimenyetso bya EMR? Dukurikije Amabwiriza y’Ubuyapani yo Kuvura Kanseri yo mu gifu, Ubwumvikane bw’inzobere mu Bushinwa, hamwe n’amabwiriza y’umuryango w’ibihugu by’i Burayi bya Endoscopi (ESGE), ibimenyetso byatanzwe kuri EMR birimo ibi bikurikira:

Ⅰ. Benip polyps cyangwa adenoma

● Ibibyimba ≤ 20 mm hamwe n’impera zisobanutse

● Nta kimenyetso kigaragara cyo gutera subucosal

Gukwirakwiza Ikibyimba (LST-G)

Ⅱ. Icyerekezo cyo mu rwego rwo hejuru intraopithelial neoplasia (HGIN)

Uc Mucosal-ntarengwa, nta ibisebe

Ibibyimba bito munsi ya mm 10

Itandukanye

Ⅲ. Dysplasia yoroheje cyangwa ibikomere byo mu rwego rwo hasi hamwe na patologiya isobanutse no gukura buhoro

Ents Abarwayi babonaga ko bakwiriye kwakirwa nyuma yo gukurikirana

Ote Icyitonderwa: Nubwo umurongo ngenderwaho uvuga ko EMR yemerwa na kanseri yo hambere mugihe igikomere ari gito, kidakomeretse, kandi kigarukira kuri mucosa, mubikorwa byubuvuzi nyirizina, ESD (endoscopic submucosal dissection) muri rusange ikundwa kugirango isuzume neza, umutekano, hamwe nisuzumabumenyi ryuzuye ry’indwara.

ESD itanga ibyiza byinshi byingenzi:

En bloc resection ya lesion irashoboka

Korohereza isuzumabumenyi, kugabanya ibyago byo kongera kubaho

Birakwiye kubinini binini cyangwa byinshi bigoye

Kubwibyo, EMR ikoreshwa cyane cyane mubikorwa byubuvuzi kuri:

1. Ibibyimba byiza bidafite ibyago bya kanseri

2. Ntoya, byoroshye guhindurwa polyps cyangwa LSTs yibara

Pre Kwirinda ibikorwa

1.Gucunga imirire: Mugihe cyamasaha 24 yambere nyuma yo kubagwa, irinde kurya cyangwa kurya amazi meza, hanyuma uhindukire buhoro buhoro mumirire yoroshye. Irinde ibiryo birimo ibirungo byinshi, bikabije, kandi bitera uburakari.

2.Imiti ikoreshwa: Inzitizi za proton pompe (PPIs) zikoreshwa cyane nyuma yo kubagwa ibikomere byo munda kugirango biteze gukira ibisebe no kwirinda kuva amaraso.

3.Gukurikirana Ingorabahizi: Witondere ibimenyetso nyuma yo kubagwa nyuma yo kuva amaraso cyangwa gutobora, nka melena, hematemesi, n'ububabare bwo munda. Shakisha ubuvuzi bidatinze niba hari ibintu bidasanzwe bibaye.

4.

Rero, EMR ni tekinike yingirakamaro yo gukuraho ibisebe byo munda. Ariko, ni ngombwa kumva neza ibimenyetso byayo no kwirinda gukoresha cyane cyangwa gukoresha nabi. Kubaganga, ibi bisaba ubushishozi nubuhanga; kubarwayi, bisaba kwizerana no gusobanukirwa.

Reka turebe icyo dushobora gutanga kuri EMR.

Dore EMR ifitanye isano na endoskopi ikoreshwa irimoAmashusho ya Hemostatike,Umutego wa Polypectomy,UrushingenaImbaraga za Biopsy.