Kết quả phẫu thuật tán sỏi thận qua da với đường vào tối thiểu dưới hướng dẫn của camera tại bệnh viện giao thông vận tải=Evaluated the effectiveness of minimum invasive percutaneous nephrolithotomy with camera-guided at transport hospital

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Tác giả: Sỹ Tuấn Anh Bùi, Thành Đông Đặng, Văn Dương Nguyễn, Vũ Minh Thiện Nguyễn, Kiên Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.10-15

Bộ sưu tập: Metadata

ID: 242668

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Đánh giá kết quả phẫu thuật tán sỏi thận qua da với đường vào tối thiểu dưới hướng dẫn của camera tại Bệnh viện Giao thông vận tải, đưa ra nhận xét về hiệu quả của phương pháp. Đối tượng và phương pháp: 250 bệnh nhân được phẫu thuật bằng phương pháp tán sỏi thận qua da với đường vào tối thiểu dưới hướng dẫn của camera tại BV Giao thông Vận Tải trong 5 năm (từ tháng 01-2019 đến 12-2023) Kết quả: 250 bệnh nhân được phẫu thuật thành công (100%), trong đó có 152 nam (61%) và 98 nữ (39%). Độ tuổi trung bình của bệnh nhân 54 ± 10 tuổi (trẻ nhất là 26 tuổi và cao tuổi nhất là 79 tuổi). không có bệnh nhân chuyển mổ mở (0%). Tỷ lệ sỏi san hô là 30%. Thời gian mổ trung bình 60 ±10 phút (ca ngắn nhất 40 phút, dài nhất 130 phút). Thời gian nằm viện trung bình 8.8 ngày (ngắn nhất 7 ngày, dài nhất 14 ngày). Tỷ lệ bệnh nhân hết sạch sỏi trên 90%. Kích thước sỏi trung bình 25 ± 10mm (lớn nhất 45mm). Thời gian rút dẫn lưu bể thận trung bình: 3.2 ngày, rút dẫn lưu hố thận: 4.5 ngày, rút sonde JJ sau 07 ngày. Tỷ lệ sạch sỏi khi ra viện là 88%, sau 1 tháng là 95.6%. Biến chứng chảy máu sau mổ cần phải truyền máu 1.2%, apxe quanh thận: 0%, chọc kim vào các tạng khác 0%. Kết luận: tán sỏi thận qua da với đường vào tối thiểu dưới hướng dẫn của Camera là một phương pháp tán sỏi có tỷ lệ thành công cao, an toàn, ít biến chứng, dễ triển khai và áp dụng ở nhiều tuyến cơ sở y tế.Minimally invasive treatments have almost completely replaced open surgery in the management of the kidney stone disease. Our study aimed to evaluated the efectiveness of minimum percutaneous nephrolithotomy with camera-guided at Department of General Surgery of Transport Hospital from 01 – 2019 to 12 – 2023. Material and methods: Propective study of 250 kidney stone cases treated by minimum percutaneous nephrolithotomy with cameraguided management at Department of General Surgery of Transport Hospital from 01 – 2019 to 12 – 2023. Patients underwent endotracheal anathesia. Minimum percutaneous renal access tract was performed under camera guidance with Amplazt dilation sheat 18fr. Holmium laser nephrolithotripsy was used with semirigidureteroscope. Results: 250 cases with successful rate 100%. 152 males (61%) and 98 females (39%) with the average age of 54±10 (range from 26 to 79 years old). Stone size mean 25±10mm (range from 20 to 45). Average operative time: 60±10 minutes (range from 75-130). Laser lithotripsy and stone removal are successful in 100% cases. The mean of hospital stay 8,8 day (range from 7 to 14). Nephrostomy tube removal after 3.2 day (range from 2 to 5). Retroperitoneal tube removal after 4.5 day (range from 4 to 7). Sonde JJ removal after 07 day. The stone-free rate when discharged from the hospital was 88%, and after 1 month it was 95.6%. Postoperative bleeding complications requiring blood transfusion were 1.2%, abscess around the kidney: 0%, needle puncture in other organs 0%. Conclusion: Minimum percutaneous with camera-guided offers many advantages and should be popular chosen in the treatment of kidney stone.

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