Nhận xét kết quả ứng dụng phẫu thuật nội soi trong điều trị viêm phúc mạc ruột thừa tại khoa ngoại Bệnh viện Bạch Mai

bdng noi soi de khong co trieu chung. Theo chung

toi: Neu benh nhdn d do tudi trdn 50, polyp Idn hon

10 mm, polip don doc, khbng co cu6ng, nghdo am thi

c6 nguy co cao bi thoai h6a dc tinh. Cdc polyp nho

ndn theo dinh ky bdng sidu dm; cdc polyp gdy con

dau qudn nguc mdt vd khdng c6 soi kdm theo, gdy

khb xu tri cho bdc sy Idm sang nhung neu thiy thuoc

tin chdc con dau Id do polyp thi nhung bdnh nhdn ndy

se chi djnh m6 cdt tui mdt. NhQng polyp Idn, don ddc

hay c6 ph6i hop vdi soi thi cin phai theo d6i nghiem

ngdt. Cdt tui mdt phbng ngua trong polyp tui mdt chi

duoc thuc hidn khi polyp Idn hon 10mm.

k £t lu a n

Polyp tui mdt thudng it bien d6i theo thdi gian.

Nhung polyp Idn thudng dc tinh; C in theo dbi djnh

ky cdc polyp nho.N^u polyp khbng Idn nhung gdy

nhung con dau qudn gan thi cb chi dmh can thidp

phdu thudt. M6 noi soi cdt tui mdt trong trudna hop

polyp cb chi dinh m6 Id phdu thudt thich hop nhat.

TAI LIEU THAM KHAO

1. Nguyen Tang Mien "Cat tui mdt npi soi dieu trj

Polyp tui mdt", So ddc biet chuyen de ngoai tong quat Y

hpc Thanh pho Ho Chi Minh, Hpi nghj Ngoai khoa va

phau thudt npi soi toan Quoc nam 2008.

2. Chattopadhyay D, Lochan R, Balubury S, et al

(2005). Outcome of gall bladder polypoidal lasions detected

by transabdominal ultrasound sacnning a nine year

experience, Worl J.Gastroenterol, 14;11 (14): 2171-3.

3. Kar M, Bhattacharyya U, Laha RN, et al (2003)

Haemobilia due to a lasge gall bladder polyp in

Med, Assoc 101(9) 554-5 PMID 15168995

4 Khomeriki SG. Orlova luN, II Chenko A et al

(2004) Quantitative analysis of morp' Kjical

manifestatins of cholesterolosis and co tant

pathology of the gall bladder Arkh Pato 15). 12-5

PMID 15575378.

5. Kim DH, Kim SR, Song SY, et al (2003) A Large

sibrous polyp of the gall bladder m im ic k im g a polypoid

carcinoma J. Gastroenterol, 38(10)1009-12

6. Mainprize KS, Gould SW, Gillbert JM (2000):

Sergical manaherment of polypoid lesions of the gall

bladder Br.J.Surg, 87(4);414-7.

7. Noton J. Greenberger,Gustave Paumgarlen

(2005). Diseases of the gall bladder and bile ducts in

Harrion's Principles of intern Med, 16 Edit, Vol.II.1880-

1891

8. Paslawski M, Krupski W, Zlomeniec J (2004); The

Value of Ultransound harmonic imaging in the dianosis

of the gall bladder cholesterol polyps. Ann Univ. Mariae

Curie Sklodowska 59(2): 293-7. PMID 16146095.

9. Persley KM (2005): gall bladder polyps. Curr.

Treat. Options Gastroenterol, 8(2): 105-108

10. Terzi C, Sokmen S, Seckin S, (2000),Polupoid

lesion of the gall bladder : Report of 100 cases with

special raference to operative indications,

Surgery,127(6):622-7.

11. Wolpers C (1989), gall bladder polyps and gall

bladder stones. Dtsch Med. Wochenscher; 114(49);

1905-12.

NHAN XET KET QUA UffiG DUNG PHAU THUAT NOI SOI TRONG DIEU TRj

VIEM PHUC MAC RUOT THflfA TAI KHOA NGOAI BENH VIEN BACH MAI

TOM TAT

Dat vin di: Vidm phuc mac mdt thira l i mdt b iin

chung ning cua vidm mdt thira cip. P hiu th u it ndi

soi d iiu tri vidm phuc mac mdt thira dd duxyc ung

dung kh i phd biin, tuy vdy vin c in tiip tuc dinh g ii

v i tinh an toan va hidu qui. Doi tinmg, phirong

phip: 64 bdnh nhin vidm phuc mac mdt thira, duxyc

phiu th u it ndi soi t$i Bdnh vidn tir thing 1 nim 2010

d in thing 1 nim 2013. Nghidn ciru hdi ciru md t i c it

ngang. K it qui: Ty Id chuyin md l i 11,9%, thdn gian

m6 tmng binh 75,4 ± 27,5 phut, thdi gian cd tmng tien

tmng binh 45,3 ± 20,4 gib, ty id b iin chimg chung l i

18,92 % (tic mdt s&m, ip xe tdn dir, nhidm khuin

chin trocar lin luxyt l i 2,7%; 2,7%; 13,52%). Thai

gian nim vi$n sau md tmng binh l i 6,5 ± 1,3 ngiy.

K it lu$n: P hiu th u it ndi soi trong d iiu tri vidm phuc

mac mdt thira an toin, hidu qui.

Tir khda: Vidm phuc mac mdt thira. P hiu thuit

ndi soi.

SUMMARY

Background: Appendicular peritonitis is a serious

complication of appendicitis. Laparoscopic procedure

had been applied routinely, but it is still in need to

TRAN HUTU VINH va CS

measure the efficiency and safety of laparoscopic

surgery in treating appendicular peritonitis. Patients

and methods: Retrospective, from 1-2010 to 1-2013

at hospital, 64 cases of appendular peritonitis have

been treated by laparoscopic approach. Results:

Conversion rate was 11.9%. Mean operative time

was 75.4 ± 27.5 minutes, mean time of flatus

passage was 45.3 ± 20.4 hours. Overall complication

rate was 18.92% (trocar site infection, postoperative

intra-abdominal abscess and early intestinal

obstmction were 13.52%, 2 7% and 2.7%

respectively). Mean hospital stay was 6.5 ± 1.3 days.

Conclusion: Laparoscopic surgery is safe and

efficient option in appendicular peritonitis

Keywords: Appendicular peritonitis

Laparoscopic.

DAT VAN 0 £

Viem phuc mac rubt thCra (VPMRT) Id bi£n chung

ndng, hay gdp cua vidm rubt thira c£p Nguydn nhdn

do viem rubt thira c ip khbng duac chin dodn vd xu

tri kip thdi, vd mu vdo 6 bgng gdy vidm phuc mac vd

din den nhidm dbc todn thdn ndng thdm chi ddn d&n

tu vong.

70 Y HOC THUC HANH (905) - SO 2/2014