Bir martali ishlatiladigan polipektomiya tuzoqli oval

1. Kesish halqasi 2. Ulagich 3. Tortish simi 4. Qopqoq 5. Qopqoq ushlagichi 6. Aylanadigan yeng 7. Simli ushlagich 8. Elektrod ulagichi 9. Slayder 10. Tutqich

Bir martali ishlatiladigan polipektomiya Tuzoq oval, endoskopist tuzoq qopqog'ini oldinga siljitadi, tuzoqni ochadi va polipni o'rab oladi. Keyin tuzoq asta-sekin va bosqichma-bosqich yopilib, polip atrofidagi oddiy to'qimalarni 1-2 mm ushlab turish uchun, so'ngra to'liq yopilgunicha va polip gilyotinlashguncha elektrokoagulyatsiyadan foydalaning. Keyin polipni so'rib olish va gistologik baholash uchun olish mumkin.

Bir martali ishlatiladigan polipektomiya Snare oval, bu sovuq tuzoqdan foydalanish asosida elektrokoagulyatsiyadan foydalanadi. HSPdan so'ng yana bir mustaqil endoskopik jarroh endoskopik eradikatsiya muvaffaqiyatli bo'lgan-bo'lmaganiga baho berdi. Shundan so'ng, polipektomiya joyida qoldiq polip to'qimalarining mavjudligini baholash uchun qo'shimcha EMR o'tkazildi, shu jumladan qo'shimcha 1 dan 2 mm gacha aniq chegara tuzoq bilan rezektsiya qilindi va aralash eritma submukozal in'ektsiyadan keyin Endocut oqimi bilan rezektsiya qilindi. Hech qanday to'qimalarni olib tashlashning iloji bo'lmasa yoki EMR in situ shilliq qavat namunalarini ololmasa. Qolgan chekkalarda forseps yordamida kamida to'rtta sovuq biopsiya olingan. Har bir protseduradan so'ng darhol qon ketishining yo'qligini tasdiqlash uchun polipektomiya joyi 30 soniya davomida kuzatildi, namunalar olinadi va formalinda saqlanadi. EMR namunalarining ko‘ndalang kesimlari 1- mm oraliqda yig‘ilgan; belgilangan joyning to'g'ri to'qima qismi ta'minlandi.

Kolorektal saraton (CRC) AQShda uchinchi eng keng tarqalgan saraton kasalligi bo'lib, yiliga 135-420 ta yangi holat 1. Polipektomiya bilan skrining kolonoskopiya CRC bilan kasallanish va o'limni sezilarli darajada kamaytiradi 2 3. Biroq, ba'zi so'nggi tadqiqotlarda yo'g'on ichak poliplarining to'liq bo'lmagan rezektsiyasining kutilmagan yuqori darajasi qayd etilgan va bu o'z navbatida kolonoskopiyadan keyingi CRC oralig'ining yuqori xavfi bilan bog'liq bo'lgan 4. Kichkina (< 5 mm) and small (6 – 9 mm) polyps represent the vast majority of polyps removed at screening colonoscopy 5. In theory, two major techniques are available for these lesions, namely biopsy-forceps polypectomy and snare polypectomy. The former, however, has been associated with a much higher rate of incomplete resection, especially for small polyps, and its use is not generally recommended 6. The latter may be further classified into hot (HSP) and cold (CSP) snare polypectomy. The basic difference is the use of a high frequency generator for HSP. Such use may, on the one hand, minimize immediate post-polypectomy bleeding by coagulation, but, on the other, it may also damage deeper vessels with increased risk of delayed bleeding 7 8 or even perforation. For this reason, CSP is usually considered safer, while resulting in equivalent rates of complete resection, and its use has dramatically increased in recent years 9 10 11 12, due also to the development of specific CSP-snares. CSP- and HSP-incomplete resection rates (IRR) for ≤ 10 mm polyps range widely, being 0.5 – 6.4 % and 1.2 – 7.4 %, respectively 12 13 14 15, and these estimates are much lower compared with forceps-polypectomy 6 16. However, any advantage of one technique (HSP vs. CSP) over the other remains unclear 17.

Issiq teglar: Bir martali ishlatiladigan polipektomiya tuzog'i oval, Xitoyda bir marta ishlatiladigan polipektomiya tuzog'i oval ishlab chiqaruvchilari, etkazib beruvchilari