Số 03 - Tập 15

Although continuous spinal anesthesia (CSA) was introduced nearly a century ago, its clinical use remains limited due to concerns about safety and potential complications. However in carefully selected high-risk patients, CSA may provide a valuable alternative to general or epidural anesthesia. This article presents a clinical case involving a patient with severe pulmonary (tuberculosis complicated by hemoptysis, a significant history of smoking, chronic obstructive pulmonary disease (COPD), and severe pulmonary emphysema) and cardiovascular (stable angina and 70% stenosis of the left descending artery) comorbidities undergoing colostomy closure surgery. In this context, general anesthesia posed significant risks such as difficult airway...

Despite the increasing incidence of early-onset colorectal cancer (EOCRC) worldwide, data from Vietnam remain limited, especially concerning long-term treatment outcomes. This study aimed to evaluate the clinical characteristics, long-term outcomes, and prognostic factors in patients with EOCRC. Patients and Methods: This retrospective study included patients diagnosed with colorectal cancer (CRC) before the age of 50. Clinical and paraclinical data were collected, and patients were followed up to evaluate long-term treatment outcomes. The primary endpoints were overall survival and the identification of prognostic factors. Results: EOCRC cases were evenly distributed between genders and were predominantly localized on the left side of...

Laparoscopic-assisted pancreaticoduodenectomy is a complex surgical procedure associated with a high rate of complications, particularly those arising from anastomotic leakage. The combination of laparoscopic dissection and resection with a mini-laparotomy for specimen retrieval and anastomosis construction is thought to potentially reduce perioperative morbidity. Patients and Methods: A cross-sectional descriptive case series was conducted involving 18 patients who underwent laparoscopically-assisted pancreaticoduodenectomy at the Department of Gastrointestinal Surgery, Viet Duc University Hospital, during the period from 2023 to 2025. Results: A total of 18 patients underwent laparoscopic-assisted pancreaticoduodenectomy. Among these, 55.6% were diagnosed with ampullary adenocarcinoma, 22.2% with solid pseudopapillary neoplasms of...

Endoscopic microvascular decompression (MVD) with intraoperative neurophysiological monitoring (IONM) is increasingly being adopted as the standard approach for treating neurovascular compression syndromes in the cerebellopontine angle. This study aims to evaluate the initial outcomes of the first five cases of endoscopic MVD with IONM. Materials and Methods: This prospective study included the first five cases of endoscopic MVD with IONM performed for trigeminal neuralgia and hemifacial spasm at the Department of Neurosurgery – Spine surgery, Hanoi Medical University Hospital between September 2024 and February 2025. The neurophysiological monitoring techniques used included brainstem auditory evoked potentials (BAEP), brainstem trigeminal evoked potentials...

The extended-view totally extraperitoneal (eTEP) approach has emerged as an innovative technique for incisional ventral hernia repair, offering several advantages such as reduced postoperative pain, fewer skin-related complications, and improved cosmetic outcomes. This study aims to evaluate the early outcomes of the eTEP technique for incisional ventral hernia repair at Can Tho General Hospital. Patients and Methods: A retrospective study was conducted on 30 patients who underwent laparoscopic eTEP repair for incisional ventral hernias between June 2022 and February 2025. Patient demographics, hernia characteristics, surgical details, intraoperative and postoperative complications, postoperative pain scores (measured using the Visual Analog Scale VAS),...

This study aims to evaluate the accuracy and the reliability of Boey’s score in predicting post-operative complications and mortality rates in patients with perforated peptic ulcers treated at district- and central-level hospitals. Patients and Methods: The retrospective case series study was conducted at two hospitals: Le Van Thinh Hospital, a district-level facility, and Cho Ray Hospital, a central-level institution. Data were collected from 114 patients at Le Van Thinh Hospital between January 2020 and December 2023, and from 255 patients at Cho Ray Hospital between January 2021 and December 2022. The study included patients diagnosed with Perforated Peptic Ulcer (PPU)...

The application of 3D technology in laparoscopic surgery is increasingly prevalent. While other medical specialties have shown benefits of 3D over traditional 2D laparoscopic surgery, its use in inguinal hernia repair remains less well-documented. Patients and Methods: This prospective, descriptive study included 60 patients diagnosed with inguinal hernia, who underwent 3D laparoscopic surgery at Hue Central Hospital and its Branch 2, from October 2022 to May 2024. Patients were divided into two groups: 30 patients underwent the Transabdominal Preperitoneal (TAPP) approach, including emergency cases, and 30 patients the Totally Extraperitoneal (TEP) approach. Results: The average operative times for the TAPP...

Endoscopic techniques have become the standard approach for pituitary adenoma surgery, providing improved visualization of the hypophyseal fossa and facilitating precise tumor resection while minimizing surgical morbidity. The one-nostril endoscopic approach further enhances minimally invasive surgery by reducing nasal mucosal trauma and optimizing access to the tumor, thereby improving surgical precision and reducing the risk of postoperative complications Patients and Methods: Between September 2024 and February 2025, a retrospective analysis was conducted on 12 consecutive patients who underwent one-nostril endoscopic transsphenoidal surgery at Viet Duc University Hospital and Hanoi Medical University. Furthermore, we provide a step-by-step description of the surgical...

The anatomical variations of the hepatic artery are a critical consideration in liver transplantation, impacting both surgical planning and postoperative outcomes. This study aimed to identify and classify hepatic artery variations in liver grafts procured from brain-dead donors at Viet Duc Hospital and to evaluate their implications for transplantation. Patients and Methods: Data were collected retrospectively from 2011 to 2016 and prospectively from 2017 to 2020, covering 53 liver grafts obtained from brain-dead donors. Results: Anatomical variants were categorized according to Hiatt’s classification and additional atypical patterns, with Type 1 (67.9%) being the most common, followed by Type 2 (13.2%)...

Gastric stromal tumors are a relatively common group of neoplasms. This study is aimed to evaluate treatment outcomes in patients with gastric stromal tumors who underwent surgery and adjuvant treatment at 108 Military Central Hospital Patients and Methods: This study included 60 patients with gastric stromal tumors who underwent surgery and adjuvant treatment at 108 Military Central Hospital from January 2021 to December 2023. A cross-sectional descriptive study was conducted to assess clinical and paraclinical characteristics, and to evaluate the outcomes of surgical treatment and postoperative adjuvant therapy. Results: The male/female ratio was 1.4:1, and the average age was 62±11.1...

Laparoscopic liver resection is a challenging procedure, yet it is increasingly applied in the treatment of hepatocellular carcinoma (HCC), including our center. Our aim is to evaluate the impact of laparoscopic hepatectomy for hepatocellular carcinoma regarding the long-term outcomes. Patients and Methods: A combined retrospective-prospective cohort study of 41 HCC patients who underwent laparoscopic hepatectomy at the Organ Transplantation Center, Viet Duc University Hospital from January 2019 to December 2023. Results: Liver resection for tumors >5 cm accounted for 24.4%, with 63.4% of cases classified as high difficulty (Ban Daisuke score). The mean operative time was 192 minutes, and the...

Percutaneous transhepatic gallbladder drainage (PTGBD) is a safe, effective initial treatment for acute cholecystitis in high-risk patients. Laparoscopic cholecystectomy (LC) is the definitive treatment. This study evaluates the feasibility and optimal timing of LC post-PTGBD at Le Van Thinh Hospital, as outcomes may be similar regardless of surgical timing. Patients and Methods: A prospective descriptive case series was conducted from January 2022 to June 2024 at the General Surgery Department of Le Van Thinh Hospital. Patients diagnosed with grade II, III acute calculous cholecystitis who underwent PTGBD followed by LC were included. Patients were categorized into two groups based on...

Kidney transplantation (KT) provided the best outcomes for patients with end-stage renal disease. Inverted kidney transplantation in which the renal pelvis orientation is reversed upward, is a technique initially used for right kidney transplants with short renal veins placed into the right iliac fossa. Consequently, the use of inverted KT was limited to cases of severe iliac atherosclerosis. This study evaluates the outcomes of inverted KT in patients with iliac atherosclerosis. We retrospectively analyzed three patients who underwent inverted KT from living donors at Viet Duc University Hospital due to iliac atherosclerosis. We performed the vessel anastomoses at the non-atherosclerotic...

Gallbladder carcinoma (GBC) is a rare but aggressive tumor. Operability is crucial for survival, yet late-stage diagnosis is common due to its asymptomatic nature. This study evaluates the clinical features and surgical outcomes of GBC treatment. Patients and Methods: A retrospective study was conducted on GBC patients who underwent surgery at Viet Duc University Hospital (2015–2022). Inoperable cases and those with incomplete records were excluded. Clinical characteristics, surgical details, and outcomes were analyzed. Results: Among 41 patients, most were diagnosed at advanced stages, with T3 being the most common stage (51.2%). Open surgery (51.2%) was slightly more frequent than laparoscopic...