MyMedR

Fulltext Single-incision laparoscopic cholecystectomy: the first Malaysian experience

Siow SL, Khor TW, Chea CH, Nik Azim NA

Asian J Surg, 2012 Jan;35(1):23-8.

PMID: 22726560 DOI: 10.1016/j.asjsur.2012.04.004

Single-incision laparoscopic cholecystectomy (SILC) is an evolving concept in minimally invasive surgery. It utilizes the concept of inline viewing and a single incision that accommodates all of the working instruments. Here, we describe a single surgeon's initial experiences of using this technique in a tertiary hospital.

Fulltext Adult intussusception: 5-year experience in Sarawak

Siow SL, Chea CH, Hashimah AR, Ting SC

Med J Malaysia, 2011 Aug;66(3):199-201.

PMID: 22111440 MyJurnal

Adult intussusception is rare. It represents only 5% of all intussusceptions and 1% of bowel obstruction. Clinical presentations are usually variable with a variety of acute, intermittent and chronic symptoms. It is associated with an underlying pathologic process in 90% of cases. A lack of Malaysia data prompted review of the Sarawak experience with this uncommon entity, focusing on the clinical features, diagnostic procedure and treatment. During the last 5 years, there were 14 cases of surgically proven adult intussusception. Mean age was 45.9 years. There were 9 enteric and 5 colonic intussusceptions. Ninety-three percent of the intussusceptions were associated with a pathologic lesion. Thirty-three percent of the enteric lesions were malignant and 67% were benign. Eighty percent of the colonic lesions were malignant and 20% were benign. Computed tomography scan has a good diagnostic accuracy of 83% and should be considered for all patients with nonspecific abdominal symptoms or suspected bowel obstruction. Treatment of choice for colonic intussusception in adults is en bloc resection without reduction whenever possible, whereas a more selective approach for enteric lesions.

Fulltext Killian-jamieson diverticulum: the rarer cervical esophageal diverticulum

Chea CH, Siow SL, Khor TH, Nik Azim NA

Med J Malaysia, 2011 Mar;66(1):73-4.

PMID: 23765152 MyJurnal

Killian-Jamieson (K-J) diverticulum is a rare cervical oesophageal diverticulum, less commonly encountered compared with Zenker's diverticulum (ZD). We report a case of K-J diverticulum in a 52-year-old lady who presented with sensation of lump in the neck and food stuck in the throat of 5 years duration. Esophagogram showed a large rightsided pharyngoesophageal diverticulum which was confirmed on endoscopy. The patient underwent a diverticulopexy and recovered without complications. Her symptoms had improved. In this report, we review the literature and describe our surgical technique.

Fulltext Ankle pseudoaneurysm: distal posterior tibial artery pseudoaneurysm in a child following blunt trauma

Aimanan K, Chea CH, Lim KY, Damodaran A

BMJ Case Rep, 2019 May 24;12(5).

PMID: 31129637 DOI: 10.1136/bcr-2018-228255

Pseudoaneurysm of the ankle involving the posterior tibial artery is a rare presentation with only four paediatric cases previously reported in English literature. We report a new case following blunt trauma with the clinical presentation and management strategy. A 6-year-old boy presented with a pulsatile swelling at the medial aspect of ankle following a history of blunt trauma 3 weeks ago. Imaging confirmed pseudoaneurysm involving the distal posterior tibial artery. Excision of the pseudoaneurysm was performed without any complication.

Fulltext Laparoscopic transabdominal approach and its modified technique for incarcerated scrotal hernias

Siow SL, Mahendran HA, Hardin M, Chea CH, Nik Azim NA

Asian J Surg, 2013 Apr;36(2):64-8.

PMID: 23522757 DOI: 10.1016/j.asjsur.2012.11.004

Using laparoscopic methods for incarcerated scrotal hernias is controversial because of the perceived technical difficulties in treating such hernias. Herein, we present our experience with laparoscopic repair of such hernias.

Fulltext Breast Cancer Care Timeliness Framework: A Quality Framework for Cancer Control

Mohd Mujar NM, Dahlui M, Emran NA, Hadi IA, Yan YW, Arulanantham S, et al.

JCO Glob Oncol, 2022 Mar;8:e2100250.

PMID: 35286134 DOI: 10.1200/GO.21.00250

PURPOSE: The aim of this study is to determine the pathway that women follow for Breast Cancer Care (BCC) and the time intervals from symptom discovery to treatment initiation and to develop a quality matrix framework.

METHODS: A retrospective cohort study was conducted at six tertiary centers in Malaysia. All women with newly diagnosed breast cancer were interviewed, and a medical records review was conducted using a structured questionnaire. The BCC timeliness framework showed that the total time between a woman discovering their first breast changes and the date of initial treatment was divided into three distinct intervals: presentation interval, diagnostic interval, and treatment interval. Four diagnosis subintervals, referral, biopsy, report, and diagnosis resolution intervals, were also looked into.

RESULTS: The BCC timeliness framework was used to capture important time points. The median total time, presentation interval, diagnostic interval, and treatment interval were 4.9 months (range, 1 month to 10 years), 2.4 months (range, 7 days to 10 years), 26 days (range, 4 days to 9.3 months), and 21 days (range, 1 day to 7.2 months), respectively. Meanwhile, the median time for the diagnosis subinterval of referral, biopsy, report, and diagnosis resolution was 8 days (range, 0 day to 8 months), 0 day (range, 0 day to 20 days), 7 days (range, 3 days to 3.5 months), and 4 days (range, 1 day to 1.8 months), respectively.

CONCLUSION: The BCC timeliness framework is based on the current sequenced trajectory of the BCC journey. Clarity in the measurement of timeliness provides a standardized language for monitoring and outcome research. It can serve as a quality indicator for community and hospital-based breast cancer programs.

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