ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ SỚM UNG THƯ TRỰC TRÀNG BẰNG PHẪU THUẬT NỘI SOI VÀ CÁC YẾU TỐ LIÊN QUAN TẠI BỆNH VIỆN ĐA KHOA TRUNG ƯƠNG CẦN THƠ

Abstract

Background: Surgical treatment remains the primary curative method for rectal cancer due to its favorable prognosis when diagnosed and treated at an early stage. Objectives: (1) Survey on clinical and paraclinical characteristics of rectal cancer at Can Tho Central General Hospital. (2) Evaluating the results of early treatment of rectal cancer with laparoscopic surgery. Subjects and methods: A cross-sectional descriptive retrospective study was conducted on 34 patients diagnosed with rectal cancer and treated with endoscopic surgery at Can Tho Central General Hospital from April 2020 to April 2022. Results: Main reason for hospital admission was rectal bleeding, accounting for 51.4% of cases. The most common presenting symptom was rectal bleeding, accounting for 82.9% of cases. Preoperative anemia was present in 48.6% of cases. Elevated CEA levels were found in 60% of cases before surgery. Ultrasound detected a tumor mass in 37.1% of cases. The rate of tumor detection on computed tomography (CT) scans was 97.1%, while lymph node involvement was detected in 20% of cases. Endoscopy findings showed polypoid lesions in 91.4% of cases, and tumors occupying more than 3/4 of the circumference of the rectal lumen accounted for 42.9% of cases. The most common anatomical location of the tumor within the rectum was the middle third, accounting for 48.6% of cases. The average duration of surgery was 210.06 ± 35 minutes. Adenocarcinoma was the predominant histological type, accounting for 82.8% of cases. According to TNM staging, stage IIIB was the most common, accounting for 45.7% of cases. According to Dukes staging, stage C accounted for 65.7% of cases. All resected margins were clear of cancer cells, and no intraoperative complications occurred. The postoperative complication rate was 11.4%, with postoperative bleeding 5.7% of case and anastomotic leakage accounting for 5.7% of cases. The majority of patients (85.7%) achieved good surgical outcomes. There was a correlation between tumor location, lymph node metastasis, postoperative bowel movements, and treatment outcomes (p<0.05). Conclusion: The middle third of the rectum was the most common anatomical location for rectal tumors, and laparoscopic surgery demonstrated a high success rate of 85.7%.