Displaying publications 1 - 20 of 47 in total

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  1. Khoo HY, Lee HY, Khor CS, Tan KK, Bin Hassan MR, Wong CM, et al.
    Am J Trop Med Hyg, 2022 Jul 25;107(3):560-8.
    PMID: 35895331 DOI: 10.4269/ajtmh.21-0988
    Zika virus (ZIKV) has had a history in Malaysia since its first isolation in 1966. However, it is believed that the immunity status among forest fringe communities has been underreported. We conducted cross-sectional surveillance of forest fringe communities from 10 Orang Asli villages and their peripheral communities in Perak, Pahang, and Sabah in Malaysia. A total of 706 samples were collected from 2019 to 2020 and screened for ZIKV exposure using an anti-ZIKV IgG ELISA kit. A neutralization assay against ZIKV was used to confirm the reactive samples. The seroprevalence results reported from the study of this population in Malaysia were 21.0% (n = 148, 95% CI, 0.183-0.273) after confirmation with a foci reduction neutralization test. The presence of neutralizing antibodies provides evidence that the studied forest fringe communities in Malaysia have been exposed to ZIKV. Multivariate analysis showed that those older than 44 years and those with an education below the university level had been exposed significantly to ZIKV. In addition, higher seropositivity rates to ZIKV were also reported among secondary school students from Bentong (Pahang) and residents from Segaliud (Sabah). No associations were identified between Zika seropositivity and gender, household size, house radius to the jungle, and income level. The presence of neutralizing antibodies against ZIKV among the study population might indicate that the causative pathogen had already circulated widely in forest fringe regions. Intervention for vector control, protection from mosquito bites, and awareness improvement should be encouraged in this population.
  2. Mun PS, Ting HN, Ong TA, Wong CM, Ng KH, Chong YB
    PLoS One, 2015;10(6):e0130011.
    PMID: 26066351 DOI: 10.1371/journal.pone.0130011
    This paper investigates the dielectric properties of urine in normal subjects and subjects with chronic kidney disease (CKD) at microwave frequency of between 0.2 GHz and 50 GHz. The measurements were conducted using an open-ended coaxial probe at room temperature (25°C), at 30°C and at human body temperature (37°C). There were statistically significant differences in the dielectric properties of the CKD subjects compared to those of the normal subjects. Statistically significant differences in dielectric properties were observed across the temperatures for normal subjects and CKD subjects. Pearson correlation test showed the significant correlation between proteinuria and dielectric properties. The experimental data closely matched the single-pole Debye model. The relaxation dispersion and relaxation time increased with the proteinuria level, while decreasing with the temperature. As for static conductivity, it increased with proteinuria level and temperature.
  3. Tan RKJ, Wong CM, Chen MI, Chan YY, Bin Ibrahim MA, Lim OZ, et al.
    Int J Drug Policy, 2018 11;61:31-37.
    PMID: 30388567 DOI: 10.1016/j.drugpo.2018.10.002
    BACKGROUND: Sexualised substance use, or 'chemsex' has been shown to be a major factor driving the syndemic of HIV/AIDS in communities of gay, bisexual, and other men who have sex with men (GBMSM) around the world. However, there is a paucity of research on chemsex among GBMSM in Singapore due to punitive drug laws and the criminalisation of sexual behaviour between men. This qualitative descriptive study is the first to explore perceptions towards, motivators to engaging in, and the barriers to addressing the harms associated with chemsex among GBMSM in Singapore.

    METHODS: We conducted 30 semi-structured in-depth interviews with self-identifying GBMSM between the ages of 18-39 in Singapore following a purposive sampling strategy. Interview topics included participants' perceptions of drug use among GBMSM in Singapore, perceptions towards chemsex, reasons for drug use and chemsex, and recommendations to address the harms associated with chemsex in Singapore. Interviews were audio-recorded, transcribed, coded, and analysed using thematic analysis.

    RESULTS: Participants reported that it was common to encounter chemsex among GBMSM in Singapore as it could be easily accessed or initiated using social networking phone apps. Enhancement and prolongation of sexual experiences, fear of rejection from sexual partners and peers, and its use as a means of coping with societal rejection were three main reasons cited for engaging in chemsex. The impact of punitive drug laws on disclosure and stigmatisation of GBMSM who use drugs were reported to be key barriers towards addressing chemsex. Participants suggested using gay-specific commercial venues as avenues for awareness and educational campaigns, and social media to reach out to younger GBMSM.

    CONCLUSIONS: This study highlights the complexities behind chemsex use among GBMSM in Singapore, and the range of individual to institutional factors to be addressed. We recommend that community-based organisations and policy-makers find ways to destigmatise discussion of chemsex and provide safe spaces to seek help for drug use.

  4. Siow SL, Wong CM, Febra S, Goh RET
    Med J Malaysia, 2020 09;75(5):609-611.
    PMID: 32918440
    Gastric leiomyoma of the antrum intussuscepted into first part of the duodenum is a rare complication. We report here an 80-year-old woman who presented at the Sarawak General Hospital, Kuching, Sarawak, Malaysia with early satiety and epigastric fullness for 3 months. She had no prior medical or surgical history other than an uneventful open cholecystectomy. Upper endoscopy showed a large submucosal mass in the first part of duodenum with pyloric converging gastric folds. Computed tomography scan of the abdomen showed a gastroduodenal intussusception with a 4x6cm mass at the junction between the first and second part of duodenum. Laparoscopic transgastric resection was performed. Histopathological examination of the resected specimen confirmed leiomyoma. She remained well at 43 months follow-up.
  5. Wong CM, Tam HK, Ng WM, Boo SY, González M
    Plasmid, 2013 Mar;69(2):186-93.
    PMID: 23266397 DOI: 10.1016/j.plasmid.2012.12.002
    A cryptic plasmid, pMWHK1 recovered from an Antarctic bacterium Pedobacter cryoconitis BG5 was sequenced and characterised. The plasmid is a circular 6206bp molecule with eight putative open reading frames designated as orf1, orf2, orf3, orf4, orf5, orf6, orf7 and orf8. All the putative open reading frames of pMWHK1 are found to be actively transcribed. Proteins encoded by orf2 and orf4 are predicted to be responsible for the mobilization and replication of the plasmid respectively. orf4 shares 55% and 61% identities with the theta-type Rep proteins from two strains of Riemerella anatipestifer. This suggests that pMWHK1 could be a member of the theta-type replicating plasmid. The origin of replication is located within the AT-rich region upstream of orf4. orf5 and orf6 encode bacterial toxin-antitoxin proteins predicted to maintain plasmid stability. orf3 encodes an entry exclusion protein that is hypothetically involved in reducing the frequency of DNA transfer through conjugation. orf1, orf7 and orf8 encode proteins with unknown functions. Plasmid, pMWHK1 is stably maintained in P. cryoconitis BG5 at 20°C.
  6. Lim LS, Csorba G, Wong CM, Zubaid A, Rahman SP, Kumaran JV, et al.
    Zootaxa, 2016 Sep 22;4170(1):169-177.
    PMID: 27701281 DOI: 10.11646/zootaxa.4170.1.10
    The Southeast Asian species of Hypsugo are rare bats, except for H. cadornae and H. pulveratus, which are distributed throughout the Indomalayan region. Hypsugo macrotis is restricted to Peninsular Malaysia, Sumatra, Java and adjacent islands, and is known only from a handful of specimens. Here we report a new locality record of the species from Seremban, Peninsular Malaysia, which also represents the first known building-dweller colony of any Hypsugo from the region. We discuss the taxonomic status of two morphologically similar species, H. macrotis and H. vordermanni, and provide the first COI and cyt b gene sequences for H. macrotis and reconstruct the species' phylogenetic relationships.
  7. Loqman MY, Wong CM, Hair-Bejo M, Zuki AB, Hafeez YM
    Med J Malaysia, 2004 May;59 Suppl B:113-4.
    PMID: 15468844
    A study was conducted to investigate the effectiveness of freeze-dried bovine pericardium (FDBP) as a biomaterial in diaphragmatic herniorrhapy in dogs. Eight adult dogs were randomly selected and divided into two equal groups. In FDBP group, a diaphragmatic defect was induced and repaired with an identical size of FDBP. In the control group, a diaphragmatic wall was incised at three-side border creating a flap and sutured. Grossly, only mild intrathoracic adhesion was observed for most of the animals, and no herniation occured. Microscopically, the biomaterial incorporated into the host's tissue by ingrowth of young muscle fiber and massive new blood vessel formation in between the fibrous tissue.
  8. Saminathan M, Sieo CC, Abdullah N, Wong CM, Ho YW
    J Sci Food Agric, 2015 Oct;95(13):2742-9.
    PMID: 25418980 DOI: 10.1002/jsfa.7016
    Molecular weights (MWs) and their chemical structures are the primary factors determining the influence of condensed tannins (CTs) on animal nutrition and methane (CH4 ) production in ruminants. In this study the MWs of five CT fractions from Leucaena leucocephala hybrid-Rendang (LLR) were determined and the CT fractions were investigated for their effects on CH4 production and rumen fermentation.
  9. Saminathan M, Tan HY, Sieo CC, Abdullah N, Wong CM, Abdulmalek E, et al.
    Molecules, 2014 Jun 12;19(6):7990-8010.
    PMID: 24927368 DOI: 10.3390/molecules19067990
    Condensed tannins (CTs) form insoluble complexes with proteins and are able to protect them from degradation, which could lead to rumen bypass proteins. Depending on their degrees of polymerization (DP) and molecular weights, CT fractions vary in their capability to bind proteins. In this study, purified condensed tannins (CTs) from a Leucaena leucocephala hybrid were fractionated into five different molecular weight fractions. The structures of the CT fractions were investigated using 13C-NMR. The DP of the CT fractions were determined using a modified vanillin assay and their molecular weights were determined using Q-TOF LC-MS. The protein-binding affinities of the respective CT fractions were determined using a protein precipitation assay. The DP of the five CT fractions (fractions F1-F5) measured by the vanillin assay in acetic acid ranged from 4.86 to 1.56. The 13C-NMR results showed that the CT fractions possessed monomer unit structural heterogeneity. The number-average molecular weights (Mn) of the different fractions were 1265.8, 1028.6, 652.2, 562.2, and 469.6 for fractions F1, F2, F3, F4, and F5, respectively. The b values representing the CT quantities needed to bind half of the maximum precipitable bovine serum albumin increased with decreasing molecular weight--from fraction F1 to fraction F5 with values of 0.216, 0.295, 0.359, 0.425, and 0.460, respectively. This indicated that higher molecular weight fractions of CTs from L. leucocephala have higher protein-binding affinities than those with lower molecular weights.
  10. Saminathan M, Sieo CC, Gan HM, Ravi S, Venkatachalam K, Abdullah N, et al.
    J Sci Food Agric, 2016 Oct;96(13):4565-74.
    PMID: 26910767 DOI: 10.1002/jsfa.7674
    BACKGROUND: Condensed tannin (CT) fractions of different molecular weights (MWs) may affect rumen microbial metabolism by altering bacterial diversity. In this study the effects of unfractionated CTs (F0) and five CT fractions (F1-F5) of different MWs (F1, 1265.8 Da; F2, 1028.6 Da; F3, 652.2 Da; F4, 562.2 Da; F5, 469.6 Da) from Leucaena leucocephala hybrid-Rendang (LLR) on the structure and diversity of the rumen bacterial community were investigated in vitro.

    RESULTS: Real-time polymerase chain reaction assay showed that the total bacterial population was not significantly (P > 0.05) different among the dietary treatments. Inclusion of higher-MW CT fractions F1 and F2 significantly (P 

  11. Goh ET, Gan CC, Lim SK, Wong CM, Lee YW, Jalalonmuhali M
    Transplant Proc, 2022 Feb 10.
    PMID: 35153058 DOI: 10.1016/j.transproceed.2022.01.006
    The short- and long-term outcome of donations from living donors of kidneys (LKDs) remains controversial. Information regarding metabolic changes after donation in Malaysia remains limited despite Malaysia having the highest record prevalence of diabetes, obesity, and hypertension in Asia. There were 159 LKDs in our center from 2010 to 2020. We analyzed pre and post donation clinical data and laboratory results from 140 LKDs, retrospectively, from electronic medical records and looked for any metabolic changes. Among these 140 LKDs, 99 were women (70.7%), with a mean age of 47.23 ± 11.67 before donation. The median follow-up was 4 years (range, 2-6 years). Median body mass index increased from 24.35 kg/m2 (range, 22.11-26.93) to 25.56 kg/m2 (range, 22.78-28.57; Z=-3.934, P = .000) after donation. Prevalence of obesity increased from 24.18% to 30.77%. Only 2.8% of LKDs developed proteinuria postnephrectomy (P = .250). Serum creatinine increased from 60 mmol/L (range, 52-74) to 87 mmol/L (range, 74-108) 1 year after donation (P = .000), and the latest results decrease to 83 mmol/L (range, 73-101; P = .000). Systolic blood pressure increased from 127.83 ± 12.25 mm Hg to 131.30 ± 18.16 mm Hg, (t[97] = -2.012; P = .047); and prevalence of hypertension increased from 19.81% to 23.58% (P = .125), with 22.64% requiring treatment. We noted that 22.54% of the LKDs had dyslipidemia before donation, a number that increased to 50% after donation (P = .000). LKDs with hyperuricemia increased significantly from 7.92% to 34.65%, with uric acid level increasing from 311.94 ± 78.51umol/L to 381.87 ± 86.96 umol/L (t[94] = -10.805; P = .000). Fasting blood glucose and glycated hemoglobin level recorded no significant changes after donation. Post donation kidney function of LKDs compensated well and stable in short term. We noted statistically significant increment of weight, post donation body mass index, systolic blood pressure, uric acid, and lipids. We suggest prospective studies with longer follow-up and more subjects for clinical correlation.
  12. Wong FN, Chua KH, Tan JAMA, Wong CM, Kuppusamy UR
    PeerJ, 2018;6:e4421.
    PMID: 29610703 DOI: 10.7717/peerj.4421
    Background: Chronic kidney disease (CKD) is characterised by long-term kidney damage and renal function decline. Diabetic CKD is the principal subtype of kidney disease in Malaysia and is associated with oxidative stress which plays an important role in development and progression of the disease. Glycaemic control slows down the progression of diabetic complications, including diabetic CKD. However, the implication of glycaemic control on enzymatic antioxidants and soluble RAGE (sRAGE) in CKD patients remains elusive. The aim of this study was to investigate the effect of glycaemic control on the levels or activities of glutathione peroxidase (GPx), superoxide dismutase (SOD) and sRAGE in CKD patients.

    Methods: A total of 150 CKD patients and 64 non-CKD patients were enrolled. The type 2 diabetic patients in the recruited study participants were categorised based on their glycaemic control; poor glycaemic control (GC) with haemoglobin A1c (HbA1c) > 7% and good GC with HbA1c ≤ 7%. The levels or activities of GPx, SOD and sRAGE in plasma were measured. These biochemical parameters were analysed using Mann-WhitneyUtest and two-way analysis of variance (ANOVA).

    Results: The activities of GPx and SOD as well as plasma level of sRAGE were not significantly different among the CKD patients with varying glycaemic control status. Irrespective of diabetes status and glycaemic control status, CKD patients also exhibited lower plasma SOD activities compared with non-CKD patients. Among the non-CKD patients, SOD activities were significantly higher in diabetic patients with good GC than diabetic patients with poor GC. Two-way ANOVA revealed that both CKD status and glycaemic control had an interaction effect on SOD activities in diabetic subjects with and without CKD. Follow-up analysis showed that SOD activities were significantly higher in non-CKD patients with good GC. There were no overall significant differences in GPx activities among the study participants. Furthermore, plasma sRAGE levels were higher in diabetic patients with CKD than those without CKD, regardless of glycaemic control status. There were no interaction effects between CKD status and glycaemic control status on GPx and sRAGE. Instead, CKD status showed significant main effects on these parameters, indicating significant differences between diabetic subjects with CKD and diabetic subjects without CKD.

    Conclusion: Glycaemic control did not quantitatively alter GPx, SOD and sRAGE in diabetic CKD patients. Despite the advantages of good glycaemic control, a well-controlled diabetes in CKD did not modulate the activities of enzymatic antioxidants and sRAGE levels, therefore may not be the primary mechanism to handle oxidative stress.

  13. Joveen-Neoh WF, Chong KL, Wong CM, Lau TY
    J Parasitol Res, 2011;2011:104284.
    PMID: 22013506 DOI: 10.1155/2011/104284
    Introduction. Malaria is currently one of the most prevalent parasite-transmitted diseases caused by parasites of the genus Plasmodium. Misidentification of human malaria parasites especially P. knowlesi based on microscopic examination is very common. The objectives of this paper were to accurately identify the incidence of human malaria parasites in the interior division of Sabah, Malaysian Borneo, based on small subunit ribosomal RNA (ssrRNA) and to determine the misidentification rate in human malaria parasites. Methods. Nested PCR was used to detect the presence of human malaria parasites. A total of 243 blood spot samples from patients who had requested for blood film for malaria parasite (BFMP) analyses were used in this study. Results. Nested PCR findings showed that there was no P. malariae infection while the highest prevalent malaria parasite was P. knowlesi, followed by P. vivax, P. falciparum, and mixed infection. Only 69.5% of the 243 samples giving consistent nested PCR and microscopic results. Conclusion. The preliminary findings from molecular detection of malaria showed that P. knowlesi was the most prevalent Plasmodium species in the interior division of Sabah. The findings from this paper may provide a clearer picture on the actual transmission of different Plasmodium species in this region.
  14. Liam CK, Loo KL, Wong CM, Lim KH, Lee TC
    Respirology, 2002 Dec;7(4):345-50.
    PMID: 12421243 DOI: 10.1046/j.1440-1843.2002.00409.x
    OBJECTIVE: The aim of this study was to investigate the prevalence of skin prick test (SPT) reactivity to common aeroallergens among Malaysian asthmatic patients with and without rhinitis.
    METHODOLOGY: An SPT using eight aeroallergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, cat fur, cockroach, Acacia sp., Bermuda grass, Aspergillus fumigatus and Aspergillus niger) was performed on 206 asthmatic patients.
    RESULTS: One hundred and forty patients (68%) were reactive to at least one of the aeroallergens. Among the SPT-positive patients, a positive prick test reaction to the house dust mites, D. pteronyssinus (93.6%), and D. farinae (81.4%) was most common, followed by cat fur (20.0%), cockroach (7.9%), Bermuda grass (7.9%), Acacia sp. (7.9%), A. fumigatus (0.7%) and A. niger (0.7%). A history of rhinitis was elicited in 111 (53.9%) patients and 95 (85.3%) of these patients were SPT-positive compared with only 45 (47.4%) of 95 patients with asthma symptoms alone (P < 0.001). The presence of rhinitis and a young age of onset of asthma were independent factors for positive SPT reaction to at least one of the aeroallergens.
    CONCLUSIONS: The prevalence of SPT reactivity to common aeroallergens is high among Malaysian asthmatics, particularly in those with an early age of onset and in those with coexisting rhinitis.
    Study site: Asthma Clinic, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
  15. Wong CM, Lim KH, Liam CK
    Respirology, 2003 Mar;8(1):65-8.
    PMID: 12856744
    OBJECTIVE: In southeast Asia, pulmonary tuberculosis (TB) is the most frequently presumed diagnosis for haemoptysis. This study was designed to assess the causes of haemoptysis, the diagnostic yield of causes in different diagnostic modalities and the distribution of older patients.

    METHODS: All patients presenting to the University of Malaya Medical Centre, Kuala Lumpur, Malaysia with haemoptysis were recruited prospectively and evaluated.

    RESULTS: One hundred and sixty patients were evaluated for haemoptysis; 71 (44.4%) were aged 60 years or more. Significantly more patients smoked in the older age group (P = 0.002). The main causes of haemoptysis in the older patients were bronchogenic carcinoma (49.3%), pneumonia (11.3%), bronchiectasis (8.6%), cryptogenic (5.6%) and active TB (4.2%). Significantly more older patients had carcinoma (P < 0.001), while the younger patients more often had TB (P < 0.001). Chest pain was significantly more common in the older patients (P = 0.025), particularly in patients with carcinoma. Bronchoscopy alone or combined with CT of the thorax was significantly more diagnostic in the older patient (P = 0.006).

    CONCLUSION: Bronchogenic carcinoma is the commonest cause of haemoptysis in patients aged 60 years and above. Presumptive anti-TB therapy should not be encouraged despite the regional high prevalence of TB.

  16. Wong CM, Lim KH, Liam CK
    Respirology, 2003 Mar;8(1):107-9.
    PMID: 12856752
    Pregnancy complicated by lung cancer has been rarely reported. The regional incidence of this complex situation is likely to increase in the future and optimal management needs to be established to better deal with this situation. We report two patients with metastatic lung cancer complicating pregnancy to highlight the evaluation and management difficulties associated with this problem and to contribute to the limited information in the literature.
  17. Wong CM, Lim KH, Liam CK
    Postgrad Med J, 1999 May;75(883):297-8.
    PMID: 10533638
    Cryptococcal infection uncommonly presents with pulmonary manifestations and even more rarely so as massive bilateral effusions. Pleural involvement is usually associated with underlying pulmonary parenchymal lesions and is unusual while on antifungal therapy. We report a patient with cryptococcal meningitis who, while on intravenous 5-flucytosine and amphotericin B, developed life-threatening bilateral massive pleural effusions with evidence of spontaneous resolution, consistent with prior hypothesis of antigenic stimulation as the cause of pleural involvement.
  18. Keng TC, Ng KP, Tan LP, Chong YB, Wong CM, Lim SK
    Ren Fail, 2012;34(6):804-6.
    PMID: 22506572 DOI: 10.3109/0886022X.2012.678208
    Peritonitis is well recognized as the Achilles tendon of peritoneal dialysis (PD). Reoccurrence of peritonitis due to the same organism, defined as either repeat or relapsing peritonitis under the 2005 guidelines by the International Society for Peritoneal Dialysis, often results in PD technique failure. Rothia dentocariosa, a low-virulent human oropharynx commensal, is a rarely reported pathogen in human infection, particularly infective endocarditis. R. dentocariosa PD-related peritonitis is exceedingly uncommon yet potentially results in repeat or relapsing peritonitis which requires catheter removal. We report a case of R. dentocariosa repeat and relapsing peritonitis in a PD patient who was treated successfully with antimicrobial therapy.
  19. Jalalonmuhali M, Ng KP, Lee YW, Gan CC, Hing Wong A, Wan Md Adnan WAH, et al.
    Transplant Proc, 2022 Feb 15.
    PMID: 35181166 DOI: 10.1016/j.transproceed.2022.01.004
    BACKGROUND: Immunosuppressive therapy is the backbone of kidney transplantation in preventing acute rejection. T-cell depletion after doses of thymoglobulin is dose-dependent, as are their side effects. At the same time, basiliximab and other maintenance immunosuppressive drugs act at different signals on T lymphocytes. Therefore, studying the pattern of lymphocyte subset depletion depending on the induction regime given at transplantation could be an added tool in managing post-transplant recipients.

    METHODOLOGY: This prospective observational study recruited kidney transplant recipients from August 2019 through April 2021 at the University of Malaya Medical Centre. Blood tests for lymphocyte subsets were taken at pre-transplant, 1 week, 1 month, 3 months, and 6 months post-transplantation. At transplantation, recipients received either basiliximab, low-dose thymoglobulin (cumulative dose: 1.5 mg/kg), or standard-dose thymoglobulin (cumulative dose: 5 mg/kg).

    RESULTS: A total of 39 patients were recruited: 38.5% received basiliximab (15 of 39), 15.4% received low-dose thymoglobulin (6 of 39), and 46.2% received standard-dose thymoglobulin (18 of 39). Absolute lymphocyte counts 1 week post-transplantation were 1.5 ± 0.84 × 109/L for basiliximab, 0.7 ± 0.57 × 109/L for low-dose thymoglobulin, and 0.1 ± 0.08 × 109/L for standard-dose thymoglobulin (P < .001). The CD4+ and CD8+ counts were severely depleted in the standard-dose thymoglobulin group, with a statistically significant differenceup to 6 months post-transplantation. In the low-dose thymoglobulin group, the CD4+ and CD8+ counts were depleted at 1 week post-transplantation and recovered at 1 month post-transplantation. There was no difference in allograft function and incidence of allograft rejection across groups.

    CONCLUSIONS: The effects on lymphocyte counts, CD4+ and CD8+, vary depending on the type and dose of induction immunosuppression. This could be a guiding tool in managing immunosuppression post-transplantation depending on the patient's immunologic risk.

  20. Siow SL, Mahendran HA, Wong CM, Hardin M, Luk TL
    Asian J Surg, 2018 Mar;41(2):136-142.
    PMID: 27955872 DOI: 10.1016/j.asjsur.2016.11.004
    BACKGROUND/OBJECTIVE: The objective of this study was to compare the outcomes of patients who underwent laparoscopic and open repair of perforated peptic ulcers (PPUs) at our institution.

    METHODS: This is a retrospective review of a prospectively collected database of patients who underwent emergency laparoscopic or open repair for PPU between December 2010 and February 2014.

    RESULTS: A total of 131 patients underwent emergency repair for PPU (laparoscopic repair, n=63, 48.1% vs. open repair, n=68, 51.9%). There were no significant differences in baseline characteristics between both groups in terms of age (p=0.434), gender (p=0.305), body mass index (p=0.180), and presence of comorbidities (p=0.214). Both groups were also comparable in their American Society of Anesthesiologists (ASA) scores (p=0.769), Boey scores 0/1 (p=0.311), Mannheim Peritonitis Index > 27 (p=0.528), shock on admission (p<0.99), and the duration of symptoms > 24 hours (p=0.857). There was no significant difference in the operating time between the two groups (p=0.618). Overall, the laparoscopic group had fewer complications compared with the open group (14.3% vs. 36.8%, p=0.005). When reviewing specific complications, only the incidence of surgical site infection was statistically significant (laparoscopic 0.0% vs. open 13.2%, p=0.003). The other parameters were not statistically significant. The laparoscopic group did have a significantly shorter mean postoperative stay (p=0.008) and lower pain scores in the immediate postoperative period (p<0.05). Mortality was similar in both groups (open, 1.6% vs. laparoscopic, 2.9%, p < 0.99).

    CONCLUSION: Laparoscopic repair resulted in reduced wound infection rates, shorter hospitalization, and reduced postoperative pain. Our single institution series and standardized technique demonstrated lower morbidity rates in the laparoscopic group.

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