Background: Pleural drainage is essential for preventing and managing respiratory complications after video-assisted thoracoscopic esophagectomy (VATE). Conventional largebore drains often cause significant pain. Small-bore drains (e.g., 19F Blake drains) may reduce discomfort; however, evidence regarding their use in VATE is limited. This study compared drainage effectiveness and pain between 19F Blake drains and conventional 28F drains after VATE for esophageal cancer. Methods: This retrospective study included 77 male patients with middle- or lower-third esophageal cancer who underwent VATE with laparoscopic retrosternal tunneling from November 2018 to November 2022. Fifty-five patients received a 28F conventional drain, and 22 received a 19F Blake drain. Outcomes included drainage duration and volume, pain levels (Visual Analog Scale [VAS]), postoperative pneumonia rates, and pulmonary function (forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1]) on postoperative day 3. Results: The 19F group reported significantly lower pain scores on postoperative days 1–3 (VAS: 2.95–3.25 vs. 4.07–4.62, p<0.001). Drainage duration and pneumonia rates were similar between groups. The 19F group demonstrated a trend toward higher drainage volume and significantly better preservation of pulmonary function, with smaller declines in FVC (ΔFVC: 0.24±0.20 L vs. 0.63±0.17 L, p<0.001) and FEV1 (ΔFEV1: 0.38±0.25 L vs. 0.58±0.25 L, p=0.02). Conclusion 19F Blake drains provide similar drainage effectiveness to that of 28F drains, with reduced postoperative pain and better pulmonary function preservation. These findings support the use of 19F Blake drains to improve patient comfort and recovery following VATE.

Background: s/Aims: Pancreaticoduodenectomy (PD) is the only radical treatment for periampullary malignancies. Superior mesenteric artery (SMA) first approach combined with total meso-pancreas (MP) excision was conducted to improve the oncological results.There has not been any previous research of a technique that combines the SMA first approach and total MP excision with a detailed description of the MP macroscopical shape. Methods: We prospectively assessed 77 patients with periampullary malignancies between October 2020 and March 2022 (18 months). All patients had undergone PD with SMA first approach combined total MP excision. The perioperative indications, clinical data, intra-operative index, R0 resection rate of postoperative pathological specimens (especially mesopancreatic margin), postoperative complications, and follow-up results were evaluated. Results: The median operative time was 289.6 min (178−540 min), the median intraoperative blood loss was 209 mL (30−1,600 mL).Microscopically, there were 19 (24.7%) cases with metastatic MP, and five cases (6.5%) with R1-resection of the MP. The number of lymph nodes (LNs) harvested and metastatic LNs were 27.2 (maximum was 74) and 1.8 (maximum was 16), respectively. Some (46.8%) patients had pancreatic fistula, but mostly in grade A, with 7 patients (9.1%) who required re-operations. Some 18.2% of cases developed postoperative refractory diarrhea. The rate of in-hospital mortality was 1.3%. Conclusions The PD with SMA first approach combined TMpE for periampullary malignancies was effective in achieving superior oncological statistics (rate of MP R0-resection and number of total resected LNs) with non-inferior short-term outcomes. It is necessary to evaluate survival outcomes with long-term follow-up.

Background: Pediatric closed abdominal trauma is a common disease in surgical practice, in which spleen is the most vulnerable organ. As adults, diagnosis of pediatric splenic trauma is not difficult but treatment attitude of splenic trauma in children having more important differences compared with in adults, tending to conservative treatment without surgery. Objectives: To assess the results of pediatric splenic trauma treatment in Hue Central Hospital from 2001 to 2005. Subjects and method: To study on 43 pediatric patients (23 male, 20 female), mean age 11.35\xb13.51 years, were diagnosed with splenic trauma due to closed abdominal trauma, treated in Hue Central Hospital from September, 2001 to September, 2006. Results: 72.1% hospitalized patients with maximum blood pressure in normal limitation. There was not a statistic significant association between hypotension and indicated surgery. The rate of patients with splenic trauma due to traffic accidents, living accidents and sport activities were 62.8%, 32.6% and 4.7%, respective. 2 patients with combined traumatic brain injury without surgery (4.65%), 3 patients with combined hand fracture (6.97%). 3 patients in conservative treatment group changed to surgery (8.33%). A total of 76.7% patients treated with successful conservation. Conclusion: More than 60% patients with splenic trauma caused by traffic accidents and having stable hemodynamic index during hospitalization. The difference between position of splenic trauma and rupture degree of spleen both in surgical treatment group and successful conservative treatment group is statistically significant.
Spleen/ injuries ; Child ;

A study aimed at investigation of knowledge- attitude and practice of people for family toilet and recommendation of intervention solutions for increasing the rate of families in using the hygienic toilet. The results have shown that 1.7% of households had no toilets, 96.6% of households had unhygienic toilet. 50.9% of households said that their family toilets were hygiene. The needs of knowledge of environmental hygiene and disease prevention were urgent (73-92% of households). While the education and communication for environmental hygiene only obtained 22.5% of households
Toilet Facilities ; Health Knowledge, Attitudes, Practice