Ứng dụng dao ligasure trong phẫu thuật u lành tính tuyến mang tai tại Bệnh viện Ung bướu Hà Nội=Application of ligasure device in parotidectomy for patients with benign parotid gland tumors at Hanoi Oncology hospital

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Tác giả: Thanh Hùng Bùi, Trọng Nghĩa Đàm, Hoàng Anh Nguyễn, Kỳ Anh Nguyễn

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.60-65

Bộ sưu tập: Metadata

ID: 478115

Thêm vào giỏ

Phẫu thuật (PT) là phương pháp chính điều trị u tuyến mang tai (TMT). Việc giữ phẫu trường sạch sẽ rất quan trọng trong việc tránh các biến chứng. Dao LigaSure cho thấy nhiều ưu thế khi ứng dụng trong phẫu thuật tuyến mang tai, tuy nhiên chưa có nghiên cứu nào ở Việt Nam đánh giá kết quả. Mục tiêu: Đánh giá kết quả ứng dụng dao LigaSure trong phẫu thuật u lành tính tuyến mang tai. Đối tượng và phương pháp: Nghiên cứu mô tả tiến cứu tiến hành trên bệnh nhân u lành tính tuyến mang tai được phẫu thuật bằng dao LigaSure tại Khoa ngoại đầu cổ, bệnh viện Ung Bướu Hà Nội từ tháng 3/2023 đến tháng 9/2023. Kết quả: Có 30 bệnh nhân tham gia nghiên cứu, trong đó có 14 bệnh nhân được phẫu thuật cắt u, chiếm 46,7%, có 12 (40,0%) bệnh nhân phẫu thuật cắt thùy nông tuyến mang tai kèm theo khối u, có 4 (13,3%) bệnh nhân được phẫu thuật cắt toàn bộ tuyến mang tai. Về kết quả phẫu thuật, thời gian phẫu thuật trung bình là 51,3 ± 17,5 phút, lượng dịch dẫn lưu sau mổ trung bình là 11,7 ± 5,4 ml, thời gian nằm viện sau phẫu thuật trung bình là 2,6 ± 0,8 ngày. Có 4/30 (13,3%) bệnh nhân có liệt mặt sau mổ, chiếm tỉ lệ 13,3%, trong đó 3 bệnh nhân liệt mặt hồi phục hoàn toàn sau 4 tuần, 1 bệnh nhân hồi phục hoàn toàn sau 8 tuần. Kết luận: Việc ứng dụng dao LigaSure trong phẫu thuật tuyến mang tai giúp giảm đáng kể thời gian phẫu thuật, giảm lượng dịch dẫn lưu sau mổ, rút ngắn thời gian nằm viện và rút ngắn thời gian hồi phục liệt mặt sau mổ (nếu có), tuy nhiên vai trò cải thiện tỉ lệ liệt mặt chưa rõ ràng. Nên ứng dụng dao LigaSure cho những bệnh nhân có nguy cơ cao về chảy máu, rối loạn đông máu hay nguy cơ khi gây mê kéo dài.Surgery is the main treatment of parotid tumors. Keeping the surgical field clean is very important to avoid complications. The LigaSure appeared having many advantages in parotidectomy, however, there have been no studies in Vietnam evaluating its outcome. Objective: To evaluate the outcome of applying LigaSure device in benign tumor parotidectomy. Subjects and methods: prospective descriptive study on patients with benign parotid tumor operated with LigaSure at the Head and Neck Surgery department, Hanoi Oncology hospital from March 2023 to September 2023. Results: Totally 30 patients were included. Tumor resection accounted for 14 patients (46.7%), 12 (40%) of them had. superficial parotidectomy, 4 (13.3%) of them had total parotidectomy. Average surgical time was 51.3 ± 17.5 minutes
average postoperative drainage was 11.7 ± 5.4 ml
average post-operative hospitalization was 2.6 ± 0.8 days. There were 4/30 patients (13.3%) had postoperative facial analysis
among them 3 totally recovered after 4 weeks, 1 recovered after 8 weeks. Conclusion: Application of LigaSure in parotidectomy helped reduce significantly the surgical time, postoperative drainage, shorten hospitalization time and recovery time of postoperative facial analysis (if occurred). However, its role in improving the prevalence of facial analysis is unclear. Hence, LigaSure should be used for patients at high risk of bleeding, coagulation disorders or at risk of prolonged anesthesia.

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