Y Hpc TP. Hb Chi Minh * Tap 18 * So 1 * 2014 Nghien ciru Y hpc
SO SANH G I C A M 6 N O I SOI VA MO MO UNG THU" TRl/C TRANG Van Tdn*, Trdn Vinh Hung*, Thamg Thanh Hdi*
TOM LU'pC
Ddt van de: Trong 3 nam (2010-2012), cd 976 benh nhdn bi binh true trdng can mo', trong do tmg soma' ung thu 777, mo tidi cue 629 (81%), (gom monoi soi542, mo'md 148), mo'tam 148 (19%>).
Muc tieu: So sUnh ket qud 2 nhdm badi nhdn.
Phucmg phdp vd doi tuang: 50 benh nhdn ung thu true tiang monoi soi. lay ken tuc tie 29/6/2011 dai 22/10/2012 va 50 badi nMn moma lay tie thdng 1/2010 deh 30/12/2012 duac so sdnh.
Bdn luan: Monoi soi ung thu true tiang, xi mieng ndi 2 benh nhan 1 xi5 ngay sau nw. mo lai lam phau thuat Hartinann. nam vien 26 ngay, lxi7 ngdy sau iw, dieu tri ndi klioa, nam viin 23 ngay. Momd, xi mieng noi 1 benh nhdn, mo ung thu true trang rat th^, khau qua hau mdn, phdt hiin 3 ngay sau mo, khau lai qua hau mon. Ngoai xi miing noi, cdc bidi diimg Ididc deu cao han momd. mac dau nhom momd bi ung thu nang liait O cdc trung tam lan, mo true trdng noi trong, thudng dd hay xi mieng noi Idiodng 5%). Co chd. cdc tdc gid khuyen nen mdHoi tidng hay mardi tiang ra da sau mo'de ^ phdng jd. Obenh -vien diung toi sau mo thudng de ohg thdng hau mon vd ddn luu truac xuong tiding ra sau hau mdn.
Kei ludn: Xi mieng noi Id van de nghiem tiong tiong noi dqi trdng vdi true trdng thap. So sdnh mo'iigi soi vd mdmd a day, monoi soi bidi ehung nhieu han momd. Ve kH qud lau ddi, chiing tdt se bdo cdo sau
Tie khoa: Md'ngi soi vd momd ung thu triec trdng.
ABSTRACT
LAPAROSCOPY AND LAPAROTOMY FOR RECTAL CANCER
Van Tan*, Tran Vinh Hung, IXrong Thanh Hcii'
* Y Hoe TP. Ho Chi Minh* Vol. 18- No 1 - 2014: 67 - 69 Summary: In 3 year (2010-2012), we liave 976 redal cancer. 777 patients have radical operation, 542 laparoscopy and 148 lapiuotomy.
Objectives: We compare the results of 2 groups cf operation.
Patients and Method: Eadi group have 50 patiairs, those are from 29/6/2011 to 22/10/2012.
Discussion: About anastomotic leakage, there are 2 patients hi laparoscopy aiui 1 patiait in laparotomy. So the leakage of anastomosis are 4% in laparoscopy and 2% in laparotomy. Besides the anastomotic leakage, as in our study, the other complications of laparoscopy are over the ones of laparotomy, though the stage (cf patients) of laparotomy are more advanced. In the big center of surgery, the complications of laparoscopy are under the one of laparotomy, specially, the anastomotic leakage (5%,) and the wound infections. To avoid the anastomotic leakage, the authors advice to create a ileostomy or a cecostomy after operation. In our study, zoe advice to put a redal sonde and a presacral drainage afier operation.
Ccmclusion: In our study, the results of laparoscopy for redal cancer are under laparotomy The results of recidive cancer will reporied in the future.
Keywords: laparoscopy and laparotomy for redal cancer
* Benh v-ien Binh Dan
Tac gia lien inc. GS.Van Tan DT 38394747 Email binhdanhospitaiigiicm i.-nn vn
Hpi Nghi Khoa Hgc Ky thual BV. Binh Dan 2014 67
Nghien cmi Y hoc Y Hoc TP. H o Chi Minh * Tap 18 * So 1 * 2014
TONG QUAN
Trong 3 nam (201O-2012), CO 976 benh nhan bi benh true trang can mo, trong do tong so mo ung thu 777, mo tich cue 629 (81%), (gom mo noi soi 542, mo mo 148), mo tam 148 (19%).
MUC TIEU
So sanh ket qua 2 nhom benh nhan tren nhieu phuong dien.
PHU'ONG PHAP VA DOI TU'ONG 50 benh nhan ung thu true trang mo noi soi, lay Uen tuc tir 29/6/2011 den 22/10/2012 va 50 b#nh nhan mo md lay tu thang 1/2010 deh 30/12/2012 iuQC so sanh.
KETQUA
Bang 1: Tuoi vd phdi
TUOI TB Nam/ni>
Mo n p i s o i 60,28 23/27
M d m o ' 59,20 22/28
Bang 2: Lam sdng
C^u mdu C^u a nh(yt
M^tk;;' Tdi phdt
1 - 6 thang 1 - 8 0 - 5 ky
0
1 - 7 thang 1 - 6 1 - 6 k y 4 benh nhan
Bang 3: Nhom mdu
0 A B AB
41,38 34,48 17.24 0
37,93 31,03 17,24 0
Bang 4: Markers
CEA C A 1 9 . 9
AFP
44 20 S
36 22 8
Bdng5:NltiemSVB
c
Bdng 6: Vi ti'i ung thu TrSn GiiJa Dirfri Cho n6iT6ng
16 21 6 7 50
16 18 12 4 50 Bang 7: Un<i thu nhieu cho. bieh chtnia, di can
Manh trang Hot trang Ban tic DT
0 0 0
1 1 1
Di can g a n Di can T C Dl can th bung
Dl can PM 4 0 0 1
7 1 1 2 B a n g 8: Thai ^ n pbSu thual
Tg mfi T B Ngan nhiit Dai n h i t
156,81 phut 80 phut 285 phut
153phi5t • ' 90 phut 220 phut Bdng 9: Giai doan ung thu
Giai do^n 1 Giai doan II Giai do^n III Giai doan IVa Giai doan IVb
0 3 26 17 4
0 2 22 25 11
Bang 10: Bidi chdng X u i t huy^t Nhiem triing Xi mi#ng n6i T i l u kho b # t rupt R + Tong
1 10 2 1 1 1 16 (32%)
1 4 1 1 0 0 7 ( 1 4 % )
Mo ngi soi, xi mieng noi 2 b?nh nhan 1 xi 5 ngay sau mo, mo lai lam phau thuat Hartmann, nam vien 26 ngay, 1 benh nhan xi 7 ngay sau mo, dieu tri npi khoa, nam vi?n 23 ngay.
Mo mo, xi mieng noi 1 benh nhan, mo ung thu true trang rat thap, khau qua hau mon, phat hien 3 ngay sau mo, khau Iai qua hau mon.
Tii vong
- 1 do mo npi soi (2011/21670, Ngo Ky Kh, 1929, ung thu tnjc trang giiia, dt noi may ngay 12/12/2011), bj xuat huyet, mo lai cung ngay, luc 17h30 nhung tre, bom 2 bpc mau, soc mat mau, tu vong, m^t cat con ung thu.
- 1 do mo mo, (210/113241, Truong thi B, 1954, da polip dai tn^c trang, cat toan bp dai true trang noi, mo hoi trang ra da ngay 27/7/2010), tran dich mang phoi, dan luu. Suy ho hap, tir vong ngay 5/8/2010.
BAN LUAN
Mo npi soi ung thu tnic trang xi mieng noi 2 benh nhan 1 xi 5 ngay sau mo, mo l^i lam phau thuat Hartmann, nSm vi^n 26 ngay, 1 xi 7 ngay sau mo, dieu tri npi khoa, nam vi^n 23 ngay. Mo
Hoi Nghi Khoa Hoc Ky thuat BV. Binh Dan 2014
Y Hpc TP. Hb Chi Minh * Tap 18 * So 1 * 2014 Nghien cihi Y hpc
ma, xi mi?ng noi 1 benh nhan, mo ung thu true trang rat thap, khau qua hau mon, phat hien 3 ngay sau mo, khau lai qua hau mon (Bang 10).
Ngoai xi mi?ng noi, cac bi&i chimg khac deu cao hon mo mo (Bang 10), mac du nhom mo mo bi ung thu nang hon (Bang 7, Bang 9).
O cac trung tam Ion, mo t n ^ trang no\ trong thuong bi do hay xi mieng noi khoang 5%i3-5-').
Co cho, cac tac gia khuyen nen mo hoi trang hay manh trang ra da sau mo de de phong sd (muc dich de tranh ap suat cao trong long true trang sau mo)'-*'^. Chung toi khuyen nen dan Imi truoc xuong thieng ra 6 sau hau mon va dong phiic mac trong trong luc de ong thong true trang ra hau mon de tranh ap suat cao trong long rupt KET LUAN
Xi mieng noi la van de nghiem trpng trong noi dai trang voi true trang thap. So sanh mo npi soi va mo mo 6 day, mo noi soi, bieh ehung nhieu hon mo mo. Ve ket qua lau dai, chiing toi se bao cao sau.
TAI LIEU THAM KHAO
1 Adam LM. Nandipab K, Astorga I
betwween preoperative eidosco{»c and intiaopaative findings in localizing colorectal ledons. Worid J ot Suig 31:
15S7
2. DaiziA(2000) Hand-assisted kparoscopic coioiectal surgen-.
Surgendosc]4:999.
3 Fdngold DL, Addtma T, Forde KA et al pOWj Safeh' and lealiability of tattooning colorectal n e c p U s n s pnor to laparoscc^c resechcKi. J Gastromtest Surg S. 543.
4 Hasegawa H, Katjeshima Y, VVatanabe M et al {20Ce)- Randomized ctrntrol trial erf lapanecofHC versus q>ai cdectranr (br advanced colorectal cancer. Surg endcGC 17 636.
5 lonescu D, laneu C Ion D. et al (2009) Implemeniating fest- track fHotocol for colorectal surgery. A proi5)ectn« RCT, Worid I Sur& 33:2433.
6 Jamali ER, Sowdd AM, Dunassi H et al (2008) Evaluating the degree of difficulty of laparoscopic colorectal surgery Aich Surg 143 762.
laj-ne E K ; Cuillou Pf, I h o i p e H, et al (3)07) Rand<inized trial of laparoscopic assisted resection of colorectal caronorrxa. 3
>-ear results of the UK MRC CLASICC Trial gniup J d i n Oncd25.3061-
S Kalady MF (2010). Surgeon irntdvement in prec^)CTafc'e ccdorectal tumor localisation Worid) Surg 34 1592 9 Nguyen Hoang B k va cs (2010). Tai bi&i va Bi&i duing FT
NS cat n S may dieu Hi ung thu true tiang Y hoc TP HCM, tap 11, phu ban so 1:119-123.
10. Fiscatdli X, Hj-man \ , OSICT T (20^): Localizing ODlocectal cancer by coloTMStt^. Arch Surg 140 932.
Ngay nhan bdi bdo: 31/10/2013 Ngdy phdn biin nhan xet bdi bdo:
Ngdy bdi bdo dirac ddng.
02/12/2013 20/02/2014 et al (2010). Correlation
Hoi Nghi Khoa Hpc Ky thuat BV. Binh Dan 2014
