Ho Chi Minh City Doctors from Tam Anh Hospital and colleagues from Thailand demonstrate endoscopic tumor resection through tunnel and endoscopic lower esophageal sphincter resection using flexible tubes for two patients.
On November 4, two surgeries to treat gastrointestinal subepithelial tumors and achalasia were performed at a conference on digestive diseases organized by Tam Anh General Hospital, held at Tam Anh Research Institute (TAMRI) in Ho Chi Minh City.
Two doctors, Dr. Pham Huu Tung and Pham Cong Khanh from Tam Anh Hospital and a doctor from Thailand demonstrated new endoscopic techniques to treat patients.
Patient Khanh, 51 years old, living in Ho Chi Minh City, had a submucosal tumor in the esophagus more than 5 years ago, now has difficulty swallowing, has signs of severe reflux, and came to Tam Anh hospital for examination.
The patient's test results showed a subepithelial tumor in the upper esophagus measuring 0.8 cm, and two adjacent subepithelial tumors in the middle esophagus measuring 15 mm and 22 mm.
Dr. Tung, Deputy Director of the Center for Endoscopy and Gastrointestinal Endoscopic Surgery, said that gastrointestinal subepithelial tumors are tumors originating from the muscular mucosa, submucosa or muscular layer of the digestive tract wall, and can occur anywhere in the digestive tract from the esophagus to the rectum. There are many types of the disease, benign or malignant. Depending on the nature and size of the tumor, the doctor will choose the appropriate treatment method.
Dr. Tung (middle) and the surgical team for patient Khanh. Photo: Provided by the hospital
The second patient is Mr. Hoc, 37 years old, living in Vinh Long, has difficulty swallowing both solids and liquids, reflux when sleeping; occasional chest pain, weight loss. Test results showed that he had esophageal dilation, increased spasm of the lower esophageal sphincter, concluding type 2 achalasia.
Achalasia is a functional disorder that prevents the esophagus from pushing food down into the stomach, and the esophageal sphincter cannot open completely, causing food to stagnate in the esophagus. If not treated early, the disease can easily lead to complications such as malnutrition, esophageal ulcers due to long-term food stagnation, aspiration pneumonia due to vomiting, and cancer in the chronically inflamed area.
The doctor indicated surgery for two patients using the submucosal tunnel technique to remove the esophageal subepithelial tumor and cut the lower esophageal sphincter using a flexible endoscope through the mouth.
Unlike the old methods of open surgery and endoscopic surgery, the technique of creating a submucosal tunnel through endoscopy to treat gastrointestinal subepithelial tumors is highly effective. "This method is quite safe, minimally invasive and avoids perforating the mucosa during surgery," said Dr. Tung.
In the demonstration treatment for patient Khanh, the doctor made a mucosal incision away from the lesion, then inserted an endoscope to dissect the subepithelial layer to create a tunnel, gradually approaching the tumor and removing it, and finally closing the incision with clips or sutures.
For patient Hoc, doctors cut the lower esophageal sphincter through a flexible endoscope. The endoscopy team performed through the natural route (oral route) without leaving scars and without damaging the 10th cranial nerve.
Achalasia can be treated medically or surgically, depending on the condition. Some previously applied treatment methods such as balloon dilation of the achalasia or laparoscopic surgery to cut the lower esophageal sphincter through the abdomen all have certain limitations. Currently, the technique of cutting the lower esophageal sphincter through flexible endoscopy has a high success rate, helping the patient recover quickly.
Associate Professor, Dr. Pham Hung Cuong (left cover) and Dr. Do Minh Hung (right cover) presented certificates of attendance to two Thai experts. Photo: Tam Anh General Hospital
To prevent these diseases, Dr. Tung advises everyone to develop and maintain reasonable, healthy and nutritious eating habits. The diet should increase liquid, warm, calorie-rich foods, divided into many small meals during the day. Limit sleeping or lying down immediately after eating to avoid reflux. Do not drink water that is too cold or too hot, do not drink alcohol or use stimulants when having symptoms of the disease.
Regular health check-ups or when symptoms appear for timely detection and treatment.
Thu Page
* Patient name has been changed
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