KẾT QUẢ SỚM PHẪU THUẬT NỘI SOI CẮT ĐOẠN ĐẠI TRỰC TRÀNG VỚI PHƯƠNG PHÁP KHÂU MŨI TÚI MÕM TRỰC TRÀNG

Abstract

Objectives: Anastomotic leakage is a serious complication in colorectal resection surgery for rectal cancer treatment. Many studies have shown that leakage reduces the effectiveness of treatment and leave many serious sequelae for patients. Although there have been many improvements in surgical techniques, equipment and stapling devices, the leakage rate is still quite high at 6 – 11%. Many surgeons belives that the “dog ears” in two-stapler method contribute to the risk of anastomotic leakage complications, and they recommend implementing the pursestring suture placement method on the rectal stump. Several international studies have reported a decreased rate of anastomotic leakage. In Vietnam, there is currently limited research on the method of pursestring suture placement on the rectal stump. Methods: A retrospective study of laparoscopic anterior resection and laparoscopic low anterior resection with a single-stapler anastomosis and the placement of two pursestring sutures on the rectal stump for the treatment of rectal cancer. Results: 38 patients underwent laparoscopic colorectal resction with a single-stapler anastomosis and the placement of two pursestring sutures on the rectal stump, with an average age of 64,87 ± 11,44 years, men have the disease more often than women (60,5%). 16 patients (42,1%) with high rectal cancer underwent laparoscopic anterior resection, 12 patients (31,6%) with middle rectal cancer and 10 patients (26,3%) with low rectal cancer underwent laparoscopic low anterior resection. The average operative time were 214,4 ± 44,2 minutes and 250,0 ± 48,6 minutes respectively, the average blood loss was 126,58 ± 52,72 ml, 0 patients requiring blood transfusion. There were no complications during surgery. Postoperative complications, such as anastomotic leakage, intra-andominal abscesses, vaginal rectal fistula, and bleeding occurred in 0% of case and there were no patient deaths. Conclusion: The method of pursestring suture placement on the rectal stump during laparoscopic colorectal resection for cancer treatment results safety and effectiveness when performed in specialized medical centers.