Kết quả ban đầu của phẫu thuật tiệt căn xương chũm tối thiểu đường xuyên ống tai

TAP CHl NGHI§N CO'U Y HQC

abdominal surgery on laparoscopic cholecystectomy in terms of complicafions and conversion I

open surgery. From among? the previous operafions, the incisions were upper abdominal, in 4

pafients and lower abdominal in 193, Conversion rates was one ease (1,7%), Intraoperative majc

complications were bile duet injury (0.4%, small bowel injury (0 8%), gallbladder injury (11,6%

and bleeding (7,7%), The lower abdominal incision group had fewer adhesions in the uppe

abdomen than did the upper abdomen. In conclusions, previous abdominal surgery is not J

contraindication to safe laparoscopic cholecystectomy. However, previous upper abdominj

surgery is associated with a prolonged operafion fime.

Keys words: laparoscopic cholecystectomy, gallbladder, conversion

K^T QUA BAN OAU CUA PHAU THUAT TIET CAN

XLPaNG CHO M T6 I THI^U DLPaNG XUYEN 6N G TAI

Nguyin Thj Td UyOn, Nguyin Tdn Phong

Trudng Dpi hpc Y Hd A/pi

Nghien cuv dwgc thwc hipn nhdm bwdc dau ddnh gid kit qud cua phiu thudt (PT) tipt cdn xwang chum

tdi thiiu dudng xuyen dng tai. Kit qua nghien cwu cho thiy 17 nw/8 nam tudi tw 16 din 67. Tmng dd 22

dugc tpo hinli hdm nhi nhd. Sau PT 10 ngdy 22/25 bdnh nhdn khdng chay dich ra cda tai 2 thdng sau hoc

md hodn toan dn djnh, chl rdng han 2 lin dng tai binh thwdng vdi cira tai gpn nhung van dam bao din luu

vd Idm hdc md thdng thodng. Kit ludn: day id pf-ixyng phap tidt cdn tdi thiiu vdi thdi gian khd tai nhanh va

tao diu kipn eho vipe phuc hdi chuc ndng nghe cho ngudi bdnh.

TCr khoa: cholesteatoma, tui co keo, ma sao bao duang xuyen dng tai, tlOt cdn xuong chum

tdi thieu

I. DAT VAN D^

Phiu thudt (PT) fiOt cdn xuang chQm duge

Kuster mO ta t& ndm 1889. dng dd hg thlp

thdnh sau dng tai xuang d l di vdo vQng bOnh

ly. Han 100 ndm qua, dd ed rat nhieu phuang

phdp PT duge dua ra vd dugc xlp thdnh hai

nhdm chlnh Id ky thudt hd (Open technic - ha

thap thanh sau dng tai xuang) vd ky thudt kin

(Close technic - gi& nguyOn ho$e tdi tao thdnh

sau dng tai xuang) vdi rit nhilu dgng eli

biOn. Cdc PT ndy diu ed ging dat tdi mdt dich

chung Id dam bao lly sach bOnh tich, hgn chl

tai phdt vd ed ging hdi phuc ch&c ndng nghe

cho ngudi bOnh [4].

Cdc PT tiOt cdn xuang chum kinh diln du

di dudng trudc tai hay sau tai diu khoan bo

phin vd xuang chum eho din khi vdo din sao

bdo, sdo dgo, thugng nhT.

Ndm 2008, Holt dd trinh bdy v l md sdo bdo

dudng xuyOn dng tai. ddy la dudng PT gan

hon d l di vdo vung bOnh tich d sdo bdo [5].

PT tiOt cdn xuang chum tdi thilu duirng

xuyOn dng tai thude nhdm ky thudt hd. Nd duoc

Nguyin Tin Phong bdo cdo tu ndm 2009 [1],

[2]. Sd dT nd duge nghT din vi trong thyc tl

ldm sdng nhilu trudng hgp viOm tai xuong

chQm mgn tinh ed cholesteatoma vd xep nhi

dd VI hay tui co kOo khdng kilm soat du-cw

ehln dodn d giai dogn bOnh tieh edn gon, vdi

kich thude sdo bdo nhd. Nh&ng trudng hap

bOnh tich ndy nlu PT fiOt cdn xuang chOm

48 TCNCYH 78 (1) - 2012