Phẫu thuật nội soi cắt lách tại Bệnh viện Hữu Nghị Đa khoa Nghệ An: Chỉ định và kỹ thuật=Laparoscopic splenectomy at the Nghe An General Friendship Hospital: Indications and techniques

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Tác giả: Nam Thắng Cù, Anh Xuân Lê, Huy Toàn Nguyễn, Văn Hương Nguyễn, Minh Tuấn Phạm

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.104-112

Bộ sưu tập: Báo, Tạp chí

ID: 477971

Thêm vào giỏ

Các nghiên cứu về phẫu thuật cắt lách nội soi (PTNSCL) vẫn chưa được thực hiện nhiều ở các cơ sở ngoại khoa, đặc biệt là các bệnh viện tuyến tỉnh. Xuất phát từ thực tế nghiên cứu và điều trị tại bệnh viện hữu nghị đa khoa Nghệ An mong muốn góp phần nghiên cứu chỉ định và kỹ thuật nhằm đưa lại kết quả tốt về cắt lách nội soi phù hợp với hoàn cảnh và điều kiện cơ sở y tế hiện nay. Phương pháp: Nghiên cứu hồi cứu, mô tả cắt ngang trên 22 bệnh nhân được phẫu thuật nội soi cắt lách tại Bệnh viện Hữu nghị Đa khoa Nghệ An từ tháng 1/2020 đến tháng 06/2023. Kết quả: Có 22 bệnh nhân 16 nam (72,7%) và 6 nữ (27,3%)
độ tuổi trung bình 37,54 ±12,25 (18 - 66 tuổi). Kích thước lách trung bình 12,31  3,06 (7- 20,2)
chỉ định cắt lách: U lách 09(40,9%), nang lách 06(27,3%), bệnh máu 03(13,6%). Tỷ lệ phẫu thuật thành công 20(90,9%) trong đó cắt lách toàn bộ 19(86,4%), cắt lách kèm lách phụ 1(4,5%)
kiểm soát động mạch lách trước rốn lách 13(65%). Tai biến chung trong mổ 3(13,6%)
biến chứng rò tụy 1(4,5%), thuyên tắc tĩnh mạch lách 1(3,2%). Kết quả sau mổ tốt 18(90%)
trung bình 2(10%) xấu. Kết luận: Chỉ định cắt lách nội soi điều trị các bệnh lý về cơ quan tạo máu, bệnh lý nội tại của lách là phương pháp an toàn, tỷ lệ thành công cao. Phẫu thuật thường có kết quả sau mổ tốt góp phần hiệu quả trong điều trị các bệnh về máu và cơ quan tạo máu.Studies on laparoscopic splenectomy (LS) are still limited in surgical facilities, particularly in provincial hospitals. Based on the research and treatment practice at Nghe An General Friendship Hospital, this study aims to contribute to the development of indications and techniques to achieve optimal outcomes for laparoscopic splenectomy, appropriate to the current circumstances and healthcare conditions. Methods: A retrospective cross-sectional study was conducted on 22 patients who underwent laparoscopic splenectomy at Nghe An General Friendship Hospital from January 2020 to June 2023. Results: The study included 22 patients, 16 males (72.7%) and 6 females (27.3%), with an average age of 37.54 ± 12.25 years (range: 18-66 years). The average spleen size was 12.31 ± 3.06 cm (range: 7-20.2 cm). Indications for splenectomy were splenic tumors (9 cases, 40.9%), splenic cysts (6 cases, 27.3%), and hematological disorders (3 cases, 13.6%). The success rate of surgery was 90.9%, with total splenectomy performed in 19 cases (86.4%) and splenectomy with accessory spleen removal in 1 case (4.5%). Splenic artery control before the splenic hilum was achieved in 13 cases (65%). Intraoperative complications occurred in 3 cases (13.6%), including pancreatic fistula (1 case, 4.5%) and splenic vein thrombosis (1 case, 3.2%). Postoperative outcomes were good in 18 cases (90%) and moderate in 2 cases (10%), with no poor outcomes reported. Conclusion: Laparoscopic splenectomy is a safe and highly successful procedure for treating hematologic disorders and intrinsic splenic diseases. It typically results in favorable postoperative outcomes and is an effective treatment option for blood-related and splenic disorders.

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