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Henry Chor Lip Tan,Jih Huei Tan,Nur Akmalrudin Nur Dzainuddin,Koon Khee Chan 대한대장항문학회 2020 Annals of Coloproctolgy Vol.36 No.2
Purpose: The purpose of this study was to demonstrate the feasibility and safety of laparoscopic-assisted anterior resection (LAAR) for colorectal cancer in a local Asian population. Methods: This is a retrospective review of all patients with colorectal cancer operated from November 2017 to October 2018. Main variables of interest were demography, type and surgery, length of stay (LOS), and the involvement of proximal and distal doughnut. Postoperative complications were analysed using chi-square or Fisher exact and Mann-Whitney tests. Results: There were 23 patients with a mean age of 62.5 ± 12.2 years. The mean time from diagnosis to surgery was 97.1 ± 154.84 days. There were 12 patients in the LAAR group and 11 in the open anterior resection (OAR) group. Duration of surgery was shorter in OAR (129.58 ± 51.38 minutes) compared to LAAR (147.91 ± 39.37 minutes). Mean LOS was shorter in the LAAR group with 5±1.5 days compared to the OAR group of 7.42 ± 4.25 days. However, there was no significant P-value for both duration of surgery (P = 0.322) or LOS (P = 0.87). A total of 3 complications were recorded after OAR and 2 after LAAR. Both groups had clear proximal and distal margins with 16 (12–18.5) harvested lymph nodes in LAAR and 18 (16–22) in OAR, which were equal (P = 0.155). Conclusion: This study reports a shorter LOS in the minimally invasive group of 2 days with similar oncologic resection outcomes. This shows that LAAR is feasible in Malaysia and has potential outcome benefits.
( Tan Jih Huei ),( Henry Tan Chor Lip ),( Chow Sing Thou ),( Yuzaidi Mohamad ),( Rizal Imran Alwi ) 대한외상학회 2020 大韓外傷學會誌 Vol.33 No.1
Pancreatic and gastric fistulas are rare complications of emergency splenectomy, and it is extremely rare for a pancreatic fistula to be further complicated by a fistulation into the stomach. Here, we present a case of pancreatogastric fistula in a 60-year-old man who experienced polytrauma due to a blunt mechanism. He underwent emergency splenectomy for splenic injury and developed a pancreatic fistula as a complication. A percutaneous endoscopic procedure was performed to drain the fistula, after which he developed a pancreatogastric fistula as a further complication. A double-pigtail stent was inserted via gastroscopy into the fistula tract to allow internal drainage of the pancreatic collection into the stomach cavity. When a pancreatic fistula is complicated by gastric fistulation, endoscopic stenting of the pancreatogastric fistula tract for internal drainage is an effective treatment option.
( Joan Gan Cheau Yan ),( Tan Jih Huei ),( Henry Tan Chor Lip ),( Yuzaidi Mohamad ),( Rizal Imran Alwi ) 대한외상학회 2019 大韓外傷學會誌 Vol.32 No.2
Percutaneous nephrostomy is relatively safe for temporary urinary diversion. However, colonic perforation due to percutaneous nephrostomy can happen with an incidence of 0.2% as reported in the English literatures. To our knowledge, this is the first case being reported as a complication following treatment for traumatic renal injury. This paper is to share our treatment approach which differs from the usual approach according to existing literatures. We report on a young man who sustained grade IV renal injury due to blunt trauma and was managed conservatively. The treatment of traumatic renal injury via urinary diversion was complicated with an iatrogenic colonic perforation. The management and subsequent treatment of this patient is discussed in this case report.