Results of operative treatment in patients with hepatic injury surgery transferred to Viet Duc Hospital from other hopitals from 1/1/2004 to 30/06/2006

Background: The liver is the largest organ in the abdomen, which is very vulnerable in closed abdominal injury. Clinical features of the mild injuries (grade I, II) are unclear, so they should be closely monitored for treating timely. The severe injuries (level IV, V) are often accompanied by other injuries such as rupture of the kidney, pancreas injury,.... required timely surgical treatment with intensive care. Objectives: to evaluate results of operative treatment in patients with hepatic injury surgery transferred to Viet Duc Hospital from other hopitals. Subjectives and Method: a retrospective descriptive study, the all of medical records of patients with liver trauma who have postoperative complications transferred to Viet Duc Hospital from January 1 2004 to June 30, 2006. Results: 16 patients, 12 men (75%), 3 women (25%), 15 patients had complete data, including 13 patients (87.75%) with symptoms of shock. 2 patients with mild pain (12.50%) who have liver rupture with grade I, II on CT, after operated to show: only whipping with catgut and lin. 2 patients with diaphragm rupture, a large bulge-diaphragm rupture, in which a patient was operated 2 times because incision was too small to exploring the injuries. 2 patients were pressed gauze because complex liver rupture, accompanied with pancreas rupture and kidney rupture, so the transfer of these patients was true. Conclusions: among the patients, most patients had no summary of medical record. Besides timely treatment, correctly and appropriately treatment plays an important role.

Hepatic trauma \ufffd?determinants to treatment attitude in Viet Duc hospital

Background: Hepatic trauma is the second injury of closed abdominal injury, but it is the leading cause of death. The most of hepatic trauma due to closed abdominal injury caused by traffic accident. Objectives: To assess determinants to treatment attitude of hepatic trauma patients treated in Viet Duc hospital. Subjects and method: A cross-section descriptive study was conducted on 157 patients with closed abdominal injury (118 male, 39 female), was diagnosed with hepatic trauma, treated in Viet Duc hospital from January, 2004 to April, 2006. Results: The average age of patients were 28.9\xb113 for male, 28.8\xb112 for female. The common occupations were farmers (35.7%), workers (14.6%), no professional 14.6% and other jobs (35.1%). Combined injuries included: cranial trauma (9.6%), facial trauma (10.2%), chest trauma (17.2%), major bone trauma (7.6%). 19.7% patients with combined injuries were operated. 130 patients with hepatic trauma (82.2%) was detected by ultrasound, 1 patient with splenic trauma combined hepatic repture. The differences between shock of admission, level of hepatic trauma and the amount of blood in abdominal CT scans to treatment attitude were having a statistically significant with p<0.001, p<0.001 and p=0.005, respective. Conclusion: Recently, the treatment attitudes with hepatic trauma patients have more changed. Hemodynamic stability, clinical close monitoring, excluding combined injuries required surgery and assessing injuries by CT scans are important factors to indicate conservation therapy for hepatic trauma. Conservation therapy is safe and effective in the treatment of hepatic trauma in Viet Duc hospital.

The result of the esophageal plastic surgery with stomach tube

Background: In surgery for treating esophageal cancer, the esophageal plastic surgery with stomach tube is the operation of choice. However, there was high rate of anastomotic leakage in the esophageal plastic surgery with stomach tube with neck anastomosis. Objectives: to evaluate the result of the esophageal plastic surgery with isoperistaltic stomach tube. Subjectives and Method: a retrospective descriptive study was carried out on 94 patients with esophageal plastic surgery with isoperistaltic gastric tube at Department of Digestive Surgery, Viet Duc Hospital from January 1994 to June 2006. Results: among 94 patients of the study: 95 males (96.0%) and 4 women (4.0%). Mean age was 54.2 \ufffd?9.0. 98 cases was esophageal cancer (99%), 1 case of benign esophageal narrow due to scarring burns (1%). 31 cases of esophageal plasties with small stomach tube (31.3%), 68 cases of esophageal plasties with a large stomach tube (68.7%). The end-to-side anastomosis was done 95 times (96%), end-to-end anastomosis was done 4 times (4%). There were four deaths. 7 anastomotic leakage (7.1%), but not fatal. The postoperative complications included: 9 cases of respiratory complications (9.1%), 1 case of hypo-diaphragm abces (1%), 7 cases of incision infection (7%). 8 cases of anastomotic narrow (8.4%). 94 patients with normal stomach circulation (98.9%). 88 patients with normal eating (92.6%). Conlussions: the esophageal plastic surgery with isoperistaltic gastric tube was a safe method, with low rates of mortality, anastomotic leakage. Most patients with eating backed to normal.

Assessing quality of life of patients after esophageal cancer surgery

Background: Esophageal cancer is a disease with poor prognosis and the treatment is very difficult, requiring a combination of methods (surgery, radiotherapy and chemotherapy), in which surgery remains the most important method. However, quality of life of patients was still less interested in the studies. Objectives: to evaluate the quality of life of patients after esophageal cancer surgery in the Department of Digestive Surgery \ufffd?Viet Duc Hospital from 1994 to 2004. Subjectives and Method: a prospective study was conducted on 164 patients with esophageal cancer surgery at Viet Duc Hospital from January 1994 to June 2004. Results: mortality of the surgery was 5%, and rate of complications was 32.9%. 146 patients were closely followed up the quality of life after the surgery, showed: postoperative quality of life was good and moderate (80.1%). Quality of life of patients with radical surgery were better than that in patients without radical surgery, there was statistically significant with p <0.05. Mean postoperative survival time was 24.2 \xb1 2.3 months. Conclussions: surgery of esophageal cancer improved quality of life of patients. Radical features of surgery significantly influenced the quality of life of patients after surgery.

The situation of child injury by injury supervision at Viet Duc hospital in 2006

Background: According to WHO, there are 5 million deaths from kinds of injury a year in the world, of which 875000 deaths occur in children under 18 years old. Injury leads to 40000 deaths which account for 10.7% deaths due to all other causes a year in VietNam. Objective: To show conclusions of the situation of child injury, recommendations for prevention of child injury and methods in order to enhance emergency activity in Vietnam. Subjects and method: The authors collected information about all patients who had emergencies due to injury at Viet Duc hospital, from March 26th 2006 to Octorber 26th 2006. However, supervised cases were the patients under 18 years old who were examined and treated at the Department of Emergency. Results: During the period of study, 2536 patients under 18 years old were examined for injury, of which death and coming back home for death were 83 cases (3.27%). 974 children had emergency resulted from injury: male was more than female: 697 verus 227. The leading causes of child injury were fall and traffic accident, respetively 34% and 60%. The most common traumas were traumatic brain injury (45%), limbs injury (41%). Although most of cases had first aid at the hospitals in district or province level, the rate of non-first aid cases was high (34%). Conclusion: Child injury is a leading cause of child death in hospitals. Methods for prevention of child injury should focus on educating and propagandizing to minimize injuries caused by traffic accident and fall.