Kỹ thuật cắt tầng sinh môn ngoài cơ nâng ở tư thế nằm sấp trong điều trị ung thư trực tràng thấp

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Hồng Quân Đặng, Hoàng Huấn Lâm, Văn Đợi Mai, Văn Hiên Nguyễn, Văn Luân Nguyễn, Văn Tuấn Nguyễn, Văn Năng Phạm

Ngôn ngữ: vie

Ký hiệu phân loại: 615.62 Pharmacology and therapeutics

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2023

Mô tả vật lý:

Bộ sưu tập: Metadata

ID: 502446

Thêm vào giỏ

Đánh giá kỹ thuật mổ và kết quả ngắn hạn của phương pháp nội soi cắt trực tràng ngả bụng tầng sinh môn ngoài cơ nâng ở tư thế nằm sấp trong điều trị UTTT thấp. Đối tượng và phương pháp nghiên cứu: bệnh nhân UTTT thấp, giai đoạn I, II, III có chỉ định PTNS cắt trực tràng ngả bụng và tầng sinh môn, cắt tầng sinh môn ở tư thế nằm sấp tại Cần Thơ từ tháng 05 năm 2019 đến tháng 05 năm 2023. Nghiên cứu tiến cứu về tuổi, thời gian mổ, tai biến, biến chứng sau mổ. Kết quả: Từ 12-2018 đến 6-2023, có 45 bệnh nhân UTTT được PTNS cắt trực tràng ngả bụng tầng sinh môn ngoài cơ nâng tại BV ĐHYD Cần Thơ. Tuổi trung bình là 68 tuổi. Khoảng cách trung bình của bờ dưới khối u cách rìa hậu môn 1,6cm. Diện cắt vòng quanh (DCVQ) (+) chiếm 28.9 %. Số hạch nạo trung bình 16,7 hạch, di căn trung bình 1,6 hạch. Khối u giai đoạn T3 chiếm đa số với 68,9 %. Không có trường hợp nào bị vỡ trong mổ. Biến chứng sau mổ chủ yếu ở vết mổ tầng sinh môn 17.8%, cắt tầng sinh môn trung bình 73 phút, Có sự khác biệt có ý nghĩa thống kê về DCVQ (+) giữa giai đoạn T2 và T3. Kết luận: PTNS cắt trực tràng ngả bụng-tầng sinh môn ngoài cơ nâng có nhiều ưu điểm như không bị vỡ khối u trong thì cắt tầng sinh môn, tỉ lệ biến chứng thấp. Tỉ lệ DCVQ (+) và giai đoạn T liên quan có ý nghĩa thống kê.Evaluate the surgical technique and short-term results of laparoscopic rectal resection of the perineum outside the levator muscle in the prone position in the treatment of low rectal cancer. Objectives and methods: The patients had low rectal cancer in stages I, II, III and underwent lAPE in the prone position in Can Tho from May 2019 to May 2023. Propective study on: age, gender, tumor characteristics. Oncology results: histopathology, lymph nodes, stage of disease, CRM status. Surgical results: operation time, intraoperative complications, postoperative complications. Results: The mean distance of the lower umferential resection margins (CRM) (+) from 49.6% to 20.3%, and the intraoperative perforation (IOP) rate from 28.2% to 8.2 margin of the tumor from the anal margin 1.6cm. The mean age in the study group was 68 years. CRM (+) accounted for 28.9%, average harvested of 16.7 lymph nodes, mean metastasis of 1.6 lymph nodes, grade T3 accounted for the majority with 68.9%, intraoperative perforation 0%, Postoperative complications commonly occurred in perineal wound with 17.8%. The average perineal resection time was 73 minutes. Conclusion: laparoscopic extra-levator abdomino-perineal excision, we found that there are many advantages in perineal dissection to reduce the rate of intraoperation perforation, perineal wound is not serious. However, the rate of CRM (+) was found to be related to the grade T of the tumor.

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