Background: Little is known about video-assisted thoracoscopic surgery in the Nuss procedure (VATS-NUSS) and its postoperative outcomes in the resource-scarce conditions in clinical practice such as Vietnam. Available evidence in the literature was mostly reported from large institutions in developed countries. Hence, this study was conducted to review our initial large single-center experience in the use of the VATS-NUSS for patients with pectus excavatum (PE) within 5 years.Methods: Data from 365 consecutive PE patients between January 2015 and December 2019 who were surgically treated with VATS-NUSS were retrospectively analyzed.Results: Of 365 patients, median age at operation was 15.61 ± 3.73 years (range = 5–27 years), most being child and adolescent. Three hundred nine patients (84.65%) were male. PE was commonly detected at puberty (n = 328, 89.9%). Postoperatively, early complications consisted of pneumothorax (n = 5, 1.37%), pleural bleeding/pleural fluid (n = 2, 0.55%), pleural hematoma (n = 1, 0.27%), pneumonia (n = 1, 0.27%), surgical wound infection (n = 1, 0.27%), incision fluid accumulation (n = 3, 0.82%), metal bar infection (n = 1, 0.27%), atelectasis (n = 3, 0.82%), and fever (n = 8, 2.19%). Late complications included surgical wound infection (n = 2, 0.55%), metal bar deviation (n = 5, 1.37%), metal bar allergy (n = 10, 2.74%), recurrent PE (n = 2, 0.55%), and persistent PE (n = 5, 1.37%). No deaths occurred. In 175 patients (47.95%) experiencing bar removal, mean operative time for bar removal was 34.09 ± 10.61 min, and the length of hospitalization following bar removal was 2.4 ± 1.34 days; the most frequent complication was pneumothorax (n = 19, 10.85%). One wound infection and one incision fluid accumulation happened following bar removal. Favorable midterm to long-term postoperative outcomes were achieved.Conclusions: From the beginning of the Vietnamese surgeons' experience, VATS-NUSS application obtained favorable outcomes with minimizing the occurrence of serious intraoperative and postoperative complications. Current rare evidence enables to give a real picture in the application, modification, and development of VATS-NUSS in the countries having similar resource-scarce conditions.

Objective: To assess mid-term outcomes of rib fixation surgery using screws in patients with thoracic trauma. Subjects: This study included 164 patients with thoracic trauma across three hospitals: Viet Duc Friendship Hospital, Viet Tiep Friendship Hospital, and Cho Ray Hospital. Methods: A non-randomized multicenter clinical trial was conducted. Results: The majority of the patients (75.6%) were male. Traffic accidents were the primary cause of injury, accounting for 65.9% of cases. One-month post-surgery, the intervention group's average VAS score was 0.83, compared to 1.47 in the control group (P < 0.05). At three months, hemothorax complications were observed in 3.1% of the control group, while only one patient (1.6%) in the intervention group experienced pulmonary embolism, although this difference was not statistically significant. The intervention group's average quality of life score increased from 0.7 points after one month to 0.95 points after three months. In contrast, the scores of the control group's scores were 0.62 points after one month and 0.77 points after three months (p < 0.01). Conclusion: Rib fixation with screws is effective in mid-term outcomes by reducing complications, enhancing quality of life, and providing effective pain relief in patients with thoracic trauma.

Đặt vấn đề: Loét dạ dày - tá tràng tác động đến 4 triệu người mỗi năm và có tỉ lệ ước tính khoảng 5-10% dân số trên thế giới [2]. Mặc dù tỉ lệ bệnh đã giảm xuống rất nhiều trong một thập kỷ vừa qua. Tuy nhiên, các biến chứng của bệnh vẫn không thay đổi [2]. Biến chứng thủng xảy ra với tỉ lệ 2-10% trong các bệnh nhân loét dạ dày - tá tràng, với nguy cơ tử vong cao, đặc biệt ở người lớn tuổi, với tỉ lệ là 10-40%[4]. Theo khuyến cáo hội phẫu thuật nội soi thế giới, chỉ định mổ cấp cứu sớm nhất có thể đối với phần lớn trường hợp bệnh nhân thủng ổ loét hành tá tràng, trong đó phẫu thuật nội soi mang lại nhiều lợi ích. Nghiên cứu nhằm đánh giá kết quả phẫu thuật nội soi điều trị thủng ổ loét hành tá tràng tại Bệnh viện Hữu Nghị Việt Tiệp ở nhóm người bệnh trên. Đối tượng và phương pháp nghiên cứu: Gồm tất cả bệnh nhân được phẫu thuật nội soi khâu lỗ thủng ổ loét hành tá tràng tại Bệnh viện Hữu Nghị Việt Tiệp từ tháng 01/2020 đến tháng 06/2025. Các dữ liệu nghiên cứu bao gồm các đặc điểm lâm sàng, cận lâm sàng, đặc điểm phẫu thuật, tai biến, biến chứng sau phẫu thuật và theo dõi sau phẫu thuật. Kết quả: Có 180 người bệnh đã được phẫu thuật nội soi khâu lõ thủng ổ loét hành tá tràng tại Bệnh viện Hữu Nghị Việt tiệp từ tháng 1/2020 đến tháng 06/2025, trong đó nam gấp 4 lần nữ, độ tuổi trung bình là 48,3±19,6. Mùa khởi phát bệnh chủ yếu là đông xuân chiếm: 64,5%. Yếu tổ nguy cơ phổ biến nhất là sử dụng rượu, chiếm 57,2%. Có 11 bệnh nhân (6,1%) có chỉ số Boey là 1 điểm, còn lại đều là 0 điểm. Tỉ lệ biến chứng sau mổ là 3,4%. Kết luận: Phẫu thuật nội soi điều trị thủng ổ loét hành tá tràng là một phương pháp điều trị hiệu quả và có nhiều ưu điểm bao gồm giảm đau sau mổ, rút ngắn thời gian điều trị, tỉ lệ biến chứng và tỉ lệ tử vong thấp.

Objective: To evaluate the outcomes of thoracoscopic surgery for mediastinal tumors at Viet Tiep Friendship Hospital from 2020 to 2025. Patients and Methods: This was a retrospective descriptive study of patients with mediastinal tumors who underwent thoracoscopic surgery at the Cardiothoracic and General Surgery Departments of Viet Tiep Friendship Hospital, from January 2020 to December 2025. Results: There were 42 patients included in the study. Chest pain was the most common presenting complaint, reported in 16 cases (38.1%). Abnormal findings on chest radiography were observed in 33 patients (78.6%). Computed tomography most frequently demonstrated anterior mediastinal lesions and solid masses, accounting for 66.7% and 47.6%, respectively. Thymoma was the most prevalent histopathological type, identified in 16 patients (38.1%).. There were no deaths recorded during the follow-up period. Overally, postoperative outcomes were favorable in the majority of cases Conclusion: Thoracoscopic surgery is applicable to most locations and types of mediastinal tumors, with early postoperative results demonstrating a low rate of intraoperative events and postoperative complications.

Objective: To evaluate the surgical outcomes of treating severe and very severe carpal tunnel syndrome (CTS) in patients with gout. Methods: This retrospective study involved the surgical release of the carpal tunnel and decompression of the median nerve in 40 patients (45 hands) diagnosed with severe and very severe CTS in the context of gout at the Huu Nghi Viet Tiep Hospital from January 2020 to June 2022. Symptom severity and hand function were assessed in all patients by using the Boston scoring system and clinical tests. Results: After 24 months post-surgery, the Boston score decreased significantly from 4.63 points to 3.2 points, with a noticeable reduction in numbness symptoms. However, recovery from muscle atrophy was slow. Conclusion: Surgical treatment of severe and very severe CTS in patients with gout contributed to symptom improvement and enhanced hand function, thereby enhancing the overall quality of life and daily activities.

Objective: We conducted this study to review our large single-center experience in Vietnam in the use of the VATS-NUSS for 365 consecutive patients with PE within the five years and to evaluate mid-term to long-term outcome in these patients. Methods: In this retrospective study, we consecutively selected the patients with the diagnosis of PE who underwent VATS-NUSS from January 2015 to September 2019. A total of 365 patients who were surgically treated for PE at the Department of Cardiovascular and Thoracic Surgery, Viet Duc University Hospital (Hanoi, Vietnam) was included in final analysis. Results: The length of postoperative hospitalization ranged from 1 to 13 days (Mean: 5.1). Early postoperative complications were recorded up to 30 days during hospital stay, consisting of pneumothorax (n = 5, 1.37%), pleural bleeding / pleural fluid (n = 2, 0.55%), pleural hematoma (n = 1, 0.27%), pneumonia (n = 1, 0.27%), surgical wound infection (n = 1, 0.27%), incision fluid accumulation (n = 3, 0.82%), metal bar infection (n = 1, 0.27%), atelectasis (n = 3, 0.82%), and fever (n = 8, 2.19%). In the late postoperative complications, surgical wound infection (n = 2, 0.55%), metal bar deviation (n = 5, 1.37%), metal bar allergy (n = 10, 2.74%), recurrent PE (n = 2, 0.55%), and persistent PE (n = 5, 1.37%) were observed. No deaths occurred. The outcomes related to the bar removal that was carried out in 175 patients (47.95%). The time the bar was in situ ranged from 2 to 49 months (mean: 28.89±7.48 years). The mean operative time at bar removal was 34.09 ± 10.61 minutes, and the length of hospitalization following bar removal was 2.4 ± 1.34 days. Of 175 patients performed bar removal, the most frequent complication was pneumothorax, which was diagnosed in 19 (10.85%) patients; surgical wound infection in 1 patient and incision fluid accumulation in 1 patient were observed following bar removal. Towards mid-term results at 6 – 30 months postoperatively, there were 124 out of 365 patients (33.97%). Of 124 patients, most patients were unremoved the bar (n = 121, 97.58%), and only 3 patients were removed the bar (2.42%). Most patients had body weight gain (n = 97, 78.23%), and increased physical activity and improved health (n = 115, 92.74%). The Haller index on chest X-ray was 2.44 ± 0.15. 220 out of 365 patients (60.27%) were postoperatively evaluated long-term results at over 30 months. Of those, 172 received bar removal (78.18%) and 48 have not yet received bar removal (21.82%). 217 patients (98.64%) had both body weight gain, and increased physical activity and improved health. The Haller index on chest X-ray was 2.45±0.21. Conclusions: The VATS-NUSS for PE was safe and effective approach with minimizing the occurrence of serious intra- and postoperative complications. From our initial one-institution experience in a resource-scare country, good mid-term to long-term postoperative outcomes in PE patients were obtained with VATS-NUSS. Current rare evidence drawn from this cohort enables to give a real picture in the application, modification and development of VATS-NUSS not only for Vietnam but also the countries having similar resource-scare conditions.