Vietnam - A doctor for goiter patients

On the occasion of Vietnam’s Doctor’s Day, February 27th, the Ministry of Health honors 15 outstanding achievements in health care in the past 10 years. Amongst them is the technique of endoscopic thyroid surgery, introduced by Dr. Tran Ngoc Luong, Vice-director of National Hospital of Endocrinology. This technique has been exported to many other countries in Asia.

Before the endoscopic thyroid surgery was applied, a scar at the lower part of the neck had been an indicator of women who have gone through goiter surgery. These women struggle very hard to hide the scar. They even have to wear high collared blouses all year round. Late in 2001, Doctor Luong was transferred from Bach Mai Hospital to National Hospital of Endocrinology to establish the surgery department. He started with the methods for goiter surgery he learned in France in 1996-1997.

Doctor Luong openly informed us about his acquisition of the new technique.

“I was trained to be an abdominal surgeon. In France, I learned abdominal endoscopy with Professor Michel Vankemei. Next door to Professor Michel’s operating room was Professor Charles Proye, who was an outstanding expert in thyroid surgery. I often spent my time in Professor Proye’s room and he was kind enough to teach me many advanced techniques in goiter surgery, different from ours in Vietnam. Returning to Vietnam to work at Bach Mai Hospital, I applied the new goiter removal techniques in my work, and reduced the duration of goiter surgeries.”

Dr. Luong continued to cherish a plan of doing endoscopic thyroid surgery including goiter surgery, to avoid scars on patients’ necks. In the early 2000s, endoscopic thyroid surgery was not performed anywhere else in the world. Having the initial idea in mind, Dr. Luong kept meditating on endoscopic surgery whenever he did an open surgery. However, he was hesitant to apply the new method.

In 2003, he read on the internet that in Italy and some other countries, doctors were beginning to implement endoscopic thyroid surgery. Then he began to choose the first patients for endoscopic surgery. He carried out the first surgery on a patient with a goiter that was only 2-3 centimeters in diameter. The result was excellent: instead of bearing an 8 to 12 centimeter long scar, now the patient only had two 1-centimeter scars at the armpit and chest. Meanwhile, the boarding time was reduced from 7 days to 2 or 3 days. By now, 20,000 patients have been treated with endoscopic thyroid surgery in the National Endocrine Hospital, many of whom had goiters that were 8-9 centimeters in diameter and 120 cube millimeters in Basedow volume. The rate of operation accident is lower than 0.5%.

Besides goiters, all kinds of thyroid diseases, including thyroid cancer with ganglion metastasis, are presently treated with endoscopic surgery. More thorough elimination of metastasis ganglions can be done thanks to magnifying lenses. On March 26, Dr. Luong is going to make a presentation at the Asian Endocrine Surgeons Congress in Singapore.

“Exporting” endoscopic thyroid surgery

By January 2012, the schedule of courses for foreign doctors to learn endoscopic thyroid surgery with Dr. Luong had been filled until July 2013. This year, he is going to train doctors from the Philippines, Malaysia, Singapore, India, and Saudi Arabia. Courses in 2013 are for Indian and Pakistani doctors.

In the poorly-furnished operating rooms of National Hospital of Endocrinology, Dr. Luong has amazed learners and observers with his expertise and speed in the 20-to-30 minute operation, bringing happiness to the patient after the effective surgery.

The US$500 training fee seems high to Vietnamese doctors. But it is cheap for foreign surgeons. Since 2009, six professors and tens of doctors from Singapore, Malaysia, Indonesia, India, and the Philippines came to Vietnam to learn with Dr. Luong. He has also trained endoscopic thyroid surgeons for Vietnam’s hospitals such as Cho Ray Hospital, Hoan My Cuu Long Hospital in Can Tho, Can Tho General Hospital, Viet Tiep Hospital in Hai Phong, and Nghe An General Hospital.

Vietnam has a population of nearly 90 million, 5 to 7 percent of which suffer from goiters. Every day in the summer, there are 20 thyroid surgeries at the National Hospital of Endocrinology. All year round, his time is mainly spent in operating rooms, and people always recall him having a friendly smiling face.

Only by his age, says Dr.Luong, he has started to feel the harsh pressure of his medical career. Nevertheless, in operating rooms, alone with the patient, he only feels the passion and not any pressure. He is a doctor for goiter patients, with unfaltering passion even after decades.

Vietnam’s 15 most outstanding medical achievements in the last decade:

1.     Multi-organ transplant from brain-dead donors in Viet-Duc Hospital

2.     Heart transplants from brain-dead donors in Hue General Hospital

3.     Outstanding achievements in organ transplants in Institute 103 of Military Medical Academy.

4.     Cardiovascular intervention in National Heart Institute

5.     Intra-vessel treatment for cerebrovascular diseases in Ho Chi Minh University Medical Center.

6.     International standard pediatric endoscopic surgery in National Hospital of Pediatrics

7.     Endoscopic thyroid surgery in National Hospital of Endocrinology

8.     Micro-surgery implementation for treatment of deep burns and burn scars in Le Huu Trac National Institute for Burns

9.     Karyoblast transplant for treatment of blood diseases in National Institute of Hematology and Blood Transfusion

10.  In vitro fertilization (IVF)

11.  Research for production of A/H5N1 and A/H1N1 influenza vaccines in Vaccine and Bioproducts Company No.1

12.  WHO-GMP standard H1N1 vaccine production in Nation Institute of Vaccines and Medical Biologicals

13.  Research on Crinum latifolium in Thien Duoc Limited Company

14.  Research on phytopharmaceuticals in National Phytopharma Joint - Stock Company No 1

15.  Cho Ray Hospital’s technology transference to local hospitals

TUOI TRE

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