Diagnostic & Therapeutic Endoscopy by Nexus Surgical Associates

Screening and therapeutic gastroscopy and colonoscopy are available at Mt Elizabeth Hospital, Parkway East Hospital, Gleneagles Hospital, Mt Alvernia Hospital, Novena Medical Centre and Thomson Medical Centre. For appointment and scheduling of Endoscopy Services, please contact Nexus Surgical Associates at (65)-6235-8633 or email us at enquiry@nexussurgical.sg or visit our website http://www.nexussurgical.sg/ and fax the downloaded request form to (65)-6235-5675.

Continuing Medical Education Talk by Dr Liau Kui Hin

Our Nexus Surgical Associates Liver Surgeon, Dr Liau Kui Hin will be speaking on The Changing Concept in Liver Surgery for Cancer Treatment on Wednesday 11 May 2011 at Lecture Theatre in Gleneagles Hospital.

Is Whipple Operation Justified in Elderly Patients?

Publication in the journal SURGEON, by Dr Liau Kui Hin & Dr Ho Choon Kiat. Abstract: Although mortality & morbidity for Whipple operation / pancreaticoduodenectomy (PD) have improved significantly over the last two decades, the concern for elderly undergoing PD remains. This study examines the outcome of the elderly patients who had PD. A prospective database comprising 69 patients who underwent pancreaticoduodenectomy between 2001 and May 2008 was analyzed. Using WHO definition, elderly patient is defined as age 65 and above in this study. Two groups of patients were compared [Group 1: Age ≤65 & Group 2: Age >65]. The mean age of our patients was 62 ± 11 years. There were 37 (54%) patients in Group 1 and 32 (46%) patients in Group 2. There was no statistical difference between the two groups in terms of gender and race. However, there were more patients in the Group 2 with >2 comorbidities (p = 0.03). The median duration of operation was significantly longer in Group 2 (550 min vs 471 min, p = 0.04). Morbidity rate in Group 2 was higher (56% vs 44%, p = 0.04). There was higher proportion of post-operative pancreatic fistula (POPF) in the elderly group (37.5% vs 16.7%, p = 0.05). Majority of them are Grade A POPF according to the ISG definition. The median post-operative length-of-stay (LOS) in hospital was 9 days longer in Group 2 (p = 0.01). Mortality rate between the 2 groups of patients was comparable (0% vs 3%, p = 0.28). In conclusion, elderly patients are at increased risk of morbidity in pancreatocoduodenectomy, in particular POPF. However, morbidity and mortality rates are acceptable. It is therefore justified to offer PD to elderly patients who do not have significant cardiopulmonary comorbidities.

Publication by Dr Lim Khong Hee in Journal of Gastrointestinal Oncology

Emergency surgery for perforated gastric malignancy: An institution’s experience and review of the literature J Gastrointest Oncol 2011; 2: 13-18. The aim was to evaluate the outcome of patients who underwent surgery for perforated gastric malignancies. A review of all patients who underwent surgery for perforated gastric malignancy was performed. Twelve patients (nine gastric adenocarcinoma and three B-cell lymphoma) formed the study group. Ten (83.3%) had subtotal gastrectomy performed, while two (16.7%) underwent total gastrectomy. All eight patients with adenocarcinoma who survived the initial operation fared poorly. The two patients with lymphoma who survived the surgery underwent subsequent chemotherapy has no disease recurrence currently. In conclusion, surgery in perforated gastric malignancy is fraught with numerous challenges.

General Surgery Journal Club

Journal Club will be held on Monday 4 April 2011 (time: 1230 hr to 1400 hr) at conference room level 2, Mt Elizabeth Medical Centre.