Displaying publications 1 - 20 of 39 in total

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  1. SAMBHI JS
    Med J Malaysia, 1963 Sep;18:1-2.
    PMID: 14064292
    Matched MeSH terms: Thoracic Surgery*
  2. Dydykin S, Paulsen F, Khorobykh T, Mishchenko N, Kapitonova M, Gupalo S, et al.
    Surg Radiol Anat, 2022 Jan;44(1):117-127.
    PMID: 34426859 DOI: 10.1007/s00276-021-02820-8
    PURPOSE: There is no systematic description of primary anatomical landmarks that allow a surgeon to reliably and safely navigate the superior and posterior mediastinum's fat tissue spaces near large vessels and nerves during video-assisted endothoracoscopic interventions in the prone position of a patient. Our aim was to develop an algorithm of sequential visual navigation during thoracoscopic extirpation of the esophagus and determine the most permanent topographic and anatomical landmarks allowing safe thoracoscopic dissection of the esophagus in the prone position.

    METHODS: The anatomical study of the mediastinal structural features was carried out on 30 human cadavers before and after opening the right pleural cavity.

    RESULTS: For thoracoscopic extirpation of the esophagus in the prone position, anatomical landmarks are defined, their variants are assessed, and an algorithm for their selection is developed, allowing their direct visualization before and after opening the mediastinal pleura.

    CONCLUSION: The proposed algorithm for topographic and anatomical navigation based on the key anatomical landmarks in the posterior mediastinum provides safe performance of the video-assisted thoracoscopic extirpation of the esophagus in the prone position.

    Matched MeSH terms: Thoracic Surgery, Video-Assisted*
  3. Tchervenkov CI, Herbst C, Jacobs JP, Al-Halees Z, Edwin F, Dearani JA, et al.
    World J Pediatr Congenit Heart Surg, 2021 05;12(3):394-405.
    PMID: 33942697 DOI: 10.1177/21501351211003520
    The optimal training of the highly specialized congenital heart surgeon is a long and complex process, which is a significant challenge in most parts of the world. The World Society for Pediatric and Congenital Heart Surgery (WSPCHS) has established the Global Council on Education for Congenital Heart Surgery as a nonprofit organization with the goal of assessing current training and certification and ultimately establishing standardized criteria for the training, evaluation, and certification of congenital heart surgeons around the world. The Global Council and the WSPCHS have reviewed the present status of training and certification for congenital cardiac surgery around the world. There is currently lack of consensus and standardized criteria for training in congenital heart surgery, with significant disparity between continents and countries. This represents significant obstacles to international job mobility of competent congenital heart surgeons and to the efforts to improve the quality of care for patients with Congenital Heart Disease worldwide. The purpose of this article is to summarize and document the present state of training and certification in congenital heart surgery around the world.
    Matched MeSH terms: Thoracic Surgery*
  4. Gunasagaran J, Ab Wahab N, Khoo SS, Shamsul SA, Shivdas S, Hashim S, et al.
    J Orthop Surg (Hong Kong), 2023;31(2):10225536231180330.
    PMID: 37256763 DOI: 10.1177/10225536231180330
    BACKGROUND: In complete brachial plexus injury, phrenic nerve (PN) is frequently used in neurotization for elbow flexion restoration. The advancement in video-assisted thoracoscopic surgery (VATS) allows full-length PN dissection intrathoracically for direct coaptation to recipient without nerve graft.

    PURPOSE: We report our experience in improving the surgical technique and its outcome.

    METHODS: Seven patients underwent PN dissection via VATS and full-length transfer to musculocutaneous nerve (MCN) or motor branch of biceps (MBB) from June 2015 to June 2018. Comparisons were made with similar group of patients who underwent conventional PN transfer.

    RESULTS: Mean age of patients was 21.9 years. All were males involved in motorcycle accidents who sustained complete brachial plexus injury. We found the elbow flexion recovery were earlier in full-length PN transfer. However, there was no statistically significant difference in elbow flexion strength at 3 years post-surgery.

    CONCLUSION: We propose full-length PN transfer for restoration of elbow flexion in patients with delayed presentation.

    Matched MeSH terms: Thoracic Surgery, Video-Assisted*
  5. Eng JB
    Med J Malaysia, 2007 Jun;62(2):177-8.
    PMID: 18705461 MyJurnal
    A 58 year-old man presented with a large aneurysm of the aortic arch and severe coronary artery disease. He underwent combined repair of the aortic arch aneurysm and coronary artery bypass grafting via a modified clamshell incision using deep hypothermic circulatory arrest and retrograde cerebral perfusion. He made an uncomplicated postoperative recovery. The operative techniques are discussed with a review of the relevant literature.
    Matched MeSH terms: Aorta, Thoracic/surgery*; Aortic Aneurysm, Thoracic/surgery*
  6. Lee YM, Lim YC, Liam CK, Majid A
    Med J Malaysia, 1996 Mar;51(1):109-13.
    PMID: 10967989
    Consecutive 25 patients (M/F:18/7) underwent video-assisted thoracoscopic surgery (VATS) for various chest illnesses. These included nine cases of pneumothorax, three cases of pericardial effusion, three cases of pleural effusion, four cases of lung lesion requiring either incisional or excisional biopsy, two cases of empyema, one case of traumatic haemothorax, and three cases of mediastinal lesion. The mean age was 36.2 years (range 19-78 years). A total of forty-three procedures were performed. The mean durations of intrapleural chest-tube requirement and hospitalisation following VATS alone were 4.5 days (range: 0-13 days) and 8.3 days (range: 2-25 days) respectively. No intraoperative complication and VATS procedure-related mortality reported. Apart from simple analgesics such as paracetamol or tramadolol, no opiate analgesia was given to patients undergoing only VATS. The results support that VATS is a safe and effective procedure in the management of pulmonary, mediastinal, pericardial and pleural diseases and the treatment of persistent and recurrent spontaneous pneumothorax.
    Matched MeSH terms: Thoracic Surgery, Video-Assisted*
  7. Narayanan LT, Hamid SRGS
    Med J Malaysia, 2020 05;75(3):226-234.
    PMID: 32467537
    INTRODUCTION: Incentive spirometry (IS) is commonly used for increasing postoperative IS inspiratory capacity (ISIC) after open heart surgery (OHS). However, little is known about the serial changes in ISIC and their predictive factors.

    OBJECTIVE: The aim of this study is to identify the postoperative ISIC changes relative to preoperative ISIC after OHS, and determine their predictors, including patient characteristics factors and IS performance parameters such as inspiration volumes (ISv) and frequencies (ISf).

    METHODS: This is a prospective study with blinding procedures involving 95 OHS patients, aged 52.8±11.5 years, whose ISIC was measured preoperatively (PreopISIC) until fifth postoperative day (POD), while ISv and ISf monitored with an electronic device from POD1-POD4. Regression models were used to identify predictors of POD1 ISIC, POD2- POD5 ISIC increments, and the odds of attaining PreopISIC by POD5.

    RESULTS: The ISIC reduced to 41% on POD1, increasing thereafter to 57%, 75%, 91%, and 106% from POD2-POD5 respectively. Higher PreopISIC (B=-0.01) significantly predicted lower POD1 ISIC, and, together with hyperlipedemia (B=11.52), which significantly predicted higher POD1 ISIC, explained 13% of variance. ISv at relative percentages of PreopISIC from POD1-POD4 (BPOD1=0.60, BPOD2=0.56, BPOD3=0.49, BPOD4=0.50) significantly predicted ISIC of subsequent PODs with variances at 23%, 24%, 17% and 25% respectively, but no association was elicited for ISf. IS performance findings facilitated proposal of a postoperative IS therapy target guideline. Higher ISv (B=0.05) also increased odds of patients recovering to preoperative ISIC on POD5 while higher PreopISIC (B=- 0.002), pain (B=-0.72) and being of Indian race (B=-1.73) decreased its odds.

    CONCLUSION: ISv appears integral to IS therapy efficacy after OHS and the proposed therapy targets need further verification through randomized controlled trials.

    Matched MeSH terms: Thoracic Surgery*
  8. Monaco F, Di Prima AL, Kim JH, Plamondon MJ, Yavorovskiy A, Likhvantsev V, et al.
    J Cardiothorac Vasc Anesth, 2020 Jun;34(6):1622-1635.
    PMID: 32276758 DOI: 10.1053/j.jvca.2020.02.038
    SEPARATION from cardiopulmonary bypass (CPB) after cardiac surgery is a progressive transition from full mechanical circulatory and respiratory support to spontaneous mechanical activity of the lungs and heart. During the separation phase, measurements of cardiac performance with transesophageal echocardiography (TEE) provide the rationale behind the diagnostic and therapeutic decision-making process. In many cases, it is possible to predict a complex separation from CPB, such as when there is known preoperative left or right ventricular dysfunction, bleeding, hypovolemia, vasoplegia, pulmonary hypertension, or owing to technical complications related to the surgery. Prompt diagnosis and therapeutic decisions regarding mechanical or pharmacologic support have to be made within a few minutes. In fact, a complex separation from CPB if not adequately treated leads to a poor outcome in the vast majority of cases. Unfortunately, no specific criteria defining complex separation from CPB and no management guidelines for these patients currently exist. Taking into account the above considerations, the aim of the present review is to describe the most common scenarios associated with a complex CPB separation and to suggest strategies, pharmacologic agents, and para-corporeal mechanical devices that can be adopted to manage patients with complex separation from CPB. The routine management strategies of complex CPB separation of 17 large cardiac centers from 14 countries in 5 continents will also be described.
    Matched MeSH terms: Thoracic Surgery*
  9. Adli Azam MR, Shahril K, Aneez Ahmed DB
    Med J Malaysia, 2020 07;75(4):428-429.
    PMID: 32724008
    We report a 39-year-old male with accidental findings of posterior mediastinum mass at right superior aspects, located at T2 with close proximity to trachea, superior vena cava, azygus vein, right subclavian artery and oesophagus. Apart from intermittent right shoulder pain, there was no other significant symptom. He opted for conservative management initially, given the benign nature and proximity to important structures. We postulated that robotic approach will be of advantage for this particular case which was successfully performed with uneventful recovery. This case illustrated the advantages of robotic-assisted surgery, compared to conventional VATS in otherwise potentially difficult case to undertake.
    Matched MeSH terms: Thoracic Surgery*
  10. Diong NC, Dharmaraj B, Sathiamurthy N
    Med J Malaysia, 2020 07;75(4):445-446.
    PMID: 32724014
    Sleeve lobectomy is a lung sparing surgery and is the preferred alternative to pneumonectomy for centrally located tumours, which has less postoperative morbidity and mortality. Surgical approach for the technically demanding sleeve lobectomy evolved over the decades from conventional thoracotomy to video assisted thoracoscopic surgery (VATS) to uniportal VATS (uVATS) which allows for quicker recovery and less pain postoperatively. We report our very first successful uVATS sleeve right upper lobectomy performed in the Hospital Kuala Lumpur, Malaysia.
    Matched MeSH terms: Thoracic Surgery, Video-Assisted/methods*
  11. Conen D, Popova E, Wang MK, Chan MTV, Landoni G, Reimer C, et al.
    Am Heart J, 2023 May;259:87-96.
    PMID: 36754105 DOI: 10.1016/j.ahj.2023.01.018
    BACKGROUND: Perioperative atrial fibrillation (AF) and myocardial injury after noncardiac surgery (MINS) are common complications after noncardiac surgery. Inflammation has been implicated in the pathogenesis of both disorders. The COP-AF trial tests the hypothesis that colchicine reduces the incidence of perioperative AF and MINS in patients undergoing major noncardiac thoracic surgery.

    METHODS AND RESULTS: The 'COlchicine for the Prevention of Perioperative Atrial Fibrillation' (COP-AF) trial is an international, blinded, randomized trial that compares colchicine to placebo in patients aged at least 55 years and undergoing major noncardiac thoracic surgery with general anesthesia. Exclusion criteria include a history of AF and a contraindication to colchicine (eg, severe renal dysfunction). Oral colchicine at a dose of 0.5 mg or matching placebo is given within 4 hours before surgery. Thereafter, patients receive colchicine 0.5 mg or placebo twice daily for a total of 10 days. The 2 independent co-primary outcomes are clinically important perioperative AF (including atrial flutter) and MINS during 14 days of follow-up. The main safety outcomes are sepsis or infection and non-infectious diarrhea. We aim to enroll 3,200 patients from approximately 40 sites across 11 countries to have at least 80% power for the independent evaluation of the 2 co-primary outcomes. The COP-AF main results are expected in 2023.

    CONCLUSIONS: COP-AF is a large randomized and blinded trial designed to determine whether colchicine reduces the risk of perioperative AF or MINS in patients who have major noncardiac thoracic surgery.

    Matched MeSH terms: Thoracic Surgery*
  12. Abdul-Rahman T, Omran MO, Ekerin O, Ghosh S, Awuah WA
    Int J Surg, 2023 Aug 01;109(8):2542-2543.
    PMID: 37158146 DOI: 10.1097/JS9.0000000000000445
    Matched MeSH terms: Thoracic Surgery*
  13. Anas R, Rahman I, Jahizah H, Hassan A, Ezani T, Jong YH, et al.
    Med J Malaysia, 2008 Sep;63 Suppl C:78-80.
    PMID: 19227680
    The formulation of the Cardiothoracic Registry. Cardiothoracic surgery is the field of medicine involved in surgical treatment of diseases affecting organs inside the thorax (the chest). It is a general treatment of conditions of the heart (heart disease) and lungs (lung disease). In Malaysia, due to lack of data collection we do not have estimates of number and outcome of such procedure in the country. Western figures are often used as our reference values and this may not accurately reflect our Malaysian population. The Malaysian Cardiothoracic Surgery Registry (MyCARE) by the Ministry of Health will be a valuable tool to provide timely and robust data of cardiology practice, its safety and cost effectiveness and most importantly the outcome of these patients in the Malaysian setting.
    Matched MeSH terms: Thoracic Surgery/organization & administration*; Thoracic Surgery/statistics & numerical data
  14. Sachithanandan A, Nur Ezrin I, Badmanaban B
    Med J Malaysia, 2012 Apr;67(2):226-7.
    PMID: 22822653 MyJurnal
    Simultaneous bilateral spontaneous pneumothorax (SBSP) is a very rare life-threatening condition that requires rapid diagnosis and treatment. Most cases are secondary to various underlying lung pathology but a primary SBSP may occur due to rupture of subpleural blebs or bullae. Surgery via an open or minimally invasive approach provides definitive treatment and can be undertaken as a staged or simultaneous procedure. We report our experience with two such rare cases utilizing a single stage minimally invasive bilateral video assisted thoracoscopic (VATS) approach. The pathogenesis of this rare condition and intra-operative technical considerations for a successful outcome are discussed.
    Matched MeSH terms: Thoracic Surgery, Video-Assisted/methods*
  15. Ng GYH, Nah SA, Teoh OH, Ong LY
    Pediatr Surg Int, 2020 Mar;36(3):383-389.
    PMID: 31993738 DOI: 10.1007/s00383-020-04619-x
    BACKGROUND: The risk factors for recurrence in primary spontaneous pneumothorax (PSP) in children are not well known. We aimed to identify possible risk factors, and to evaluate the utility of computerised tomography (CT) scans in predicting future episodes.

    METHODS: We reviewed children aged 

    Matched MeSH terms: Thoracic Surgery, Video-Assisted/methods*
  16. Krishnasamy S, Krishna Nair A, Hashim SA, Raja Mokhtar RA
    Interact Cardiovasc Thorac Surg, 2019 12 01;29(6):976-977.
    PMID: 31363757 DOI: 10.1093/icvts/ivz191
    Liposarcoma is the second most common type of soft tissue malignancy in adults. They are malignant tumours with a mesenchymal origin. Mediastinal liposarcoma accounts for <1% of mediastinal tumours and 2% of liposarcoma. We report a patient with mediastinal liposarcoma who presented with cardiac tamponade, 25 years after the initial liposarcoma in the popliteal fossa.
    Matched MeSH terms: Thoracic Surgery, Video-Assisted/methods*
  17. Sachithanandan A, Badmanaban B
    Interact Cardiovasc Thorac Surg, 2011 Mar;12(3):434.
    PMID: 21345828 DOI: 10.1510/icvts.2010.241950A
    Matched MeSH terms: Thoracic Surgery, Video-Assisted/adverse effects; Thoracic Surgery, Video-Assisted/standards*
  18. Mohd Esa NY, Faisal M, Vengadesa Pilla S, Abdul Rahaman JA
    BMJ Case Rep, 2020 Dec 22;13(12).
    PMID: 33370965 DOI: 10.1136/bcr-2020-236414
    Tracheal tear after endotracheal intubation is extremely rare. The role of silicone Y-stent in the management of tracheal injury has been documented in the previous studies. However, none of the studies have mentioned the deployment of silicone Y-stent via rigid bronchoscope with the patient solely supported by extracorporeal membrane oxygenation (ECMO) without general anaesthesia delivered via the side port of the rigid bronchoscope. We report a patient who had a tracheal tear due to endotracheal tube migration following a routine video-assisted thoracoscopic surgery sympathectomy, which was successfully managed with silicone Y-stent insertion. Procedure was done while she was undergoing ECMO; hence, no ventilator connection to the side port of the rigid scope was required. This was our first experience in performing Y-stent insertion fully under ECMO, and the patient had a successful recovery.
    Matched MeSH terms: Thoracic Surgery, Video-Assisted/adverse effects; Thoracic Surgery, Video-Assisted/methods
  19. Kumaraguru P, Mazri YM, Yaacob AF, Hanif H, Zainal AA, Lau JH
    Med J Malaysia, 2011 Oct;66(4):381-2.
    PMID: 22299568 MyJurnal
    Conventional open repair for Thoracoabdominal aortic aneurysm (TAA) is associated with high morbidity and mortality. Spinal cord ischemia (SCI), renal failure, bowel ischemia and mortality are established complications following this procedure. With the advent of endovascular stent technology, various novel approaches have been described to reduce these complications, namely fenestrated stent graft and hybrid procedure. We present a case of hybrid procedure in a pseudoaneurysm of descending thoracic aorta done in Kuala Lumpur Hospital.
    Matched MeSH terms: Aortic Aneurysm, Thoracic/surgery*
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