Kết quả phẫu thuật điều trị 296 trường hợp thoát vị cơ hoành bẩm sinh bằng phẫu thuật nội soi lồng ngực



 !"#$%&'()*+',-.
/01(2/3456748#$97/
:;<
G
)
=>?@ABCAB:DEF HIJABCABK

LMNOPQ
MNRSTOUSVQNWXYZ
LMNOPQMN5OQ3[\N]^_N]

5]OQ`NYa\NObW RcNO]QcTdef\gRQh\e[ieOUcePiY_OUjNOklW mQNOkbN]nOo\eO\peNqQmUQrsN]
N]tYu5]OQ`NYa\OsQYa\YcYkMNOcNYvSeweYgkMNONOxNRyR^zYW{eOUcePiY_OUjNOkbN]nOo\eO\pe
NqQmUQrsN]N]tYe|N}W
22
2
e~QkMNOPQMN5OQ3[\N]^_N]u3[UN]eOQ]QSNN]OQ`NYa\RyY
1
kMNONOQkieOUcePiY_OUjNOklWmQNOR^_YnOo\eO\pekbN]NqQmUQrsN]N]tYkSU]sW
1e[m_mQNOPj

e[N]UjQm_mQNOu292ZkMNONOxNnOgQYO\NmSN]W{Wu3OQ]QSNnOo\eO\pee[\N]kNOrj
2Z
ZnOeYOUNOWm_mQNOPjrjZ8
ZnOeYOUe[N]UjQm_mQNOuON]YePUN]e[UN]W{u

9
Z
kMNONOxNePUN]mS\W{u5]\`NNOxNYOvd\rjNOQW e[N]Pje}N]cnrtYRqN]W~YO

nO{Qu3OQ]QSNNbW PQMNe[\N]kNOYOUYcYkMNONOxNYNmN]m_mQNOrjZN]jPjrj
N]j
NOWN]UjQm_mQNOuOo\eO\peNqQmUQrsN]N]tYTOgeOQZSNeUjNPjOQM\f\gRRQh\e[ieOUcePiY_OUjNO
klWmQNOe[XWkSU]sWYge[m_mQNOu
BCB BABĂÂFÊDABHÔBƠ>B>ƯAĐDÊD

%1%&

ỏứẵẵấẻ ồỹẫ ảẫỵảậẳ ồịằẵé ồàồ
ểẫẻ ẵộảỏìỏỳẫảạảàảáạằẳẵóịủ
ếấồỹẫảẫỵảỏỳẫảạảàảáạằẳẵắ
ẵỏịựảệởẵắẵéồỹẫảẫỵảẩẫấử
ẵéệấẻửắíẵéóỹẫảẫỵảẵậõẵé
ẵéệửảẫĩáạảẳẵẵẵỏịự0ậễẵảệởẵ
ậ1ẵỏ1ẫảẵẵ2 3445áẳ6ẵéảừảệởẵ
ậ1ẵỏ1ẫảẵửằẵẵ27887ò93
7ó
ợú ểổ ỏ

ẵỳẫ ừẵé ảũẵ ẵéẵ
ùẫáỳồỹẫảẫỵảẵậõẵéẵéệỏỳẫảạ
ảàảáạằẳẵẵịẵéịấ
ảẵéẵ
ùẫẵẳ
ảốéấẵểẳáẳờậịựẵéắởẵ
ẵụẵậủẵỏỉỏì
àỏàẵéàáẳếứảậẫỵẵáỳ
ẵẵé ịẫ ỏì áẳ ẵ ứ ỉấ ồịằẵé
ồàồẵẳẻó
ợíỏỉấắààẵẳẻậẳẵ ỏàẵ

ăiSYOârQ`NOMê5]\N3OSNOôQ`WZLMNOPQMNRSTOUS éàếứảẩẫỗỏỳẫảạảàảáạằẳẵáủ74
VQNWXY
ảịốẵé ựồ ảắởẵ áởẵ ẫẵé ịằẵé
ơWSQrêrQXWNOnưOUeWSQruYUW
ảẵé ảốéấẵ 33 ẵ2òảọ ẵ2 7883 ỏứẵ
N]jNOpNê2đđ
2

5]jR^zYYOwneO\pNê
1đ8đ
2

ẵ27837ó
àảáạằẳẵắẵặầẩẫấậè
ấẫ ắẵ ấẻ ẽẵ éẹậẳ ảàảáạẩẫấ ậè
ềểấậễếậẳệểẫẻìẵỉấàảẵéẵ
ảẵéĩắíẵéẵịểểẳẻòẫảẵẵòỏảẳẵéò
éấẵòậàậẵảẵậõẵéẵéệóàảẵéảọĩ
ắíẵéẫậẵậõẵéẵéệậẳ ồĩổẵé
ắẵắạéỗẵỏõẵéảốỏẻảẫẵéảộảấẵé
ắẵỏờểởẵỡẵớồáẳồĩáẳậẳ éỗ
ẵồĩỏờểởẵóợùỏảĩẵảịằẵéồĩ
ồíảẫảốéấẵỗẻấảàảáạòàảẵé
ậẵ ĩ ắíẵé ẳẵé ủ ảũồĩắạéỗ ẵ
ẳẵéẵúẵéó
àảáạằẳẵéụẻẵẵảũẵảẵé ẫẻ
ừ ộồ ẵúẵé ửảữ ằ ẵòẵứẫếừẵé
ỏịựỏỳẫảạ ếạồảố ỷểỹẵỏứẵảýáẵéó

12

345467819

2



 !"#$!%&

'()*+,./0)1*./0234 56+,)178.94
.:.;<,),)*;=5)>:5?=.8)>@,)ABC.D)E0
5)0F5;G,(,H*7>*I1,(,(3.5J5):,(K,LM
NOOKAP,5):,(KN,LM NOKN5Q*;<,)?*<,
')*R60,(B8,(S
TUVWYZW[\]^_YZ`\aRb5.c;<,),)d,;=
5)>:5?=.8)>@,);eM 7*,)ABC.D)E05)0F5
;G,(,H*7>*I1,(,(3.If,Af0S
TUVWYZW[\]ghUijka5)>:5?=.8)>@,) 2>
.)b,5)B8,(l5)>:5?=.8)>@,)5:*D):5S
'()*+,./0ABC.5)m,(n04oH*A1,(AQ>
A/.;<,)?*<,')*R60,(B8,(,(@pqO5):,(
KN,LMNOKNS



rstu

R6>,( 5)v*(*4, ,()*+, ./0l5w,( 7x .y
Nz{ ;<,) ,)d, ;=5)>:5?=.8)>@,)ABC.
D)E05)0F5 ;G,(,H*7>*I1,(,(3.;4>(1M

K|}~{Nl},4MlKKK~ql},SyKz56
I@787*,)~}Olq?@K;<,),)d,,(>@*
50w*787*,)~zlS
R)@,)D)f,)x*5)>:5?=,)yM50w*78
7*,).)9 pP0 I@60H5,>,lAQ*56@,(lMQ.,x*
?@I:.)l5)@,)D)f,.)9pP0.945)>:5?=.8
)>@,),)yM50w*,(>@*787*,)I@2Q2@p?@
(4,~;*0A1KS


RI<5)>:5?=.8)>@,).yM@,(;.I@q}l| 50w*,(>@*787*,)5)bD)8,?*5)>:5?=.8
)>@,)50w*787*,)~{lNS3):.;*<5.y,()Ă45)x,(+~ÂÊÔOlNqlDƠOlO}S
Ư)B8,(D):DĐăIâIê5)>:5?=ABC.56ô,);@p56>,(;c,(KS
yqO56Bv,()CDAơD)c*.)0p,74,(MwM~KOlKSRưI<.)0p,MwM)m,():.
,)40,)yM50w*787*,)7>?*,)yM50w*,(>@*787*,)~;c,(KS

234356789




8



 !"#$%&'!"(%)(*+,-./0,%1),23
-86'64!% "1>46'64!%
AB
45!67
CDEFHIJ

9!#:#;<=
9!?:#;@=
KLMNOQRNSTNUVW
^^C__`aFJ
adCaeFJ
_`c
HX
aabCcc`DFJ
a^^CDeFJ
Ca`^fE`cJ
YZ[\]
hSijNOkSRklSTm
nZo\Z\]pq
DeCbe`dFJ
d_C^eFJ
^`w
nrpqstuv
EDC^D`bFJ
aeECceFJ
C_`^fb`^J

(
ge`eE
ge`eE

4xyz{?$|.}1~%yx!
nZt]t\sr\]\Z\ZXsrt\Zoce`a_c`ECvZsJ\ZXstt\ZocE`w
_E`bCvZsJ
Hqtu\qZ\]\Zs\]vpq\]qZ`sro\qZ`sro\Zsrt\Z
qZ\tsr\]otstt\ZZĂ\]pZqtÂs\oÊÔqXƠ\]ZƯsZĐ\]ăCvge`eEJ

Câ\]_J
 !"?$45!~%ê!"6ôy
45!67
NORk àảNOãVSkSáLạm
ãá
HX
YZ[\]
ẳẵNắSưlSãẵNOkSáL
HX
YZ[\]
12

-86'64!% "1>46'64!%
9!#:#;<=
9!?:#;ơ=

hư
AB9<đ=

^wCDc`dJ
aaaCd^`_J

aC_`bJ
adbCEb`wJ

ge`eea
EeCw`af_e^wJ

_dCww`DJ
a_ECdb`EJ

^Caa`aJ
addCE^`EJ

ge`eea
D`_C_`cfdw`bJ

345467819

2





 !"$%&'()*+!,!,-!./01!"23(4)564*71"89:;.<=$>$?!,0@(.<=!"1@?.A ?$>$?!,4
$BC,D&*?+.&'E!",F7.,%!"CG42HIJ4JJ36K
LD&!"AMG!!,-!./01!"NOP&.STUVWXVYZ[UU\]U^_`aUV
VYZ[UU\]U^_`aUV cdefU\ghij VakfedefU\ghij
lUV
m,?n9.:x2y)436
(23JJ4J6
:y
q!"DHrB&Ns!"9t&,H, ?
)32xx4:6
32)x4J6
))
u%?r1t!Nv!"9DA

z23x4;6
J
z
w,D&
x23:4:6
J
x
 !"&s!"
:;
(
()
,{?"?7!!|90?+!.3)!"@M!,'9!"1@?$>$?!,K

€XS‚ƒ

w„.…AR!",?G! &†A&‡!" &,1.,ˆMH,‰A
.,AŠ.!s?$1?r8!" !"B&7! .1@! N‹ N?ŒA .<}
.,1D.0}&>,1@!,Kw,v!"&'.&,†!"0@./01!"!@1RM<7.<1!"9 K
Ž,‰A.,AŠ.!s?$1?r8!"!"B&&'.,‹.?„!
,@!,N‹N?ŒA.<}.,1D.0}&>,1@!,&R.<=$>
$?!,0?.r+.,@!,&v!"&71Kr+&,AM‹!9
9.<1!"!",?G!&†A&~7 &,‘!".v?.,ˆH,>!
$1 0?&D&.D&"?R C,D&’:“y”KLD&!"AMG!
!,-!&,AM‹!9 9&,~M„Ar@C,'C,q!C,?
NO7.,@!,H,•!.,1D.0}.<rt? *–!"4r—.,1D.
0}!,-!KL,‘!".v?&,1<|!"N‹"?R9.r+&,AM‹!
9 9&•!&,‘EN„!9s.$%0ˆ!NŒ$7Aš

›œ}.<Nž..<1&7šŸž.&D&.<1&7<&@!"&71
&@!".%.Kœ?&D&,*%.<.<1&7<&71&,‘!".v?
rAv!&'9s.C,v!""?7!N~&D&.,71.D&H,‰A.,AŠ.KL'.,‹N-Mr@M„A.%
…A7! .< !" C,?„! .r+ &,AM‹! 9 9 &~7
&,‘!".v?.,ˆH,>!&D&.D&"?RC,D&<ˆ.!,?ŒA
’:“(“;”K
›w¡.,AŠ.N¢M&D&.t!".,1D.0}0Œ *–!"š
N¢M&D&.t!"0Œ *–!"r@.,QC,'C,q!!,ˆ.
.<1!"9 .,1D.0}&>,1@!,*|!"NO{!"!s?
234356789




$1?r8!"!"B&KL!D&N}!,NOP&r.,1D.0}
.*|!"NÂMrD&,KƠo!" ) H7!, CƯH !,@!"0@rA-!H,?G!!,7ANÂM0?r.,1D.0}KÂMrD&,&!,.$&.!,}0Q
ănr@90ârD&,KLH!,Ư0@19t&!%?0}.QNÂM
9t&!%?0}.QA%!" *!"N8!".,{?ăo!"3
H7!,C,D&,1&3Aê.q9Hv!"NÂM!,Ư0@1
*{rD&,Kw,?r.,1D.0}*ô&!H,R?9*|!" &Ô.9ôH &> ,1@!, ..t!"0 *!"K
wĂ .,A.C,-A r .,1D.0}N7 $% &D&
.*|!" C,-A .<B&.?H ,7?9ôH &>,1@!, 0?

!,7AKAM!,?G!.<1!"!,?A..t1.,@!,"?ơ7)9ôH&>,1@!,0@.,@!,!"B&
C,D&>,1@!,0?!,?9MA0@r@
0}.<ăn"-M.,1D.0}.D?H,D.K<1!"&D&.,PH!@M&,!".v?.,B&,?+!rHC!"'&"?ơ7)
*{&>,1@!,0@.,@!,!"B&*|!"C,-A)9ôH
&>,1@!,0?.,@!,!"B&Kut&,ă7.!"B&4AMG! C?9 .ư !"1@?.,@!, !"B& 0@1
8



!"#%&"#"#'()*+,-%./01234((5+!6"+
78-9:*+,-%./;<2=>(5+!6"+9?;@;A")
B-/C"*;0 D%E;+6"+"#'(F6%60 "?=-G(
D=C""#!6;+6"+"#'(HI+;%J+!KFLM-K
G"#N+3>"#C"O*+!P"#%;C"73>"Q*+R"#
"C"(?*+,-O012(5+!6"+F4;"+8-FS(5
+!6"+7T=LK(+@!K2%'(HU;P;2+K2?"+.
%6@V"#0;<"#FK"+,"E!HW;<"#FK2+P;%6
%!E;*+R"#+.0"34(9XK"+@L(+YZ=["#
=L+\%C"C""#'(@!K2%'(,0D%&"#"#'(H
]^%A_F!"#!"#"#+;C"(`-(a8(+\"#
R;%6bc)OdH]_F!"#BP/ 8(+a/<-D"+:0
-Z;757;"+He,/%60Gf%A*+K+.2!"#
9;g-L+!KFL(5+!6"+7!F4;"+h"#"i0
34( 9,/F6 (j"# 35"# 935"# F4;"+;g=K!(K!*+K(C"+<#;4;klmnoH
p#-/C""+,"_F!"#(+a/<-%6@!"+;q0
V"#+-/<(:%;C"M-8"9<"+D0K/F6i"#

K2%'(9G"#0E(+2+Z;H]+'(<"6/(+!+./
f%A_F!"#(:+X#;P0 +.2"<-(+\"#8
+'(+;A"(K(=;A"2+K2(+?"#"+;q0 *+-r"
F69;g-Li"#K2%'(9G"#0E(+2+Z;?+5"
s+t-+-u"G;7!;%&"#"#'(9;g-L+!K
FL(5+!6"+ (: "+;g- 3- 9;X0Hv! (K((5
+6"+=["#+!w(+6"+"#'(*+R"#=L(x9`
"C"(+`("i"#+R+.2y=LP"++3D"#+5"7!
F4;0D=["#+!w(0D"#'(Hv!?"#;C-+:8
y=L9["#(+E0!"#M-KS"+2+t-+-u"C"
%3-+R"# -G(j"#(+:"#D%E;+5"HI<M-P
Fg+r0 0z(j"#?+5"@!F<0Z=1+5"H
{-8""#E;%4""+.%6+>;#;8"0Z*1!@6;-/
"+;C"+>;#;8"0Z7T \"#x"@|"*+;*;"+
"#+;A0i"#%C"H]!"#"#+;C"(`-(a8(+\"#
R;+>;#;8" 0Z -"# =S"+ %6 }~)l  l~)l
N2+\QH
! F4;2+t- +-u"G;7!;Z =["#)2+t+-u"G;7!;%&"#"#'((+!2+12;<2(u"%J
+!KFL@q+5"@!*+R"#=L-G(P"DHWG
7?=K!(K!9(+!+./f%A(+-/X"0Z0D
!"#2+t-+-u"G;7!;Z=["#(8!+5"2+t+-u"G;7!;%&"#"#'(koH
12

Ww(@V2+t- +-u"G;7!;%&"# "#'((:
"+;g-3-9;X0 "+3"#(j"#(|"(,""+x((+!
 (: (," "w"# +.2 O #80 FS2+t3>"#*+K+2Hs+t-+-u"G;7!;%&"#"#'(
(j"#*+R"#"C"(+f9L"+(+!(K(3>"#+2
(:@Lu;0 2+`(E22+?;+2FS@q(:(K(
=;<"%!E"*+y0K-F6+-/<9G"#|0 "#
!"#0ZH



s+t-+-u"G;7!;%&"#"#'(*+P+;)8"
!6"F6+;A-M-P9X@;g-L+!KFL(5+!6"+
=r07;"+D0=8!#&0(P757;"+H



+\"#R;B;"(+,"+6"+(P0 5"u2+X
(K"=G*+!8"#!E;)*+!8+&;7`("#!E;)2+"#
0Z)2+"#@L(+qF;A""#+;C"(`-7`(*+
0)=A"+"+;F6#;89S"+"#3>;=A"+9
#;\2(+\"#R;+!6"+6"+"#+;C"(`-"6/H



ĂÂÊ Ô ƠƯƠĐĐÊă â Ô
êăôơêưƠĐơÊ  ÊđƠÂ;@!
877;7@+!8(;(7-#;(8%28;!à8à!80"
!àả!(+@8%* +";8Hãáá 3ạằẳẵ ắằ)Ô
cccH
êặÊ ơƠơ ÊÔÊ â H
]+!8(!7(!2;( 28; à! (!"#";8%@;82+8#
08;(+";8ầ%77!"7à!0c(877Hẩẫấậèẳằ
ắằ)ẻ)b~blb~bH
ẽHăƠéÔẹƠăơƠăđâÔÊÂÂéÊđ
ƠÂẽề8%/ B2;"( ể;+ 0;";08%%/
;"F87;F 28; !à(!"#";8%@;82+8#08;(
+";87ầ7-%78"@%77!"7%8"@Hẩẫấậèẳằ

ắằl))b}lb}H
ẻƠễÔÂÂÊếÊăÔéệơĐệ
ĂÊđƠÂHp!"88%+!8(!7(!2;( 28;
!à(!"#";8%@;82+8#08;( +";8ầ7%(;!"
(;;8à! 7-((77à-%!-(!0Hẩẫấậèẳằắằ


×)ÎÂ)bl}n´bl~ÃH
3454678192

2


 !"#$%&'()*'+&,$-".-,#/-0
234456 789:;<9=<9>?<:@>;?: 9A B@9B;C;D
E?;>8:;FG;C?< 8@:B?;HI JKLKMNOPQNRS TQU
VWMX2OSYTZ[5Z\]^_\\`H
a %b'--$*b'c+./d&%/$-!**e&d(0f#$gh
%b'i#$./ ,& #/ -0 23446 j 789:;<9_
=<9>?<:@>;?:9A<9BF@B?C;DE?;>8:;FG;C?<8@:_
B?;kl?BAD;C?9B_;==?=C@Ek9m@D:@En:@=n=VWMXtPsZ3[Z\`u_\`\H
v '(%w&d$+*'"-*i-c+%&xb)##e&
#/ -0 2344y6 zB;Dl=?= 9A {| <9B=@C?}@C89:;<9=<9>?<:@>;?:= 9A<9BF@B?C;D E?;_


>8:;FG;C?< 8@:B?;?B B@9B;C@= <9G>;:@E C9
8?=C9:?<;D<9BC:9D=HIqOQrKsMVWMX~Z\`_\uH

5 (c#* €#$$#+$- & #+"f#$g ‚&
ƒ#bc#!$€#/-02344y6H„@9B;C;DG?B?G;DDl
?B};=?}@=n:F@:lA9:<9BF@B?C;DE?;>8:;FG;C?<
8@:B?;=o; GnDC?<@BC@:=CnEl n=?BF C89:;<9_
=<9>l9:D;>;:9=<9>lHVWMX…PQNRSZ3†Z‡u^`
_‡u^|H
y d+c ,&ƒ$ˆ"#$ƒ%&,)-ˆ ƒ #/-0
2344y6H 789:;<9=<9>?<:@>;?: 9A<9BF@B?C;D
E?;>8:;FG;C?< 8@:B?;?B B@9B;C@=o D@==9B=
D@;:B@EHIJKLKMNOPQNRSTQUVWMX2OSYTZ[y
26Z^]^_^\`H

‚‚x‰%‚€‚,‚%‚‰,€‚3ya,%‰%‚€‚h
‰,Šw,,x,‰,

78@=CnElm;=C9@};Dn;C@@;:Dl9nC<9G@=9AC89:;<9=<9>?<:@>;?:9A<9BF@B?C;DE?;>8:;FG;C?<
8@:B?;‹ŒŽHz:@C:9=>@m?C8ŒŽm89nBE@:m@BCC89:;<9=<9>?<:@>;?:A9:ŒŽA:9G{``‡_{`‡{;CC8@„;C?9B;DŽ9=>?C;D
9A@E?;C:?<=9A‘?@CB;GHn:?BFC8@=CnEl>@:?9EZ{|u<8?DE:@BnBE@:m@BCC89:;<9=<9>?<:@>;?:A9:
ŒŽ ?B<DnE?BF‡’|B@mk9:B=;BE‡’]?BA;BC=;BEC9EED@:=HŒ9B}@:=?9BC99>@B=n:F@:lm;=
:@“n?:@E?B’]>;C?@BC=‹‡`H‡”H•@;B9>@:;C?}@C?G@m;=]`H‡G?BnC@=–{]H^A9:B@mk9:B=;BE
]^H\–{^HuG?BnC@=A9:?BA;BC=;BEC9EED@:=H78@:@m@:@B9?BC:;9>@:;C?}@E@;C8=9:<9G>D?<;_
C?9B=H’{>;C?@BC=E?@E>9=C9>@:;C?}@DlH78@G;?B<;n=@=9AE@;C8m@:@=@>=?=;BE>nDG9B;:l
;:C@:?;D8l>@:C@B=?9BH•@E?;B>9=C9>@:;C?}@89=>?C;D=C;lm;=‡—H—E;l=A9:B@mk9:BF:9n>;BE
‡{E;l=A9:?BA;BC=;BEC9EED@:=H˜B<9BA9:ŒŽH
d#ˆi($.*™("g#"+/-0.+-š'$-gc-/+b'#$"+-&/'($-b(*b(š+b

234356789





8