Y Hpc TP. Hb Chi Minh * Tap 18 * Sb 1 * 2014 Nghien cmi Y hpc
NQI SOI SO V6l MO MO UNG THlf DAI TRANG
Van Tdn*, Trdn Vinh Hung*, Duong Tiianh Hdi*
TOM TAT
Trong thdi gian tit thdng 1/2010 dai thdng 12/2012, diung toi da md'ngi soi cho 265 benh nhdn vd nwmd cho 137 binh nhdn trai tong so 947 binh nhdn hi ung thu dai trdng.
Miic tieu: Oiuiig toi so sdnh giiea mo ngi soi vd mo'md 2 nhom binh nlidn.
Phuang phdp vd dm tugng. Chung idi lay tie daw tuc nam 2010 vd dii so sdnh 50 badi nhdn monoi soi vd 50 binh nhdn moma.
Kei luqtu Nhu vgy trong giai dogn 2010-2012, trong nghien cuu cua ehung toi. trie dudng mo ngan han mo'md, monoi soi ung thu dgi trdng, thdi gian phdu thugt ddi han, tii vong vd bien chimg nhieu hem moma.
Tif khoa: Ung thu dgi trdng.
ABSTRACT
LAPAROSCOPY AND LAPAROTOMY OF COLON CANCER.
Van Tan, Tran Vinh Hung, Duong Thanh Hai * Y Hoc TP. Ho Chi Minh * Vol 18 - No 1 - 2014:49 - 51 From 1/2010 to 12/2012, wepaform laparoscopy for 265 patiaits and laparotomy for 137 in the some of 947 patients.
Objective. YJe compare of results in 2 operations
Patients and methods: We commence from 2010 to 2012, each group compose 50 patients.aud a prospecti-ve method.
Ccmclusion: So in the period of 2010-2012, in our study, except the small incision, for laparoscopy of i cancer, the operative time, the complications and death is over ihe opai opa-ation.
Keywords: Colon cancer.
TONG QUAN
Trong thbi gian tir thang 1^010 den het thang 12/2012, tuc 3 nam, ehung tbi da mb tich cue cho 402 truang hgp ung thu dai trang trong tbng so 947 benh nhan.
So tren gom co 265 mb npi soi vbi duong mb nhb > 5 cm de noi dai trang ngoai 6 bung va 137 mb mb, gom ca duong mo nhb (5-6 cm), nhu vay so mb nbi soi gan gap dbi mb mo trong nhiing truong hop ung thu dai trang.
O ngo^ qubc, so sanh mo npi soi vbi mo ma rat nhieu va cho ket qua hogc hon, hoac tuong duong, nhat la ket qua tuc thbi va ngan
jianC-3.57.11,15)
Muc tieu
Chung toi so sanh 2 nhbm giira mb nbi soi va moma.
Phuong phap va dbi tupng
Chung toi lay tu c^u tuc nam 2010 va chi so sanh 50 benh nhan mb nbi soi va 50 b?nh nhan mbmd.
Ket qua Bdng 1: Tuoi vd p
Tudi 20-29
Noi soi Nam
0 Nir
1
Momd' Nam
2 NO'
1
* B^nh Vien Binh Dan
Tac gid lien lac DT'0918 411 401 Email' Hpi Nghi Khoa Hpc Ky thuat BV. Binh Dan 2014
Nghien cmi Y hpc Y Hpc TP. Hb Chi Minh * Tap 18 * Sb 1 * 2014 •
Tuoi
30-39 4 t M 9 50-59 6{>69 70-79 8 M 9 Tong Tu6iTB Nam-NO
Noi SOI Nam
1 3 7 8 4 2 26
Nir 3 2 8 3 5 3 24 58 57 1 61
M b m o * Nam
2 3 8 7 1 3 25
NO' 2 1 7 4 8 2 25 60 59 1 61
Nhu vay, so benh nam, nii, tubi gan tuang duong.
Bdng 2: Vj tri ung thu
V j t r i DT phai DTtr^i D T Sigma Tn/c t r i n g T6ng
M 6 m d - 14 11 19 2 50
Noi s o i 10 19 15 2 50
Vi tri, cung gan tuong duong.
Bdng 3: Giai dogn ung thu
Giai d o ^ n G D I GOH GDIII GO IV Khongra
Tfing
M d m o ' 2 5 16 20 7 50
Npi s o i 2 11 20 14 3 50
Giai d o ^ ung thu, giai doan IV mo mo nhieu Hon, nhung khong y nghia thong ke.
Bdng 4: Thai gian mo
Thdi gian mo TB c i t d^l trdng
C l t h ^ D T C a t h ^ t D T v S t n / c
trdng
M& mir (phu^
97 144 180
Npi s o i (phut) 95 130 157
Thbi gian mb TB, 145 phut mo NS dai hon moma khoang 15 phut.
g 5: Thai gian nam viin
Tmng binh N g i n n h i t Dai nhk
>15 ngay
M ^ m d r 12,58 ngay
8 ngay 35 ngay 14 TW
Npi s o i 12,4 ngay
7 ngay 21 ngay 1 7 T H
Thbi gian nam vien noi soi va mb mo tuong duong.
Bdng 6: Tai biai, bim ehung
Bung thanh byng Nhiem trung
Chay mau X i mieng n6i
Tong T y i ?
M o mo*
0 3 0 0 3/137 2 , 1 9 %
N p i s o i 2 10 1 1 14/265 5 , 2 8 %
Tai bien \'a bien chiing, dac biet la xi mi^ng nbi va bung thanh bung, nhiem trung vet mb^
mb NS nhieu han mb" mo, cb y nghia thbng ke.
Tii vong do mo npi soi.
La 1, cung nhieu han mb mo, nhung khong cb y nghia thbng ke.
BAN LUAN
Mb nbi soi ung thu dai trang la van de thbi su- Hinh nhu moi ngubi bi ung thu d^ trang deu thich mb npi soi vi nghe nbi dubng mo nho, it dau, it bien ehung, ngay nam vien ngSn, thoi gian hoi phuc nhanh. So vbi mb mo kinh dien tiii vet mb Ibn, dau nhieu, de niuem trimg, de gay ra bien chiing, ngay nam vien dai va thoi gian hoi phuc cham<i^'^-5A^.io.i3.Hi5). E)6 la ly thuyet, digt ra, theo nghien ciiu cua ehung t6i, duong mb nho la dung (5 cm so vbi 10-15 cm), it dau thi khbng chinh xac, it bien chiing thi khbng dung, ngay nam vien ngan hon 2 ngay va thbi gian phuc hoi nhanh cung khbng rb.
Thuc te nhat la hay xem Iai ket qua cua dujng tbi, chi cb dubng mb nho han, ngay nam vien ngan cbn hon, mpi dieu khac deu khbng chinh xac \'i mb noi soi va mo mo cho thuoc giam dau nhu nhau, nhieu bien chiing hon, va thbi gian hoi phuc nhanh thi khong ro.
Nhiing dieu tren chi dung khi so sanh o ngogi qubc hay a mot vai trung tam Ibn trong nubc (khong theo doi).
Nhiing truong hpp khb, trong mb mb vbi dubng mb nhb (5-6 cm), chiing tbi da bbc tach dai trang ngang hay dai trang xuong nhb nang thanh bung len va dimg tay nSm dai trang de nao hach, cat mang treo i*-"''-i.
Hpi Nghi Khoa Hpc Ky thuat BV. Binh Dan 2014
Y Hpc TP. Hb Chi Minh * Tap 18 * Sb 1 * 2014 Nghien ctru Y hpc
KETLUAN
N'hu \'ay trong giai doan 2010-2012, trir duong mb ngan han mb" ma, mo npi soi ung thu dai trang, thoi gian phau thuat dai han, hi vong va bien chiing nhieu hon mo mo.
TAI LIEU THAM KHAO:
1 A companson of laparoscopically asasted and c^^en a J e c t o m y W colon cancer (2004) NEnglJMed 350:2050.
2. Bihmoria KV, Bertrem DJ, Meikow RP et al (2008) La[>aiosoc^c-asa5ted \'s qjen colectrany for c a n e s ' companson of short-term outcomes fixan 121 hospiiab. J Gasdtrintest S u ^ 12: ^ H l .
3 D d a n e y CP, d i a n g E. Senagore AJ et al (2008) OincaJ oulccmes and resource utilisation associated with l a p a r o s a ^ c and open colectomv u a n g large nation^
database. Ann Surg 247:819.
4. GuUer U, Jain N, Hervey S et al (2003) Laparoscope vs o p a i colectomy. Outcconcs companson based on large nabinwide databases. A n * Surg 138:1179
5 Hasegawa H, Kabeshima Y, Watanabe M rf al (2003) Randomized control tnal of laparoscopic versus open colectomy for advanced colorectal cancer Surg endosc 17:636 6 Hazd)roek EJ (2002). A randomized cUnical tnai c a n p a n n g
laparoscopic and opoied resection for colon cancer. Surg Endoscl6:949-
7 Kang JC, Chung MH, Chao PC et al (20M) Hand-assisted laparosccpic colectomy verstis open colectomy- a postspective randomized trial. Surg endosc 18:577.
Kuwabara K. Matsuda S, Fustuim K et al (2010). Quartitatve crarparisCHi of difficulty of performing laparoscopic cdectomv at d i ^ B i t hnnore locatitms. Wodd J Surg 34:133.
Lacy AM, Ddgado S, Castells A et al (2008). The Img-tenn results of a landcsnized dinical tnal irf laparosci^c-assisted VOTSUS (^iien surgery for cxAon cancer. Arm Surg 248.1.
Lacy AM, Gaida-Valdecasas J C Ddgado S et al (2002).
LaparoscDpy-asfflsted colectomy \'ersus open ccJectcsny fe*
treatment of non-metastic oolcni cancer a randomised triaL Lancet 359-2224
Nakagoe T, Sawai T, Tsi^ T et al (2007). Use irf minilaparotomy in treatmrait of ccJai cancer. Br J Surg 88 83L Takakura Y, (Mapma M, Yodnmilsu M el al (2009). H>-brid hand-assisted colectomy for trans\'erse colon cancec a useful technique for non-expat lapiaroscc^- surgeons. World J Suig 33:2683
The dirucal outccanes erf surgical therapy group (2004) A comparison of laparoscopically asEdsted and open cdectomy far ccJon cancer. N E n ^ J Med 350:2050.
Varda JF, Asciati H Huerta S et al (2008). Outconws of laparoscofnc and open ccdectomy m acadordc coiteis Am J Surg 196 403-
Vddksmp B, Kuhry E, Hop WC et al (2005) Laparusccpic s u r g e y versus open colectomy: shoO-term outcomes of a randomised tdaL Lancet onccd 6:477.
Ngay nhdn bdi bdo: 31/10/2013 Ngdy phdn biin nhan xet bdi bdo: 02/12/2013 Ngdy bai bdo dime dang: 20/02/2014
Hpi Nghi Khoa Hpc Ky thuat BV. Binh Dan 2014
