Background: Laparoscopic cholecystectomy is the first laparoscopic surgery that was performed at Cho Ray hospital in September 1992. In 2005, Quang Tri general hospital has performed successfully the first case of laparoscopic appendectomy. Objectives: To access the preliminary results of application on endoscopic surgery in Quang Tri general hospital. Subjects and method: A prospective study was conducted on 140 patients with laparoscopic surgery or retroperitoneal surgery, was performed in Quang Tri general hospital from September, 2005 to April, 2006. Results:Among 140 patients was operated, there was only one case of postoperative intestinal obstructive complication (accounted for 0.7%), no case of death. Operative aged was between 11 and 70 years old. The average surgical time was 65 minutes for cholecystectomy, 35 minutes for appendectomy, 85 minutes for ureterolithotomy, 80 minutes for gynecological diseases. 2 cases of cholecystectomy and appendectomy changed open surgery. Conclusion: Laparoscopic surgery is a safe and effective method. It can be developed in provincial hospitals. Quang Tri general hospital has successful preliminary developed the new technique.
Laparoscopy ;

Background: Gastric cancer is the second common disease among types of cancer, followed by lung cancer for male and breast cancer for female. The selection of appropriate regimens for illness and economic conditions of patients is always a difficult problem for clinicians. Objectives: To assess preliminary results of chemotherapy in treatment of gastric cancer in Hai Phong. Subjects and method: A longitudinal, cross-section study was conducted on 57 patients with gastric cancer (35 male, 21 female), treated in Viet Tiep hospital from January, 2002 to June, 2006. All of them were in stage of Dukes C, treated postoperative supported chemotherapy. Results: Side effects were common seen as vomit, nausea and diarrhea. They were often mild and disappeared after stopping medication. 30/57 patients responded to treatment. 21 patients were treated with regimen 5FU, however, amount of treatment cycles was very scattered and treatment effect was unclear. 36 patients were treated with multi-chemical regimens as FUFA, FAM and ELF. Their response to treatment was more clearly than regimen 5FU. During treatment, there were 6 patients who had not completely responded to treatment. In which, 4 patients developed more seriously: metastasis to liver, ovary, bone and lung. 2 patients had died. Conclusion: Regimen 5FU had a little toxicity. Regimen FUFA was more effective. The role of chemotherapy in supported treatment was unclear. Chemotherapy could be applied to patients with early stage of Dukes B.
Stomach Neoplasms/ therapy ; Drug Therapy ;

Background: Situation of extremity injury caused by traffic accidents and occupational accidents are increasing in Vietnam. Therefore, the prevention and fight against these accidents are one of the key objectives to reduce the burden on the families of victims as well as for society. Objectives: To outline situation of extremity injury patients caused by traffic accident, treated in Viet Duc hospital from 2000-2004. Subjects and method: A retrospective study was conducted on 19.845 patients (14.562 males, 5.283 females, aged from 1-97 years old). The subjects were divided into 3 main groups: alone upper extremity injury, alone lower extremity injury and multiple fractures. Results: Extremity injury was common seen in people of working age (78.1%), men more than women (2.76/1 ratio), left foot more than right foot and it was common been in multiple fracture situation due to complex mechanisms of injury (50.3%), alone extremity injury (49.7%). The lower extremity injury was more common seen than upper extremity injury. Open fracture injury (27.3%), in which open fractures in lower extremity were more common seen. Open fractures in both 2 leg bones was the most common seen, accounted for 57.4% among total of open fractures. Amputation accounted for 8.3% among all case of open fractures and 2.3% among all case of extremity injuries. Conclusion: Extremity injury (lower extremity and upper extremity) caused by traffic accidents is common seen. The average, there are 3 emergency surgeries due to open fracture injury were performed daily in Viet Duc hospital per a total of about 11 traumatic emergency surgeries.
Fractures ; Bone ; Arm Injuries ; Leg Injuries ; Accidents ; Traffic ;

Background: Intractable pain is the most distressing symptom in patients suffering from unresectable pancreatic carcinoma and chronic pancreatitis and thoracoscopic splanchnicectomy is an emerging method in the past decade for pain control. Objectives: To evaluate the effectiveness and safety of thoracoscopic splanchnicectomy in controlling pain due to pancreatic diseases. Subjects and method: This descriptive, cross-sectional study was carried out between May 2004 and August 2006, on 29 patients with unresectable pancreatic carcinoma and chronic pancreatitis, treated by thoracoscopic splanchnicectomy. Their subjective pain was assessed by visual analogue scale (VAS). Intra- and post- operative complications and mortality, operative time and hospital length also so have been evaluated. Results: Among 29 patients, there were 21 cases of pancreatic carcinoma (11 males and 10 females) and 8 cases of chronic pancreatitis (100% were male). The average operative time was 133.27 \xb1 8.32 min (range 90-270 min). 27 cases (93.1%) underwent bilateral thoracoscopic splanchnicectomy and 2 cases (6.9%) underwent unilateral procedure. There was no death due to procedure. The mean hospital stay was 4.86 \xb1 0.56 days (range, 1\ufffd?3 days). Pain relief was most effective in the 1st week after operations. Conclusion: Thoracoscopic splanchnicectomy is a safe and effective procedure of treating malignant and benign intractable pancreatic pain. It is needed to study long-term efficacy of pain relief for chronic pancreatitis.
Pancreatic Diseases/ surgery ; Thoracoscopy ;

Background: Deltoid fibrosis is caused by congenital disorder or complication of intramuscular injection or trauma, and can affect aesthetics and functions of shoulders. Objectives: To remark on the risk factors and pathology of deltoid fibrosis, and to evaluate the results of surgical procedure. Subjects and method: This clinical study involved 156 patients with 281 shoulder joints were surgically treated at National Hospital of Pediatrics from August 1994 to June 2005. All patients were physical and radiological examinations, and surgically treated by 1 of 4 techniques. Postoperative outcomes were evaluated. Results and Conclusion: Of 156 patients, there were 72 male and 84 female children, 62.8% in age group of 11-15 years old, and 29.5% over 15 years old. Severity of deltoid fibrosis was: severe in 95.4% of shoulder joints, moderate: 4.6%, and mild: 0%. 12.2% patients experienced deltoid fibrosis in combination with fibrosis of another muscles. The postoperative outcomes included; good: 92.5% of shoulder joints, moderate: 2.9% and bad: 4.6%. Type IV technique give best results (99%).
Deltoid Muscle/ surgery ; Child ;

Background: peripheral vascular wounds/trauma is a severe type of surgical emergency, the increasing rate due to the rapid increase of traffic, labor and living accidents. Subjectives and Method: retrospective study, all patients with peripheral vascular wounds/traumas (alone or combination in multiple trauma) were emergency operated at Viet Duc Hospital from January 2004 to June 2006. Results: A total of 310 patients with peripheral vascular injuries in the study, of which accounted for 62.3% of injury, trauma group accounted for 37.7%. The mean age of 30. In first aid, pressed tape accounted for high rate (71.5%). Rate of popliteal vascular trauma due to fractures around the knee accounted for 65.5%, the rate of brachial vascular trauma with fractures around the elbow was 50%. Rate of late diagnosis of arterial trauma was 14.6%, higher than the arterial wounds (2.6%). The rate of ultrasound for forelimbs - where vessels were many wounds, was lower than that for hindlimbs - where vessels were many traumas (44% vs 67.9%). For vascular wounds, more directly vascular connection and more intervention on veins, whereas, for arterial trauma, more vascular graft. Rate of complications was low (7.4%), with no deaths. Conclusions: Overall, the results of emergency surgery for peripheral vascular wounds/trauma were well. No cases was death from vascular lesions, rate of complications was low.
Blood Vessels/ injuries ; Emergencies ;

Background: in head trauma, increased intracranial pressure and cerebral edema are the main factors causing death. One of the most effectiveness anti-cerebral edema measures is to ensure ventilation, mechanical ventilation is best. But in practical conditions of Vietnam, with a very large number of patients, number of ventilator is insufficient for patients, so tracheostomy is a relatively simple method but has saved the lives of many patients. Objectives: to assess the situation of respiratory tract infections in patients with tracheostomy due to head trauma; to study the common bacterial species and antibiotic response in the treatment of these infections. Subjectives and Method: a prospective descriptive study on all patients with head trauma had been tracheostomy, treated and monitored at department of neurosurgery, Viet Duc Hospital from November 25, 2005 to April 25 in 2006. Results: 80% of patients infected with multiple bacteria. The rate of respiratory infection after 3 days of tracheostomy was 90%. The common bacterial species were gram (-) (82.58%), highest P.aeruginosa (34.04%), followed by other intestinal Gram (-). The species of Gram (+) only accounted for 17.02%, including staphylococcus (6.38%). Results of Antibiotics Sensitivity Test showed that 2nd regimen (Augmentin + aerosol including: ampicinllin and Nebule) was effective treatment. Conclussions: the ability of bacterial infecting to respiratory tract was very soon. The rate of respiratory infection after 3 days of tracheostomy was very high. The common bacterial species were gram (-). Antibiotic combination was high effective regimen.
Respiratory Tract Infections ; Craniocerebral Trauma ; Tracheostomy ;

Background: Laparoscopicappendectomyisasafeandeffectiveprocedureforacute appendicitis. This surgeryhasashorterdurationofhospitalstayandatrendtowardless postoperative infectious complications. Objectives: To evaluate advantages and disadvantages of laparoscopic appendectomy with one navel trocar. Subjects and method: Subjects included 38 cases diagnosed acute appendicitis in Cho Ray hospital, from October 2006 to September 2007. The subjects treated by laparoscopic appendectomy with one navel trocar. Results: The subjects included were 14 males (36.8%) and 24 females (63.2%). The subjects\ufffd?average age was 28.82 years (ranged from 14-68 years). The average time of abdominal pain was 18.39 hours (ranged from 8 to 24 hours). The average operative time was 28.34 minutes (ranged from 15 to 65 minutes). The average time of hospital stay was 2.9 days (ranged 1 to 5 days). 36/38 patients (94.7%) had appendix\u2019s location in right iliac fossa. There were 68.4% of patients who reexamined at postoperation. Conclusions: Laparoscopic appendectomy with one navel trocar is a useful method for reducing hospital stay, complications and return to normal activity.
Appendectomy/methods ; Appendicitis/surgery ;

Background: Massive blood transfusion is common in surgery: trauma, complicated surgery, organ implantation. Stored blood contains much lactate, ammonia, products of metabolism. These products have negative effects on patient\u2019s metabolic function which may be a cause of death. Objective: To study the change of blood biochemical indexes in surgical patients with massive blood transfusion at Viet Duc hospital. Subjects and method: A prospective study was conducted in the adult patients who had emergency and operation at Viet Duc hospital, from December/2004 to August/2006. All of them were transfused over 3000 ml of blood within 24 hours (pre-operation, intra-operation and post-operation). Results: During the period of study, there were 70 surgical patients with massive blood transfusion: men were more than woman (64%) and the mean age: 38\xb117. The survival rate was significantly improved (57%). The average transfused blood per patient per 24 hours was 3995ml\xb11067ml. There was a decrease in the value of pH, acid-base and HCO3 (the average pH value 7.218\xb10.181, lowest value 6.7). The average value of pH and HCO3\xac was higher in the survival patients than died patients (p<0.05). The mean level of K+ was 3.8\xb10.96mml/l. The increase in the level of K+ had a positive association with the amount of transfused blood. The mean level of Ca++ \xac\xacdecreased under the normal level (0.98mml). Conclusion: It should monitor blood gas and electrolytes continuously in surgical patients with massive blood transfusion in order to identify disorders soon for timely treatment.
Blood Transfusion

Background: Untill now, many minimal invasive methods have been applied in treating ureteral stones such as the endoscopic ureterolithotripsy technique of Perez-Castro and Martinez-Pinero (1980), the tetroperitoneal laparoscopic ureterolithotomy technique of Wickham (1979) and so on. Retrograde endoscopic ureterolithotripsy with holmium laser has been applied in management of ureteral stones at the Post hospital I Hanoi since 2003. Objective: To show results of retrograde endoscopic ureterolithotripsy with holmium laser in management of ureteral stones at the Post hospital I Hanoi. Subjects and method: A retrospective study was conducted in 183 patients who underwent retrograde endoscopic ureterolithotripsy with holmium laser at the Post hospital I Hanoi, from July/2003 to July/2005. Results:In 183 patients, female was more than male (54.7% versus 45.4%); the mean age was 45.4 (range 14-77). There were total 212 lithotrity stones, of which the rate of left, right, upper-third, middle-third and lower-third ureteral stone was respectively 51.9%, 48.1%, 43.2%, 22.4% and 34.4%. The mean size of ureteral stone was 15.1mm x 11.17mm and the average time of ureterolithotripsy was 48.1 minutes (range 15 -120). Conclusion: The rate of success for etrograde endoscopic ureterolithotripsy with holmium laser was high (92.9%), especially the success rate for lower-third ureteral calculi (100%) and the success rate for upper-third ureteral stones (84.8%). However, 5/165 patients (3%) who had follow-up examination for 2-4 years after surgery had ureteral stenosis. This complication was resulted from burned mucous membrane during endoscopic ureterolithotripsy with laser.
Ureterolithiasis/ surgery ; therapy ; Endoscopy/ methods ; Lasers