
endoscopic mucosal vichhedan

endoscopic mucosal resection ack takneek haye jiska upayog paachan tantra mein paae jaane vaale cancer yaa anya asamanya ghaavon koo hataane key liye kiya jaataa haye. yeh mucosectomy karane kii ack vidhi haye.
annapranali key liye.
endoscopic mucosal resection kii vakaalat praarambhik annapranali cancer (yaani, joe satahi hain aur kewal shleshma taka seemit hain) key liye kii gaee haye aur praarambhik squamous cell carcinoma key liye cumm aakramak, surakshit aur prabhaavi chikitsa key roop mein dikhaai gaee haye. yeh barrett key annapranali mein utpann honey vaale praarambhik adenocarcinoma key liye bhee surakshit aur prabhaavi dikhaaya gayaa haye. iss vidhi key saath upchaar key baad kaa purvanuman shalya chikitsa vichhedan key saath tulaniya haye. iss takneek kaa prayaas una rogiyon mein kiya jaa sakata haye jinake paas nodal yaa door key metastes kaa koee saboot naheen haye, alag-alag tumour joe thodaa oopar uthaaye gaye hain aur vyaas mein 2 semi seey cumm hain, yaa alag-alag tumour joe ulcerated hain aur vyaas mein 1 semi seey cumm hain. endoscopic mucosal resection key sabse adhik niyojit tarikon mein strip biopsy, double-snare polypectomy, atyadhik kendrit khaara aur epinephrine key sanyukt upayog key saath resection aur ack topi kaa upayog karke resection shamil hain.
annapranali cancer key endoscopic mucosal resection key liye strip biopsy vidhi koo grosping forceps aur fandaa seey lais double-channel endoscope key saath kiya jaataa haye. ack vidyut coagulator key saath ghaav kii seema koo chihnit karane key baad, ghaav koo maanspeshiyon kii parat seey alag karane aur isake baahar nikalane koo majboor karane key liye ghaav key neeche submucosa mein khaara injection diyaa jaataa haye. pakad bull koo fandaa loop key madhyam seey paarit kiya jaataa haye. ghaav key aspas key shleshma koo pakad liya jaataa haye, uthaaya jaataa haye, aur galaa ghontkar nikala jaataa haye aur vidyut-aghaat dwara vichhedit kiya jaataa haye. endoscopic double-snare polypectomy vidhi koo baahar nikalane vaale ghaavon key liye ingit kiya jaataa haye. double-channel dayare kaa upayog karate hue, ghaav koo pahale fande seey pakada aur uthaaya jaataa haye aur poore vichhedan key liye dusare fanday key saath galaa ghonta jaataa haye.
kendrit khaara aur epinephrine key injection key saath endoscopic vichhedan ack double-channel dayare kaa upayog karke kiya jaataa haye. ghaav kii seemaon koo ack coagulator key saath chihnit kiya jaataa haye. atyadhik kendrit khaara aur epinephrine koo upashleshm parat mein inject kiya jaataa haye (15-20 ml) taaki ghaav vaale kshetra koo phoolaaya jaa sakey aur nishan spasht kiye jaa sakein. seemankit seema key baahar shleshma koo upashleshm parat kii gaharaai taka uchch aavritti vaale scalepel kaa upayog karke nikala jaataa haye. vichhedit shleshma koo uthaaya jaataa haye aur balpurvak pakada jaataa haye, ack fandaa key saath ghaav koo fansaaya jaataa haye aur galaa ghonta jaataa haye, aur phir vidyut-shleshma dwara vichhedan kiya jaataa haye.
endoscopic mucosal resection kii ack anya vidhi topi key ander ack spasht topi aur loop kiye gaye fande kaa upayog karati haye. daalane key baad, topi koo ghaav parr rakhaa jaataa haye aur ghaav vaale shleshma koo aspiration dwara topi key ander kheencha jaataa haye. shleshma koo fandaa pakad letaa haye aur galaa ghont curr galaa ghont curr anta mein vidyut-chaalan dwara vichhedit kiya jaataa haye. ise "baind aind snare" yaa "choosane aur kaatane" kii takneek kahaa jaataa haye. vichhedit namoone koo punarpraapt kiya jaataa haye aur tumour aakraman kii gaharaai, vichhedan margine aur sambhaavit samvahani bhagidari key nirdhaaran key liye sookshm pariksha key liye prastut kiya jaataa haye. parinamswarup "alsar" teen saptah key bheetar thheek hoe jaataa haye.
endoscopic mucosal resection kaa upayog yaa tou dibluck yaa poori tarah seey polypoid dysplastic yaa berret key annapranali mein ghaatak ghaavon key ilaaj key liye bhee kiya jaa sakata haye, joe annapranali adenocarcinoma key liye gyaat agradoot ghaav haye. germany kii ack praarambhik report mein, ise barrett key annapranali mein praarambhik adenocarcinoma key liye prakaashgatik chikitsa key baad praathamik upchaar yaa sahayak chikitsa key roop mein kiya gayaa thaa. choosane aur kaatane" takneek (poorv khaara injection key saath aur binaa donon) kaa upayog kiya gayaa thaa, saath hii "baind aur cutt" takneek kaa bhee upayog kiya gayaa thaa. haalaanki sabhi tumour binaa kissy kathinaaee key vichhedit kiye gaye they, 12.5% raktasraav vikasit huaa (jise endoscopic therapy dwara safaltapurvak prabandhit kiya gayaa thaa). 81 pratishat ghaav poori tarah seey vichhedit kiye gaye they. anya ghaavon kaa bhee anya endoscopic takneekon key saath ilaaj kiya gayaa thaa.
endoscopic mucosal resection kii pramukh jatilataon mein operation key baad raktasraav, chhidran aur sakht gathan shamil hain. prakriya key dauran, uchch aavritti jamaavat yaa clipping key saath, maanspeshiyon kii deewaar mein 1:100,000 patala epinephrine kaa ack injection, haemostasis key liye raktasraav bindu parr lagaaya jaa sakata haye. operation key baad raktasraav koo rokane key liye acid-cumm karane vaali davaaen denaa mahatvapurna haye. ghaav vaale shleshma koo badhaane key liye paryaapt khaare injection seey chhidra koo rokaa jaa sakata haye. gair-uthaane kaa sanket" aur dard kii shikaayaten jaba fandaa ghaav kaa galaa ghontata haye tou prakriya karane key liye matbhed hain. jaba chhidra koo turant baad mein pahachaana jaataa haye, tou chhidra koo clip dwara bund curr diyaa jaanaa chaahiye. endoscopic bund honey kii viphalata key mamalon mein shalya chikitsa parr vichaar kiya jaanaa chaahiye. jatilataon kii ghatanaaen 0-50% seey laker annapranali squamous cell carcinoma kii punaravritti 0-8% taka hoti hain.
brihadantra aur malashay key liye.
endoscopic mucosal vichhedan aur submucosal vichhedan bhee vichhedan yaa badey, gair-ghaatak colorectal polypse aur satahi (charan tii1aeye) aakramak colorectal cancer key liye atyadhik prabhaavi tareeke hain. australiyai sangh dwara endoscopic mucosal resection key sabse badey adhyayan mein 1000 mamle aur deerghakaalik nigrani shamil thee. 79 unrevectable ghaavon koo hataane key baad, shesh kaa ilaaj endoscopic mucosal resection dwara kiya gayaa. kull milakar 98.1% dou daur key anta mein (aamtaur parr 6 aur 18 maheenon mein) roga mukt they. aant key badey, gair-aakramak polypse key shalya chikitsa vichhedan kii tulanaa mein endoscopic mucosal vichhedan cumm kharchila aur surakshit dikhaaya gayaa haye.
endoscopic mucosal vichhedan mein praveenta praapt karane key liye prashikshan kii aavashyakta hoti haye. meyo clinic florida samooh ney bataaya kii praveenta praapt karane key liye cumm seey cumm 100 prakriyaon kii aavashyakta hoti haye. sanyukt raajya america mein kaee kendra abb uchch gunavatta vaale, uchch matra vaale colorectal endoscopic mucosal resection pradaan karate hain.

