Colorectal Arteriovenous Malformations causing Prolonged Bleeding were Managed Successfully by Laparoscopic Low Anterior Resection with Sphincter Preservation: A Case Report / 대한소화기학회지

Gastrointestinal arteriovenous malformations (AVMs) are a rare disease. Sigmoid-anorectal AVM has only been reported in a few cases. The condition is usually detected when patients have gastrointestinal bleeding complications. The diagnosis and treatment of colorectal AVMs are still challenging. This paper presents a case of an Asian 32-year-old female patient admitted to hospital because of lower gastrointestinal bleeding lasting 17 years. The patient was diagnosed with sigmoid-rectal arteriovenous malformation and failed with other medical treatments. The damaged gastrointestinal tract was removed by a laparoscopic low anterior resection. The results were positive after a three-month follow-up; the bleeding was resolved, and the anal sphincter function was intact. Laparoscopic low anterior resection is a safe, less invasive, and effective approach for managing patients with digestive tract bleeding due to extensive colorectal AVM and preservation of the anal sphincter.

Laparoscopic Lateral Pelvic Lymph Node Dissection for Advanced Lower Rectal Cancer: a Preliminary Vietnamese Study.

BACKGROUND: Lateral pelvic lymph node dissection (LPLD) in rectal cancer has been carried out in several major centers. However, there are still many controversial issues regarding this method such as feasibility, safety, and oncological outcome. OBJECTIVE: The aim of this study was to evaluate the short-term outcomes, safety, and feasibility of LPLD. METHODS: This was a retrospective study. A total of 117 patients with lower rectal cancer (clinical stage II/III) below the peritoneal reflection underwent surgery between January 2019 and November 2020 at 108 Military Central Hospital, Hanoi, Vietnam. RESULTS: Total amount of 25 patients underwent laparoscopic total mesorectal excision (TME) plus LPLD and 92 patients underwent laparoscopic TME without LPLD. The rate of lateral pelvic lymph node metastasis in the LPLD group was 16% (4/25), of which 12% (3/25) were on the left side and 4% (1/25) were on the right side. The rate of intraoperative complications in the LPLD group was significantly higher at 16.0% (4/25) compared with 3.3% (3/92) in the TME only group (p = 0.037). There were no statistically significant differences in the rate of postoperative complications between the two groups (24.0% of patients in the LPLD group compared with 26.1% patients in the no LPLD group, p = 0.832). CONCLUSION: Pelvic lymphadenectomy has an important role in the treatment of advanced lower rectal cancer. LPLD is a safe and feasible procedure. However, it is necessary to study a larger number of patients with a longer follow-up period to fully evaluate oncological outcomes.

A large lipoma of the descending colon: A rare case report.

Colon lipoma is a rare benign disease in the gastrointestinal tract with an incidence rate of approximately 0.035%-4.4%. The disease is often asymptomatic, so it is frequently discovered incidentally through endoscopy, computed tomography , or autopsy. When the tumor is over 2 cm in size, symptoms such as abdominal pain, bowel disorders, and bowel obstruction are common. Surgery is considered the mainstay of treatment for colonic lipomas. Furthermore, surgical (rather than endoscopic) resection is preferred for lipomas >2 cm to avoid complications such as bleeding and perforation. We report on a 61-year-old female patient who was diagnosed with a 4-cm descending colonic fat tumor detected by endoscopy and computed tomography and confirmed by pathology.

Outcomes of Right Thoracoscopic Esophagectomy Combined with Laparotomy: a Preliminary Vietnamese Study.

BACKGROUND: Esophageal cancer is the fourth-most-common cancerous disease of the gastrointestinal tract, with increasing incidence rates. AIM: The present study aimed to assess the outcomes of right thoracoscopic esophagectomy combined with laparotomy for esophageal cancer treatment in Vietnamese patients. METHODS: A cross-sectional study of 71 patients was conducted at 108 Military Central Hospital, Hanoi, Vietnam, from January 2010 to December 2017. RESULTS: Right thoracoscopic esophagectomy combined with laparotomy was performed in 71 patients with esophageal cancer. The mean patient age was 55.8 years, and 100% were male. Patients were diagnosed with the following cancer stages: Stage 0: 4.2%; Stage I: 14.1%; Stage II: 59.2%; and Stage III: 22.5%. The lymph node metastasis rate was 33.8%. The overall complication rate was 42.3%, which included a pneumonia rate of 12.3%, a respiratory failure rate of 7.0%, an anastomotic leak rate of 11.3%, and a chylothorax rate of 4.2%. The mean postoperative time was 16.4 days. The mean follow-up time was 21.7 months. The median overall survival was 45.7 months. The 1-year, 2-year, 3-year, and 4-year survival rates were 79.7%, 62.3%, 52.3%, and 43.6%, respectively. CONCLUSIONS: Thoracoscopic esophagectomy combined with laparotomy for esophageal cancer was a safe, effective, and minimally invasive procedure that should play a continued role in cancer treatment.

Some remarks on lymph node dissection and recovering of gastrointestinal circulation after gastrectomy caused by cancer at B15 department of Military Central Hospital N.108

Background: Gastric cancer is a common disease in the world. For treatment, gastrectomy is still considered as the first choice. However, recovering of postoperative gastrointestinal circulation remains a controversial issue. Objectives: To assess the early results of 2 methods as gastroduodenostomy (Billroth I type) and gastrojejunostomy (Billroth type II) in recovering of gastrointestinal circulation. Subjects and method: A descriptive, retrospective study was conducted on 98 patients (61 males, 37 females, mean aged 48.1\xb112.7), were confirmed diagnosed with gastric cancer, treated in Military Central Hospital N.108 from May, 2001 to December, 2005. Results: Tumor positions were seen in 1/3 lower and 1/3 middle of gastric organ (59.2% and 40.8%, respective). There was no significant difference for invasive level of tumor between 2 groups (P>0.05). 62.2% patients with invasive level of tumor in stage of T4 in both 2 groups. Generally, the lesion between 2 forms of ulcer and rough differed significantly. The patients with and without metastatic lymph nodes were 57 and 41 patients, respective. All of patients were conducted with lymph node dissection at the stage of DIII-DIV. The difference between 2 groups for surgical time was no statistic significant. Conclusion: Billroth type I method combined with lymph nodes dissection was a safe and feasible technique in treatment of gastric cancer.

Using Alvarado practical score and rate of neutrophil to lymphocyte in diagnosis of acute appendicitis

The study was conducted on 150 patients (82 males, 68 females) with acute appendicitis these were undergone appendectomy at the Military Central Hospital 108 between January 1998 and December 1999. These patients were examined retrospectively using Alvarado Practical Score combined with rate of neutrophil to lymphocyte more than 3.5. Mean age of patients was 3719.86 years (ranged from 92 to 2 years). Time from disease onset to operation is 20.8814.54 hours. The Alvarado practical score was applied easily, simple and appropriate for health clinics without modern equipment. For patient group in this study, the Alvarado practical score provided the sensitivity of 96.2% and specificity of 57.1% in diagnosis of acute appendicitis. Rate of neutrophil to lymphocyte produced the sensitivity of 73.6% and specificity of 85.7%. There was significant gender difference in diagnosis of acute appendicitis. Male is sevenfold more likely to be diagnosed accurately than female.

Value of the abdominal endoscopy in the diagnosis of the acute appendicitis

Advance study on 50 patients (male:22; female: 28) with appendicitis in the army central hospital 108 during 8/1999-8/2000. The patients received the abdominal endoscopy before operation, ages of 36,42+/- 18,62 oldest: 74, youngest:9. 46/50(92%) patients with the positive cytopathological diagnosis and 4/50 (8%) with the negative cytopathological diagnosis. These 4 patients were women. 3/4 patients diagnosed as cystic rupture of digraph, 1/4 received negative appendectomy. The correct clinical rate of diagnosis was 92%. The correct rate of laparoscopic diagnosis was 49/50= 98%, the sensitivity: 100%, the specificity: 75%. That reported that the laparoscopy(endoscopy) is very important method of diagnosis that reduces significantly the rate of the negative appendectomy.