MyMedR

Dermatofibrosarcoma protuberans of the scalp: therapeutic challenges

Kanesen D, Zakaria Z, Ch'ng ES, Nandrajog P, Kandasamy R

ANZ J Surg, 2019 03;89(3):261-264.

PMID: 28513108 DOI: 10.1111/ans.14040

The sequelae of barium aspiration

Gendeh HS, Hashim ND, Mohammad Yunus MR, Gendeh BS, Kosai NR

ANZ J Surg, 2018 09;88(9):937-938.

PMID: 27122196 DOI: 10.1111/ans.13624

Intravesical explosion during transurethral resection of the prostate

Dublin N, Razack AH, Loh CS

ANZ J Surg, 2001 Jun;71(6):384-5.

PMID: 11409027

Intraoperative methylene blue sentinel lymph node mapping in colorectal cancer

Chan SH, Ng C, Looi LM

ANZ J Surg, 2008 Sep;78(9):775-9.

PMID: 18844907 DOI: 10.1111/j.1445-2197.2008.04648.x

Isosulfan blue is not available for clinical use in Malaysia. This study describes the use of methylene blue as an alternative to isosulfan blue in colorectal sentinel node mapping.

Recurrent laryngeal nerve in thyroid surgery: a critical appraisal

Hisham AN, Lukman MR

ANZ J Surg, 2002 Dec;72(12):887-9.

PMID: 12485227 DOI: 10.1046/j.1445-2197.2002.02578.x

BACKGROUND: Identification and preservation of the recurrent laryngeal nerve (RLN) is of major concern in surgery of the thyroid gland. The purpose of this study was to review the surgical anatomy of the nerve and to describe its relationship to other important structures.
METHODS: A total of 325 patients were accrued in this prospective non-randomized study from January 1999 to December 2000. All patients who had total, subtotal and hemithyroidectomies were included in this study. Each side of the thyroid gland was considered as a separate unit in the analysis of the results.
RESULTS: Two hundred and seventy-six patients had thyroidectomies as their primary operation, while 49 patients had them as a reoperative procedure. There were 276 women and 46 men (6:1 female to male ratio) with a mean age of 43.1 years (range: 10-84 years). The total number of dissections was 502. The RLN was clearly identified in 491 (97.8%) dissections: single trunk in 323 dissections (65.8%), two extralaryngeal branches in 164 dissections (33.4%), and three extralaryngeal branches in three dissections (0.6%). One non-recurrent laryngeal nerve was encountered (0.2%) in the series. The proximity of the RLN to the inferior thyroid artery (ITA) was noted in 444 (90.4%) dissections: 372 (83.8%) nerves were described to be posterior and intertwined between the branches of the ITA, and in 72 (16.2%) RLNs, they were observed to be anterior to the ITA. The close association of RLN to an enlarged tubercle of Zuckerkandl was documented in 381 dissections (73.7%). A total of 231 RLNs (60.8%) was seen in the tracheoesophageal groove, 18 (4.9%) nerves were observed to be lateral to the trachea, and in 109 (28.3%), they were posterior in location. Of concern in 23 (6.0%) dissections the RLN was on the anterior surface of the thyroid gland, which is at highest risk of injury before curving down to pass behind the tubercle of Zuckerkandl. It appears that the anterior course of the RLN was seen more often in the reoperative procedures to the thyroid gland (20%).
CONCLUSIONS: Although various methods of localizing the RLN have been described, surgeons should be aware of the variations and have a thorough knowledge of normal anatomy in order to achieve a high standard of care. This will ensure the integrity and safety of the RLN in thyroid surgery. The anatomical variation may be minor in degree, but is of great importance as it may affect the outcome of the surgery and the patient's quality of life.

Evolving a common surgical curriculum for ASEAN nations with a public health approach

Lum SK

ANZ J Surg, 2013 Mar;83(3):118-21.

PMID: 23320799 DOI: 10.1111/ans.12055

The Association of Southeast Asian Nations (ASEAN) Mutual Recognition Arrangement (MRA) on medical practitioners' agreement will become a reality in the year 2015. Doctors registered in one ASEAN country will be given reciprocal recognition in another country under this agreement. Rapid and excessive movement of human resources between countries in a short span of time is undesirable and can be destabilizing. The surgical fraternity in the ASEAN countries should plan for a common surgical curriculum, a common examination and an ASEAN Board of Surgery so that standards of future trainees in different countries are comparable. The curriculum should take into consideration the diversity of the countries in socio-economic development. Ideally, it should be based on a public health approach to bring affordable quality surgical care to the masses in an efficient and effective manner.

Smartphone-controlled patch electro-acupuncture versus conventional pain relief during colonoscopy: a randomized controlled trial

Joan Gan CY, Chan KK, Tan JH, Tan Chor Lip H, Louis Ling LL, Mohd Azman ZA

ANZ J Surg, 2021 06;91(6):E375-E381.

PMID: 33876547 DOI: 10.1111/ans.16870

BACKGROUND: Smartphone-controlled patch electro-acupuncture (SCEA) is a novel device which gives the same analgesic effect as with conventional acupuncture. There are no published articles in the English literature on the use of this device as a primary mode of pain relief during colonoscopy. Primary aims of this study were to investigate the efficacy of SCEA as a substitute for pain relief during colonoscopy.

METHODS: Thirty-seven patients were randomized to receive SCEA (n = 19) or placebo (n = 18) during colonoscopy. Additional rescue sedation was administered to patients if they had pain or discomfort during the procedure. Visual analogue scale was used to quantify the intensity of pain from the beginning to end of the procedure. Other variables analysed were the amount of sedation used, duration from start to caecal intubation, length of time for completion of colonoscopy and recovery time to home discharge.

RESULTS: Patients who received SCEA had a lower median pain score of 4.6 (interquartile range 5.7) compared to the placebo group of 6.0 (interquartile range 3.2). Statistical analysis comparing the groups revealed a non-significant P-value of 0.12, although more than 90% of the patients indicated willingness for SCEA as the primary analgesia if they were to repeat the procedure. Throughout the study, there were no adverse complications that occurred during the use of SCEA.

CONCLUSIONS: Even though this study did not demonstrate, a significance in pain reduction, SCEA remains a safe modality which, more than 90% of patients favoured as a substitute for pain relief during colonoscopy.

Antibiotic prophylaxis in elective colorectal surgery

Gul YA, Lian LH, Jabar FM, Moissinac K

ANZ J Surg, 2002 Apr;72(4):275-8.

PMID: 11982514

Antibiotics are often administered in elective colorectal surgery to prevent wound infection. The tendency for surgeons to prolong the administration of prophylactic antibiotic therapy in the postoperative period is a well-known fact. The aim of this study was to elucidate the pattern of prophylactic antibiotic utilization in elective colorectal surgery and to determine if evidence-based medicine is employed in relation to this practice.

Appendiceal mucinous neoplasm

Khor Ee IH, Chor Lip HT, Muniandy J

ANZ J Surg, 2021 Jul 29.

PMID: 34324784 DOI: 10.1111/ans.17107

Re: benign free air under the diaphragm: a case of pneumatosis cystoides coli

Hayati F, Wong MJJ, Jailani RF, Ng CY

ANZ J Surg, 2021 10;91(10):2226.

PMID: 34665495 DOI: 10.1111/ans.17088

Ductal carcinoma in situ of the breast in Singapore: recent trends and clinical implications

Tan KB, Lee HY, Putti TC

ANZ J Surg, 2002 Nov;72(11):793-7.

PMID: 12437689

Breast ductal carcinoma in-situ (DCIS) is increasingly being diagnosed as a result of screening mammography and better pathological recognition. With this and the rising breast cancer incidence in Singapore, DCIS is poised to become a bigger part of surgical practice. Principles of screening, diagnosis and management of DCIS have also been rapidly evolving. Against this background, a clinicopathological audit of recent cases of DCIS in our centre was performed.

Avulsed ureter

Dublin N, Razack AH

ANZ J Surg, 2003 Apr;73(4):254-5.

PMID: 12662241

Fulltext Use of contemporary live tele-video conferencing for continuing surgical training at the time of COVID-19 pandemic

Tan HCL, Tan JH, Sagap I

ANZ J Surg, 2020 07;90(7-8):1526.

PMID: 32535949 DOI: 10.1111/ans.16105

RACS and its Fellows: a contribution to sustainable healthcare improvement in South East Asia

Hollands M, Hisham AN, Kong J, Moss D, Pusponegro A, Wora-Urai N, et al.

ANZ J Surg, 2021 03;91(3):245-248.

PMID: 33580574 DOI: 10.1111/ans.16534

The question of whether small non-government organizations with comparatively small budgets can make a substantial contribution to sustainable improvement in health care in low- and middle-income countries is crucial to funding global surgical projects. The Royal Australasian College of Surgeons and its Fellows have partnered with local organizations and clinicians to deliver a wide range of projects in South East Asia. These projects have proved sustainable and have increased healthcare capacity in these nations. This provides strong evidence that small non-government organizations such as the Royal Australasian College of Surgeons can make a major contribution to global surgeryI.

Aggressive renal tumour: squamous cell carcinoma with sarcomatoid differentiation

Shepherd ARH, Hoh IMY, Goh EH, Cohen PA, Steele D

ANZ J Surg, 2017 Dec;87(12):1054-1056.

PMID: 25962888 DOI: 10.1111/ans.13155

Re: Rare case of wandering spleen causing intra-thoracic megacolon

Hayati F, Azizan N, Ng CY, Payus AO, Syed Abdul Rahim SS

ANZ J Surg, 2021 01;91(1-2):214.

PMID: 33590622 DOI: 10.1111/ans.16380

Strangulated obturator hernia with ischaemic and perforated small bowel

Chuah JS, Tan Chor Lip H

ANZ J Surg, 2021 Sep 19.

PMID: 34541761 DOI: 10.1111/ans.17196