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Purpose: the treatment of concomitant gallstones and common bile duct (CBD) stones by endoscopic retrograde cholangiopancreatography (ERCP) following laparoscopic cholecystectomy (LC). The analysis of single-step or separated-step characteristics. Object: during the three years (2015-2017), 68 patients having CBD stones concomitant gallstones suitable criteria for inclusion at Hue Central Hospital. Retrospective clinical description study. Results: the average age is 52.2±12.5 years (24-90) and the male/ female ratio is 0.7/1 (27/41). Abdominal pain was the most common symptom 91.2%, which was followed by jaundice 51.5%; direct bilirubin increased by 27.3±15.6 μmol/l (2.2-165). The size of CBD stones is 12.4±3.2 mm (6-20), the size of gallstones is 11.3±6.2 mm (5-36). The first time CBD stones 95.6%, recurrent CBD stones 4.4%. Single-step ERCP and LC 34 patients, separated-step group: ERCP 1.4±2.5 times and secondary LC. Single-step ductal clearance 76.5%, separated-step ductal clearance 94.1% (p=0.041). Length of hospital stay 6.5±4.3 days and 13.6±2.2 days (p

Objectives: The evaluation of feasibility, safety, and outcomes of single port laparoscopic colectomy (SPLC) for colonic cancer. Prospective study of 114 patients with colonic cancer (84 right side, 17 left side, and 13 sigmoid colon) who underwent SPLC between October 2010 and October 2016 in Hue Central Hospital. Results: Mean age of patients was 56.1±15.2 (25-87 years), male/female ratio was 70/44. Mean BMI was 23.5±2.2 kg/m2. Procedures included 84 right hemi-colectomies (73.7%), 17 left hemi-colectomies (14.9%), and 13 sigmoidectomies (11.4%). Six cases required additional ports, and 19 were converted to open surgery. Mean tumor size was 3.7±2.7 cm. Stage I: 6.1%; stage IIa: 43.9%; stage IIIa: 36.8%; and stage IIIc: 13.2%. Mean operation time was 160.5±75.5 min. There had been no deaths/intraoperative complications. Mean incisional length (including extraction) was 5.5±2.2 cm. Mean lymph nodes was 16.2±4.5. Mean hospital stay was 7.5±6.1 days. The surgical site infection rate was 3.5%, and 1 patient required reoperation (anastomotic leakage: 0.9%). After 32.2±7.5 (3-65 months) follow-up, there were no late surgical complication, incisional hernia, or incision metastasis. There were five local recurrences, and three patients developed liver metastasis in the open conversion group. The overall survival time after 2 years was 87.5%, and after 5 years, it was 59.4% (Kaplan-Meier). Conclusion: SPLC is feasible and safe procedure for the treatment of colon cancer. The cosmetic value is better (short incision confounded by umbilicus). Other outcomes were equivalent to conventional laparoscopy.

Objective: Natural Orifice Transluminal Endoscopic Surgery (NOTES) is an important evolution in minimally invasive surgery (MIS) nowaday. This paper presents the techniques and early results of the pure transanal and transvaginal laparoscopies (NOTES) used for the treatment of colorectal cancer. Material and method: Prospective studies were conducted at Hue Central Hospital, Vietnam. Patients: From December 2013 to September 2015, 22 cololorectal cancer patients (18 rectum, 3 sigmoid tumors and 1 descending colon), adenocarcinoma, T≤ T3N1M0. Methods: The patients were placed in lithotomy and Trendelenburg positions, and the lone-star retractor was placed in the anus (rectum cancer) or vagina (sigmoid cancer). The surgical cavity was then inflated with CO 2 and set at 12 mm/Hg. Dissection was continued until inside of the abdominal cavity (transanal technique). After that, the rectum was pushed into the abdominal cavity. The IMA and IMV were divided (TME included) in both techniques. After finishing dissection, the specimens were pulled out through the anus or vagina to prepare anastomosis. Coloanal and colorectal anastomosis were either hand-sewn (6 cases) or sealed with EEA staplers (16 cases). Results: 2 patients needed one more 5 mm umbilical port in RLQ, 2 patients needed two 5 mm trocars (post radiation hemorrhage, and urethral perforation). One patient converted to open and 1 patient converted to the HYBRID-NOTES procedure. The operation time was 258±40 (190-300) minutes. All patients required minimal analgesia. Bowel movement returned on the first day to 16 patients (average: two days, maximum: three days). The hospital stay was 7±2.8 (4-14) days. Kirwan classification (sphincter function) was very good (stage I: 18). Conclusions: Pure transanal and transvaginal laparoscopies for the treatment of colorectal cancer are feasible and safe. We believe that this is the first pure transvaginal laparoscopy (NOTES) for human in the world. A multicentric study in a large numbers of patients and a long follow-up is necessary.