Research

Objective: To evaluate the result of arthroscopic anterior cruciate ligament reconstruction with all inside technique in Orthopaedic department - Thong Nhat hospital. Subjects and research Methods: 186 patients with ACL ruptured have arthroscopic surgery in Thong Nhat hospital from 02/2021 to 06/2024, the prospective study. Results: All patients were monitored 1 month, 3 months, 6 months after surgery, evaluated on a Lyshome score, good and very good, reaching 17.75% after 1 month, 87.64% after 3 months. Conclusion: Arthroscopic ACL reconstruction with all inside technique is a new promising method with the advantage of small skin incision, no cavity fracture into bone, large size graft, and tension force.

We conducted this study to investigate the etiology and histopathological characteristics of kidney diseases in elderly patients undergoing kidney biopsy at Thong Nhat Hospital. This cross-sectional, retrospective study included all patients who underwent kidney biopsy at Thong Nhat Hospital from the period between May 2012 and May 2022, excluding cases with (1) inadequate samples for pathological analysis, (2) repeated biopsies and (3) incomplete medical records. The results showed that steroid-resistant nephrotic syndrome was the leading indication for kidney biopsy in the elderly (64%). Primary glomerular diseases were the leading cause of kidney diseases, with focal segmental glomerulosclerosis and membranous nephropathy being the commonest types, accounting for 32,5% and 19,4%, respectively. In contrast, minimal change disease and IgA nephropathy were less common than in younger patients. Additionally, diabetic nephropathy and tubulointerstitial lesions appeared more frequently in the elderly group. Our study revealed that the histopathological features of kidney diseases in elderly patients differ significantly from those in younger patients, with a higher prevalence of focal segmental glomerulosclerosis and membranous nephropathy. Therefore, early and accurate recognition of these features is crucial for precise diagnosis, prognosis, and appropriate treatment of kidney diseases in the elderly.

Diabetes mellitus remains a major risk for lower extremity artery disease. The ankle-brachial index (ABI) is a noninvasive technique for assessing the lower extremity artery disease. To estimate the ABI in older patients with diabetes mellitus. This case series study was conducted on the older patients with diabetes mellitus from 01/12/2021 to 31/05/2022 at Department of Cardiology in Thong Nhat Hospital. This study included 100 patients aged ≥ 60 years (mean age 72.5 ± 8,1years; male 54.0%). 71.0% of patients had diabetes mellitus with duration of diagnosis more than 5 years and 21,0% of patients has been being treated with insulin. The rates of comorbidities: hypertension (94,0%), dyslipidemia (62,0%), coronary artery disease (21,0%), history of ischemic stroke (3,0%), and heart failure (18,0%). There was 22 patients having claudication. The rates of ABI: ≤ 0.9: 27.0% and 1-1.4: 73.0%. No patient in our study had ABI higher than 1.4. In our study, 27.0% of diabetic patients had ABI of  ≤ 0.9 and 22.0% of patients had claudication.

Bowel obstruction due to colorectal cancer is a common emergency complication, especially in elderly patients with multiple comorbidities, requiring optimal surgical treatment decisions to improve clinical outcomes.To evaluate the effectiveness of one-stage right hemicolectomy with primary anastomosis in the management of bowel obstruction due to colon cancer at Thong Nhat Hospital. A retrospective and prospective descriptive case series study was conducted on 48 patients with bowel obstruction due to right-sided colon cancer who underwent one-stage right hemicolectomy with primary anastomosis at Thong Nhat Hospital from January 2019 to December 2024. Evaluation parameters included clinical characteristics, surgical methods, complications, and early treatment outcomes. The mean age of patients was 62.3 ± 13.2 years, with males accounting for 58.7%. Laparoscopic surgery was performed in 17 cases (35.4%) and open surgery in 31 cases (64.6%). The overall early complication rate was 16.7%, with the laparoscopic group showing a lower rate than the open surgery group (5.9% vs 22.6%). Mean hospital stay in the laparoscopic group was significantly shorter than the open surgery group (7.8 ± 2.4 vs 10.2 ± 3.5 days). The anastomotic leak rate was 2.1% and mortality rate was 2.1%. One-stage right hemicolectomy with primary anastomosis is a safe and effective method for treating bowel obstruction due to colon cancer. Laparoscopic surgery showed better outcomes regarding recovery time and reduced complications compared to open surgery.

Evaluate the clinical efficacy of silver-containing antimicrobial dressings on superficial burn wounds. A prospective study involving 32 patients treated for thermal burns at the Trauma and Orthopedic Surgery Department of Thong Nhat Hospital. The patients were dressed with silver-containing antimicrobial bandages, and clinical efficacy was assessed based on the local wound progression. The dressing adhered well to the wound, was easy to change, and caused minimal pain and bleeding during dressing changes. The average treatment duration was 11.2 ± 5.8 days. Only 9.4% of patients experienced wound infection. Silver-containing antimicrobial dressings are effective in the clinical management of superficial thermal burn wounds.

Colorectal cancer is one of the most common malignancies with high incidence and mortality rates. KRAS and BRAF mutations play a crucial role in its pathogenesis and prognosis, but their association with clinical characteristics in Vietnam requires further investigation. To investigate the prevalence of KRAS and BRAF mutations in colorectal cancer patients and analyze their relationship with clinical, epidemiological, and disease-stage features. A retrospective descriptive study was conducted on 92 colorectal cancer patients diagnosed and treated at Thong Nhat Hospital from February 2020 to December 2024. Data included demographic characteristics, clinical symptoms, tumor location, disease stage, and genetic mutation test results. The median age of patients was 66, with a male/female ratio of 2.1. Common symptoms included abdominal pain (71.7%) and bloody stools (38%). The mutation rates were 35.9% for KRAS (predominantly G12D and G12V), 6.5% for BRAF, and no NRAS mutations were detected. KRAS and BRAF mutations showed no significant association with age, gender, clinical symptoms, or disease stage (p>0.05), but were linked to peripheral lymphadenopathy (p=0.035). KRAS and BRAF mutations are relatively common in colorectal cancer patients but are not strongly associated with clinical features or disease stage. Genetic testing remains essential for personalized diagnosis and treatment.

To evaluate arterial blood gas test results in patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD). Cross-sectional descriptive study, evaluating blood gas results on 150 patients diagnosed with AECOPD, inpatient treatment at the Respiratory Department in Thong Nhat Hospital from January 2023 - March 2024.  The majority of patients (80%) have decreased PaO2 and 60% of patients have increased PaCO2. The average value of some blood gas indicators: pH 7.37 ± 0.08, PaO2 61.2 ± 10.5, PaCO2 48.3 ± 8.2, HCO3- 27.1 ± 3.4. There were 126 patients with COPD exacerbated hospitalization (84%) with respiratory failure manifested in arterial blood gas Respiratory failure characteristics according to arterial blood test in the study were mainly increased PaCO2 accounting for 30%, in patients with mixed respiratory failure had 26% and reduced respiratory depression PaO2 had 32%.  Arterial blood gas is a significant test for diagnosis the respiratory failure and discovered acid- base disorders.

Abdominal wall aggressive fibromatosis (Desmoid tumor) is a rare, locally invasive tumor with a high recurrence rate. This study reports a case of surgical resection of a large tumor and multi-material abdominal wall reconstruction, evaluating functional and aesthetic outcomes. A 29-year-old male presented with a 10x15cm abdominal wall mass, diagnosed as Desmoid tumor via biopsy. The patient underwent complete tumor resection, resulting in a significant abdominal defect. Reconstruction was performed using a combination of intraperitoneal onlay mesh (IPOM), rectus abdominis muscle flap, and fascia flap. Pathology confirmed R0 resection. The patient was discharged on day 7 without major complications. At 1-year follow-up, results showed excellent aesthetic and functional recovery with no recurrence. Surgical resection of Desmoid tumors combined with multi-material abdominal wall reconstruction is a feasible approach, ensuring long-term functional and aesthetic success. This case highlights the importance of selecting appropriate reconstruction techniques for large post-resection defects.

Retroperitoneal liposarcoma is a rare condition, accounting for approximately 15% of adult soft tissue tumors and has a high recurrence rate. We report a case of recurrent retroperitoneal tumor to evaluate and review treatment approaches. We report a case of a 45-year-old female with a history of surgical resection of a large pelvic retroperitoneal liposarcoma (23x12cm) in 2020, which was well-differentiated (Grade I) but had tumor cells in an ovarian cyst (Stage IIIB). After 3 years of follow-up, the patient was found to have a tumor recurrence at the lower pole of the right kidney measuring 37x38mm on CT scan. The patient underwent complete surgical resection of the recurrent tumor with negative margins (R0), and pathology confirmed well-differentiated liposarcoma (Grade I). After 9 months of followup, no recurrence has been detected. This case emphasizes the importance of regular postoperative follow-up, which helps detect early recurrence when tumors are still small, increases the possibility of complete treatment, and improves patient prognosis.

The global population is aging rapidly, leading to an increase in the number of elderly individuals who are more vulnerable and require comprehensive healthcare services, including long-term care and skilled nursing facilities. In this context, aspiration pneumonia has become a significant concern due to its high incidence, mortality rate, and substantial financial burden, particularly among elderly patients requiring intensive care unit admission. Aspiration pneumonia is defined as a pulmonary infection resulting from the inhalation of food, liquid, saliva, or stomach contents into the lungs, often due to impaired swallowing or consciousness. Symptoms may include cough, fever, shortness of breath, chest pain, and fatigue . Risk factors include neurological disorders, impaired consciousness, advanced age, and conditions affecting swallowing. Diagnosis is based on clinical presentation, imaging studies such as chest X-rays or CT scans, and, if necessary, swallowing assessments. Treatment typically involves antibiotics, and in severe cases, may include oxygen therapy or mechanical ventilation . Preventive measures focus on managing risk factors, improving swallowing function, and maintaining oral hygiene. This article aims to provide information on aspiration pneumonia in the elderly, including its causes, symptoms, diagnosis, and treatment, to raise awareness and help reduce the incidence and mortality associated with this condition.

The survey aimed to evaluate and improve the performance of testing methods of 10 biochemistry assays on AU5800 (Beckman Coulter) and cobas c503 (Roche Diagnostics) by Sigma metrics. Cross-sectional study. Ten biochemistry assays: glucose, urea, creatinine (Jaffe), cholesterol, triglycerides, AST, GGT, uric acid, HDL-Cho, total bilirubin. Collect internal and external inspection data on 2 devices under the same laboratory conditions, same test materials, at the same time from January to March 2024, calculate Sigma value. Evaluate performance and take improvement action on low-performing tests. On the AU5800 analyzer, 5 out of 10 tests (urea, creatinine, cholesterol, HDL-cholesterol, and total bilirubin) had Sigma values less than 3; 2 out of 10 tests (glucose and AST) had Sigma values between 3 and 6; and 3 out of 10 tests (triglycerides, GGT, and uric acid) had Sigma values greater than 6. On the Cobas c503 analyzer, 1 out of 10 tests (creatinine) had a Sigma value less than 3; 4 out of 10 tests (urea, cholesterol, AST, and total bilirubin) had Sigma values between 3 and 6; and 5 out of 10 tests (glucose, triglycerides, GGT, uric acid, and HDL-cholesterol) had Sigma values greater than 6. The tests with “acceptable to excellent” performance accounted for 50% on the AU5800 analyzer and 90% on the Cobas c503. The creatinine test (Jaffe method) showed “not good” performance on both systems. After improvement by switching to the enzymatic method on the c503 system, its performance changed from “not good” to “excellent.” On the AU5800 system, the performance of the creatinine (Jaffe) test improved from “not good” to “good".

Appendiceal cancer is a rare condition, often diagnosed late due to nonspecific symptoms. We report a case of appendiceal cancer invading the abdominal wall to evaluate the effectiveness of laparoscopic surgery and a multimodal treatment strategy. A 60-year-old male patient was admitted with persistent right iliac fossa pain for 2 months and a 3kg weight loss. Imaging confirmed an 6x8cm appendiceal tumor invading the abdominal wall and cecum, causing partial bowel obstruction. The patient underwent laparoscopic right hemicolectomy with D2 lymphadenectomy. Pathology confirmed moderately differentiated adenocarcinoma with metastases to 12/17 lymph nodes and peritoneal fluid (stage IVB). Postoperative recovery was uneventful, and the patient was discharged on day 7 with adjuvant chemotherapy scheduled. After 3 weeks of follow-up, the patient remained stable. This case highlights the importance of early diagnosis and radical surgery, combined with adjuvant therapy, in improving outcomes for patients with advanced-stage appendiceal cancer.

This study was conducted to analyze drug expenditure in treatment at Thống Nhất Hospital in 2024. A retrospective cross-sectional descriptive study analyzing drug usage costs in treatment at Thống Nhất Hospital in 2024. In 2024, Thống Nhất Hospital provided medical examination and treatment services to 650,000 health insurance patients, with over 595,000 outpatient visits, accounting for 90.63%. The total drug expenditure was VND 490.89 billion, representing 36.98% of the total health insurance medical examination and treatment costs. Western medicines accounted for 97.32% of the drug costs, while herbal and traditional medicines made up 2.86%. Imported drugs constituted 76.2% of the total drug expenditure. Original brand-name drugs, Group 1, and Group 2 drugs were the highest-cost categories, accounting for 38.63%, 25.59%, and 13.11% respectively. Cardiovascular drugs and those affecting the endocrine system and hormones were the most utilized, comprising 35.61% and 22.0% respectively. According to the ABC/VEN analysis, essential drugs classified as ‘E’ were the most used in terms of both quantity and cost, accounting for 58.55% and 75.51% respectively. Drug groups such as AV, AE, AN, BV, and CV represented 84.72% of the total drug expenditure. The CN group accounted for only 0.87% of the total drug expenditure in 2024. The study results indicate that the drug formulary used at Thống Nhất Hospital in 2024 aligns with the hospital’s disease patterns. The diverse and comprehensive drug list meets the treatment needs of patients.

Non Small Cell Lung Cancer (NSCLC) is the second most common cancer in both sex but it is still the leading cause of cancer death. Most of NSCLN appear in the late stage so the prognosis is very poor. Although, the patient in early stage NSCLC who underwent standard lobectomy but the recurrent rate is still so high. Adjuvant therapy after standard surgical therapy gives the patient better overall survival (OS) and disease Free Survival (DFS). Recent advances in diagnosis and treatment for NSCLC show the benefit of adjuvant therapy with TKI or Immunotherapy for selected NSCLC patients.

Population aging is a global trend driven by rising life expectancy and declining birth rates, creating profound socio-economic impacts. Vietnam officially entered this stage in 2011 and is now facing one of the world’s fastest aging rates, projected to become an “aged society” by 2036. The country’s primary challenge is the risk of “getting old before getting rich,” as its demographic transition outpaces its national financial accumulation, placing immense pressure on multiple sectors. The healthcare system is unprepared for the surging demand from the elderly, who often suffer from multiple chronic diseases and have treatment costs 7-8 times higher than younger individuals. Vietnam currently lacks sufficient geriatric hospitals, nursing homes, and integrated healthcare models. In terms of social security, a staggering 73% of the elderly do not have a pension and must continue to work or rely on their children, while the pay-as-you-go (PAYG) social insurance system is threatened by demographic shifts. The labor market, despite being in its “golden population” period, is constrained by a low rate of trained labor and low productivity, which affects future financial accumulation capabilities. Simultaneously, traditional family support systems are weakening due to smaller family sizes and geographic dispersion. To adapt effectively, Vietnam needs a comprehensive reform strategy, including promoting sustainable economic growth , improving the labor market , and restructuring the healthcare system towards integrated care, geriatric network development, and long-term care models. Concurrently, developing a multi-pillar social security system is critical to expand coverage and ensure the well-being of the elderly.

To survey the characteristics of inguinal hernia and compare between the open and laparoscopic inguinal hernia surgery at Thong Nhat Hospital from April 2023 to April 2024. A restrospective study of 139 patients with laparoscopic and open inguinal hernia surgery in Thong Nhat hospital during the study period. Of 139 included patients, 97.8% were men, and the median (IQR) age was 60 (20-88) years. Compared between open and laparoscopic repair was associated with a nonsignificant duration of hospitalization. Most of patient lived in Ho Chi Minh City. We performed 72.66% open surgery. The majority of patients with unilateral inguinal hernias were treated with open surgery (80.34%) and bilateral inguinal hernias were treated with laparoscopic surgery (68.18%). The average duration of hospitalization for patients undergoing inguinal hernia surgery was 7.99±3.6 days. Most of patients has lived in Ho Chi Minh city. Duration of hospitalization was similar for the laparoscopic and open general anesthesia groups. Individualisation treatment with laparoscopic or open repair for patients and the decision should be made considering both patient and surgeon factors.

Femoral hernia is a rare type of hernia with a high risk of complications, commonly seen in elderly women and often mistaken for other groin pathologies. Imaging, particularly computed tomography (CT), plays a crucial role in detecting and differentiating femoral hernias from inguinal hernias and other groin conditions. Key CT imaging findings distinguishing femoral hernias from inguinal hernia are the location of the hernia sac lateral to the pubic tubercle and associated compression of the ipsilateral femoral vein. Additionally, CT can help detect complications of femoral hernias such as incarceration, bowel obstruction, or bowel ischemia, thereby guiding timely and effective management. The presented clinical case clearly illustrates the important role of CT in diagnosing this uncommon type of abdominal wall hernia.