Kết quả phẫu thuật nội soi cắt toàn bộ mạc treo đại tràng trong điều trị ung thư đại tràng trái

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Tác giả: Minh Tín Bùi, Bá Lập Dương, Hải Triều Phạm, Văn Minh Tuấn Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y Dược học Phạm Ngọc Thạch, 2023

Mô tả vật lý: tr.67

Bộ sưu tập: Metadata

ID: 339339

Thêm vào giỏ Liên kết toàn văn

- Mở đầu: Phẫu thuật nội soi (PTNS) theo kỹ thuật cắt toàn bộ mạc treo đại tràng (TBMTĐT) trong điều trị ung thư đại tràng đã làm cải thiện kết quả lâu dài về mặt ung thư học và đang trở thành tiêu chuẩn cho phẫu thuật điều trị ung thư đại tràng.- Mục tiêu: Đánh giá tính an toàn của phẫu thuật và kết quả về mặt ung thư học của PTNS cắt TBMTĐT trong điều trị ung thư đại tràng trái giai đoạn I - III.- Đối tượng và phương pháp nghiên cứu: Nghiên cứu tiến cứu ở 68 bệnh nhân ung thư đại tràng trái được PTNS cắt TBMTĐT tại bệnh viện Bình Dân từ tháng 01/2018 đến 07/2021.- Kết quả: Trong số 68 bệnh nhân có 38 nữ và 30 nam. Tuổi trung bình là 58,35 ± 10,67 tuổi (từ 34 - 81). Thời gian phẫu thuật trung bình là 180,56 ± 40,30 phút. Lượng máu mất 100,20 ± 27,56 ml. Không có tai biến trong mổ. Biến chứng sau mổ chiếm tỉ lệ 13,23%: nhiễm trùng vết mổ 7,35%, xì miệng nối 4,41% và tắc ruột sau mổ là 1,47%. Thời gian nằm viện trung bình là 8,24 ± 4,82 ngày. Số lượng hạch lấy được trung bình là 17,42 ± 4,52 hạch, có 48,53% bệnh nhân có di căn hạch. Chiều dài mẫu bệnh phẩm 38,56 ± 8,20 cm. Tỉ lệ bệnh nhân sống không di căn là 87,3%. - Kết luận: PTNS cắt TBMTĐT là phương pháp chọn lựa an toàn cho ung thư đại tràng trái với tỉ lệ biến chứng thấp. Cắt TBMTĐT đã cải thiện tỉ lệ sống và chất lượng mẫu bệnh phẩm về mặt ung thư học.Abstract- Background: Laparoscopic complete mesocolicexcision (CME) for the treatment of colon cancer hasimproved long - term survival and become the standard procedure in surgical management of colon cancer.- Objectives: Evaluation of surgical safetyand oncological results of laparoscopic complete mesocolic excision in stage I - III left colon cancer.- Patients and methods: A prospective study of 68 patients with left colon cancerwho underwent laparoscopic complete mesocolic excision between January 2018 and July2021 at Binh Dan Hospital.- Results: Of all the 68 patients, 38 were females and 30 were males. The age ranged from 34 to 81 (average 58,35 ± 10,67). The average length of surgical time accounted for 180,56 ± 40,30 minutes . The mean volume of intraoperative blood loss was 100,20 ± 27,56 ml. There were no complication during operation. Post operative complications which occurred in 13,23% of patientincluded 7,35% of surgical site infection, 4.41% of anatomosis leakage and 21,47% of postoperative obtruction. The average length of stay was 8,24 ± 4,82 days. The average number of harvested lymph nodes represented 17,42 ± 4,52. The patients who hadnode metastasis were 48,53%. The length of specimens was 38,56 ± 8,20 cm. The disease - free survival (DFS) became 87,3%.- Conclusions: Laparoscopic complete mesocolic excision is safe to treat left colon cancer with less postoperative complications. Moreover, CME hasimprovedDFS and the quatily of oncologic specimens. DOI: 10.59715/pntjmp.1.3.9

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