Endoscopic xa tawm subsection (ESD) hloov kev tswj hwm thaum ntxov lub plab zom mov neoplasms los ntawm kev tawm tsam ntawm cov kab mob loj lossis cov kab mob uas muaj cursion. Cov tub ntxhais yog ESD riam - ib pawg ntawm cov khoom tshwj xeeb tsim los tsim cov kua dej rau hauv cov kua ripucosal. Nrog kev hloov pauv nruam hauv rab riam tsim, ESD riam ua lub luag haujlwm txhim kho, ua haujlwm tau zoo, thiab siv tau ntawm ESD hla cov cheeb tsam sib txawv thiab kev qhia.
Cov hom ESD riam
ESD Knif yog cais los ntawm lawv cov lus tsim qauv thiab ua haujlwm. Koob -}}} Tsis muaj ib hom riam, xws li Dualknife thiab Flushing, tau siv dav lawm vim lawv simplicity thiab nrawm. Rwb thaiv tsev - tipped riam (nws -}}}}}} pa ntawm perforation los ntawm kev tiv thaiv cov leeg nqaij tsis sib xws. Nuv rab riam tso cai rau cov hom phiaj ntawm cov ntaub so ntswg xa tawm. Tsis ntev los no, scissor {{{{}}, sb riam
Cov Pov Thawj Pov Hwm thiab Kev Kawm Sib Xws
Ntau lub chaw kuaj mob kev sim siab thiab kev tshuaj xyuas yav dhau los tau ntsuas qhov ua tau zoo thiab kev nyab xeeb ntawm riam riam sib txawv:
1. Scissor -}}}} Cov neeg mob retrospective, nyob rau hauv ib tus nqi sib cav sib ceg Tsib -}} xyoo tag nrho cov ciaj sia tau mus txog 94.1%, underscoring churable ntev- kev tshwm sim. Lwm qhov kev tshawb fawb pom tias scissor -}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} Nrhiav riam, tsis muaj nqi ntxiv.
Cov kev txiav txim siab randomized uas tsis - kws tshaj lij endions {}}}}- Siv hom riam. EX Vivo Scudies tau lees paub txo cov txheej txheem thiab tus nqi qis dua, uas txhawb nqa lawv lub luag haujlwm yog cov cuab yeej qhia muaj nuj nqis.
2. Txawm li cas los xij, lawv yuav nqa txoj kev pheej hmoo siab dua ntawm kev raug mob hauv fibricotic lossis anatomically nyuaj.
3. HybridKnife thiab ntau cov cuab yeej: hybridknife, uas sib txuas lus siab heev, ua kom pom kev txhaj tshuaj zoo dua qub, thaum tswj hwm kev nyab xeeb piv thiab hemostasis. Ib qho - kauj ruam knife (OSK), ntsuas kev txhaj tshuaj luv luv, txawm hais tias qhov sib txawv tsis tas mus cuag lub tswv yim tseem ceeb.
Cov mob kuaj mob thiab nthuav qhia cov lus qhia
Tshaj dhau kev ua plab zom mov thiab cov xim ESD, cov riam hluav taws xob tau ua rau kev kho mob lossis qhov txhab teeb meem nyuaj. Cov ntaub ntawv qhia muaj xws li rov ua tiav ntawm kev rov ua tiav ntawm lub bronchoma nyob rau hauv ib tug hluas uas siv lub hybridKnife, hais txog hla- lub peev xwm kev qhuab qhia. Ib yam li ntawd, cov riam kub kub tau siv nyob rau hauv ib qho endoscopic subcucosal lub qhov (ESTD) rau lub plab zom mov (140 est 88 mm), ua tiav curative rov qab. Scissor -} Hom riam muaj kuj muaj txiaj ntsig zoo rau cov lus qhia lossis cov pa riam phom ua rau muaj kev phom sij ntau dua.
Cov kev txiav txim siab tseem ceeb rau riam Xaiv
Kev xaiv ntawm ESD riam yog nyob ntawm cov yam ntxwv lesion, cov neeg teb xov tooj kev paub, thiab cov tuam tsev muaj.
For trainees, scissor-type knives may provide a safer learning curve by enabling controlled grasp-and-cut dissection.
Rau cov neeg ua haujlwm paub, koob -}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}}} Cov kab mob ceev ntawm cov txhab ncaj qha.
Hauv cov chaw ua haujlwm nyuaj xws li fibrosis, angulated anatomy, los yog tsis {} gi}}}}}}}}}}}}}}}}}}}}}}}}}} {}}}} Kuv yuav txo cov kev pheej hmoo thiab txhim kho qhov kev pheej hmoo.
Cov Khoom Siv Khoom Siv Tsim Nyog, suav nrog kev saib xyuas kev ua haujlwm thiab cov lus qhia txog Prophylactic kaw (piv txwv li, OTSC), ntxiv kom tau txais txiaj ntsig ntxiv.
Yav Tom Ntej Cov Lus Qhia
Kev tsim kho hauv ESD riam txuas ntxiv mus hloov zuj zus mus rau kev ua haujlwm ntau, ua haujlwm, thiab kev nyab xeeb. Kev sib xyaw nrog cov neeg hlau thiab kev txawj ntse -}}}} yuav pab tau cov txiaj ntsig thiab luv luv txoj kev kawm nkhaus. Kev siv pov tseg thiab tus nqi {{{5} Cov qauv tsim tau zoo nyob rau Western Chaw, qhov chaw ESD tau qeeb dua li Asia.
