Đánh giá kết quả phẫu thuật nội soi ổ bụng điều trị tắc ruột sau mổ

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Tác giả: Chí Thanh Hồ, Văn Tiệp Nguyễn, Ngọc Viên Vũ

Ngôn ngữ: Vie

Ký hiệu phân loại: 572 Biochemistry

Thông tin xuất bản: Tạp chí Y học Việt Nam 2023

Mô tả vật lý: 55-59

Bộ sưu tập: Metadata

ID: 406539

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Đánh giá kết quả phẫu thuật nội soi điều trị tắc ruột sau mổ. Đối tượng và phương pháp nghiên cứu: nghiên cứu mô tả, hồi cứu trên 49 bệnh nhân được chẩn đoán tắc ruột sau mổ và được phẫu thuật nội soi ổ bụng để điều trị tại Bệnh viện Quân y 103 giai đoạn từ 05/2018 đến 5/2022. Kết quả: Tuổi trung bình là 41,8 ± 17,3 (13-76)
nữ chiếm 61,2%, nam chiếm 38,8%. Thời gian biểu hiện bệnh trung bình: 2,7 ± 0,9 ngày, tiền sử mổ bụng là 1 lần chiếm 87,8%. Phẫu thuật nội soi được áp dụng để xử trí các nguyên nhân tắc ruột đơn giản, không phức tạp. Trong đó: cắt dây chằng (53,1%), gỡ dính ruột (38,8%) và 3 bệnh nhân xoắn ruột (6,1%). Phẫu thuật nội soi giúp bệnh nhân sớm phục hồi sớm, thời gian trung tiện sau mổ trung bình là 1,8 ± 0,8 ngày, thời gian ăn lỏng sau mổ trung bình của là 2,1 ± 1,1 ngày. Phẫu thuật nội soi cũng rút ngắn được thời gian nằm viện với thời gian nằm viện trung bình là 4,5 ± 1,4 ngày. Tỷ lệ tai biến, biến chứng sau mổ thấp. Rách thanh mạc ruột (chiếm 8,1%), thủng ruột non trong quá trình gỡ dính 4%, nhiễm khuẩn vết mổ (chiếm 2%), tắc ruột sớm sau mổ (chiếm 2%), không có tử vong. Kết luận: Phẫu thuật nội soi điều trị tắc ruột sau mổ ở nhóm bệnh nhân lựa chọn là an toàn, khả thi, giúp bệnh nhân nhanh phục hồi, tỷ lệ tai biến, biến chứng thấp., Tóm tắt tiếng anh, to evaluate the results of laparoscopic surgery in the treatment of postoperative small bowel obstruction. Patients and methods: retrospective, clinical description on 49 patients diagnosed with postoperative small bowel obstruction and undergoing laparoscopic surgery for treatment at Military Hospital 103 from May 2018 to May 2022. Results: Mean age was 41.8 ± 17.3 (13-76)
female accounted for 61.2%, male accounted for 38.8%. Mean time of disease manifestation: 2.7 ± 0.9 days, history of abdominal surgery was 1 time, accounting for 87.8%. Laparoscopic surgery is applied to manage simple, uncomplicated causes of intestinal obstruction. In which: ligament removal (53.1%), removal of intestinal adhesions (38.8%) and 3 patients with intestinal volvulus (6.1%). Laparoscopic surgery helps patients recover early, the mean time after surgery is 1.8 ± 0.8 days, the average time after surgery is 2.1 ± 1.1 days. Laparoscopy also shortens the hospital stay with an average length of stay of 4.5 ± 1.4 days. The rate of complications and complications after surgery is low. Intestinal serosa tear (8.1%), small bowel perforation during de-adhesion 4%, wound infection (2%), early bowel obstruction after surgery (2%), no mortality. Conclusion: Laparoscopic surgery to treat postoperative small bowel obstruction in the research group of patients is safe, feasible, helps patients recover quickly, has a low rate of complications.

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