ĐÁNH GIÁ KẾT QUẢ ĐIỀU TRỊ PHẪU THUẬT TẮC RUỘT SAU MỔ

Abstract

Patient and method: Retrospective study. Time: 1/2018-12/2018. Result: There were 30 patients of postoperative obstruction were observed in K hospital. The mean age was: 56,0; male 76,7%, femail 23,3%, History feature: There were 66,7% had  history of one abdominal surgery, 33,3% had more than 2 abdominal surgery; 66,6% were coloreral cancer operation; 30,0% were gastric cancer operation. Clinical feature: Abdominal pain 100%, vomissement: 57,7%, Gazless 90,0%, bowel mouvement 80,0%, abdominalfullness: 90,0%. Plain badominal X-Ray: all had air-fluid level (100%),CT Scan were carried out in 96,7%, the sign of intertinal dilatation was 93,1%, one case of  bowel anemie due to intertinal torsion  and 5  reccurent patients were detected on CT scan. The result of operation: Open surgery were perfomed in all patients. There were 7(23,5%) patients had adhesive intertinal obstruction,10 patients had obstruction on band (33,3%), 5 patients (16,6%) had  torsion obstruction, 5 others patients (16,6%) had recurrent obstruction, 3 patients had phytobezoar obtruction. Operation perfomed: all had open surgery including adhesiolysis; band resection and adhesiolysis, intertinal resection (necroses oj bowel due to torsion or band), colon resection, colostomy (recurrence), liberation of phytobezoar. There was no death per and postoperation. Complication: 1 patient had digestive fistulas post adhesiolysis and bypass operation who had medical treatment. - Conclusion: We conclude that: In our study there were 66,6% of patients who had post operative obstruction after colo-rectal cancer operation (20,0% post Harmann procedure), 30,0% of patients  after  gastric cancr surgery. There were mainly adhesive  and/or  band and torsion obstruction as high as 73,3%, recurrent cancer obstruction was 16,7%, phytobezoar obtruction post gastrectomy was 10,0%.  All the patients had open operation. There was no death per and post operation.1 patient had digestive fistulas treated medical. We find that laparosopic operation could be performed in 50,0% of patients especially who had adhesive, band, torsion, phytobezoar obstruction.