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Role and outcome of conventional surgery in the treatment of pyogenic liver abscess in the modern era of minimally invasive therapy

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World Journal of Gastroenterology 2008年第5期14卷 747-751页

作者： Simon Siu-Man Ng janet fung-yee lee Paul Bo-San Lai Department of Surgery The Chinese University of Hong Kong Prince of Wales Hospital Shatin Hong Kong China

AIM:To evaluate the role and outcome of conventional surgery in the treatment of pyogenic liver abscess in the modern era of minimally invasive therapy. METHODS:The medical records of thirteen patients with pyogenic liver abscess who underwent surgical treatment between January 1995 and December 2002 were retrospectively reviewed to determine the clinical presentation, indication and nature of surgery, and out-come of surgery. RESULTS:The patients were predominantly women (10/13) with a mean age of 65 ± 17 years. Their main presenting symptoms were abdominal pain (100%) and fever (77%). The aetiologies included biliary (n = 6), cryptogenic (n = 3), portal (n = 2), and trauma (n = 2). Seven patients underwent percutaneous drainage as the initial treatment. Of these, three patients developed peritonitis secondary to peritoneal spillage. Another four patients failed to respond because of multilocula-tion. Salvage surgery was required in these patients. Six patients proceeded to straight laparotomy:two had marked sepsis and multiloculated abscess that precluded percutaneous drainage, and four presented with perito-nitis of uncertain pathology. Surgical procedures included deroofment and drainage (n = 9), liver resection (n = 3), peritoneal lavage (n = 2), cholecystectomy (n = 4), and exploration of common bile duct (n = 2). One patient required reoperation because of bleeding. Three patients required further percutaneous drainage after surgery. The overall mortality was 46%. Four patients died of multiorgan failure and two patients died of pulmonary embolism. CONCLUSION:Surgical treatment of pyogenic liver ab-scess is occasionally needed when percutaneous drainage has failed due to various reasons. Mortality rate in this group of patients has remained high.

关键词： Pyogenic liver abscess Surgical drainage Liver resection Percutaneous drainage Outcome

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Multi-limb necrotizing fasciitis in a patient with rectal cancer

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World Journal of Gastroenterology 2006年第32期12卷 5256-5258页

作者： Shirley Yuk Wah Liu Simon Siu Man Ng janet fung yee lee Department of Surgery Prince of Wales Hospital 30-32 Ngan Shing StreetShatinN.T.Hong KongChina

Necrotizing fasciitis is a devastating soft tissue infection affecting fascias and subcutaneous soft tissues. Literature reviews have identified several related risk factors, including malignancy, alcoholism, malnutrition, diabetes, male gender and old age. There are only scanty case reports in the literature describing its rare association with colorectal malignancy. All published cases are attributed to bowel perforation resulting in necrotizing fasciitis over the perineal region. Isolated upper or lower limb diseases are rarely identified. Simultaneous upper and lower limb infection in colorectal cancer patients has never been described in the literature. We report an unusual case of multi-limb necrotizing fasciitis in a patient with underlying non-perforated rectal carcinoma.

关键词： Necrotizing fasciitis Soft tissue infection Colorectal cancer Malignancy Group G streptococcus

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Hepatic venous outflow obstruction after piggyback liver transplantation by an unusual mechanism:Report of a case

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World Journal of Gastroenterology 2006年第33期12卷 5416-5418页

作者： Simon Siu-Man Ng Simon Chun-Ho Yu janet fung-yee lee Paul Bo-San Lai Wan-yee Lau Departments of Surgery and Diagnostic Radiology & Organ Imaging Chinese University of Hong Kong Prince of Wales Hospital Shatin Hong Kong China

Hepatic venous outflow obstruction after piggyback liver transplantation is a very rare complication. An unusual mechanism aggravating it is reported. A 33-year-old man with end-stage hepatitis B liver cirrhosis underwent a piggyback orthotopic liver transplantation using a full-size cadaveric graft. Two months after transplantation, he developed gross ascites refractory to maximal diuretic therapy. Doppler ultrasound showed patent portal and hepatic veins. Serial computed tomography scans revealed a hypoperfused right posterior segment of the liver which subsequently underwent atrophy. Hepatic venography demonstrated a high-grade stenosis with an element of torsion of venous drainage at the anastomosis. The stenosis was successfully treated with repeated percutaneous balloon angioplasty. The patient remained asymptomatic six months afterwards with complete resolution of ascites and peripheral edema. We postulate that liver allograft segmental hypoperfusion and atrophy may aggravate or result in a hepatic venous outflow problem by the mechanism of torsion effect. Percutaneous balloon angioplasty is a safe and effective treatment modality for anastomotic stenosis.

关键词： Hepatic venous outflow obstruction Piggyback Liver transplantation Percutaneous balloon angioplasty

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Portal venous gas and thrombosis in a Chinese patient with fulminant Crohn’s colitis: A case report with literature review

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World Journal of Gastroenterology 2006年第34期12卷 5582-5586页

作者： Simon Siu-Man Ng Raymond Ying-Chang Yiu janet fung-yee lee Jimmy Chak-Man Li Ka-Lau Leung Department of Surgery The Chinese University of Hong Kong Prince of Wales Hospital Shatin Hong Kong SAR China

Ever since its earliest reports, portal venous gas (PVG) has been associated with numerous intraabdominal catastrophes and has served as an indication for urgent surgical exploration. It is traditionally regarded to be an ominous finding of impending death, with highest mortality reported in patients with underlying bowel ischemia. Today, computed tomography has demonstrated a wider range of clinical conditions associated with PVG, some of which are ‘benign’ and do not necessarily require surgery, unless when there are signs of intraabdominal catastrophe or systemic toxicity. One of these ‘benign’ conditions is Crohn’s disease. The present report describes a 19-year-old Chinese boy with Crohn’s pancolitis who presented with septic shock associated with PVG and portal vein thrombosis, and was successfully managed surgically. To our knowledge, this is the fi rst report of PVG and portal vein thrombosis associated with Crohn’s disease in a Chinese patient. In addition, we have also reviewed the reports of another 18 Crohn’s patients with PVG previously described in the English literature. Specifi c predisposing factors for PVG were identified in 8 patients, including barium enema, colonoscopy, blunt abdominal trauma, and enterovenous f istula. The patients who developed PVG following barium enema and blunt trauma were all asymptomatic and no specifi c treatment was necessary. Eleven patients (58%) who presented with signs of intraabdominal catastrophe or systemic toxicity required either immediate or eventual surgery. The overall mortality rate among the 19 patients was only 11%. The present literature review has shown that the f inding of PVG associated with Crohn’ s disease does not always mandate surgical intervention. It is the clinical features and the related complications that ultimately determine the treatment approaches. The overall outcome of PVG associated with Crohn’s disease has been favourable.

关键词： Portal venous gas Portal vein thrombosis Pylephlebitis Crohn's disease Chinese

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Telerobotic-assisted laparoscopic abdominoperineal resection for low rectal cancer: Report of the first case in Hong Kong and China with an updated literature review

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World Journal of Gastroenterology 2007年第17期13卷 2514-2518页

作者： Simon Siu-Man Ng janet fung-yee lee Raymond Ying-Chang Yiu Jimmy Chak-Man Li Sophie Sok-Fei Hon Department of Surgery The Chinese University of Hong Kong Prince of Wales Hospital Shatin Hong Kong SAR China

Telerobotic surgery is the most advanced development in the field of minimally invasive surgery. The da Vinci surgical system, which is currently the most widely used telerobotic device, was approved by the Food and Drug Administration of the United States of America for clinical use in all abdominal operations in July 2000. The first da Vinci surgical system in China was installed in November 2005 at our institution. We herein report the first telerobotic-assisted laparoscopic abdominoperineal resection using the 3-arm da Vinci surgical system for low rectal cancer in Hong Kong and China, which was performed in August 2006. The operative time and blood loss were 240 min and 200 mL, respectively. There was no complication, and the patient was discharged on postoperative day five. An updated review of published literature on telerobotic-assisted colorectal surgery is included in this report, with special emphasis on its advantages and limitations.

关键词： Telerobotic-assisted surgery da Vinci Colorectal surgery Abdominoperineal resection China

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Quality of life after laparoscopic vs open sphincter-preserving resection for rectal cancer

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World Journal of Gastroenterology 2013年第29期19卷 4764-4773页

作者： Simon Siu-Man Ng Wing-Wa Leung Cherry yee-Ni Wong Sophie Sok-Fei Hon Tony Wing-Chung Mak Dennis KwokYu Ngo janet fung-yee lee Division for Colorectal Surgery Department of Surgery The Chinese University of Hong Kong Prince of Wales Hospital

AIM: To compare quality of life (QoL) outcomes in Chinese patients after curative laparoscopic vs open surgery for rectal cancer. METHODS: Eligible Chinese patients with rectal cancer undergoing curative laparoscopic or open sphincterpreserving resection between July 2006 and July 2008 were enrolled in this prospective study. The QoL outcomes were assessed longitudinally using the validated Chinese versions of the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQCR38 questionnaires before surgery and at 4, 8, and 12 mo after surgery. The QoL scores at the different time points were compared between the laparoscopic and open groups. A higher score on a functional scale indicated better functioning, whereas a higher score on a symptom scale indicated a higher degree of ***: Seventy-four patients (49 laparoscopic and 25 open) were enrolled. The two groups of patients were comparable in terms of sociodemographic data, types of surgery, tumor staging, and baseline mean QoL scores. There was no significant decrease from baseline in global QoL for the laparoscopic group at different time points, whereas the global QoL was worse compared to baseline beginning at 4 mo but returned to baseline by 12 mo for the open group (P = 0.019, Friedman test). Compared to the open group, the laparoscopic group had significantly better physical (89.9±1.4 vs 79.2±3.7, P = 0.016), role (85.0±3.4 vs 63.3±6.9, P = 0.005), and cognitive (73.5±3.4 vs 50.7±6.2, P = 0.002) functioning at 8 mo, fewer micturition problems at 4-8 mo (4 mo: 32.3±4.7 vs 54.7±7.1, P = 0.011; 8 mo: 22.8±4.0 vs 40.7±6.9, P = 0.020), and fewer male sexual problems from 8 mo onward (20.0±8.5 vs 76.7±14.5, P = 0.013). At 12 mo after surgery, no significant differences were observed in any functional or symptom scale between the two groups, with the exception of male sexual problems, which remained worse in the open group (29.2±11.3 vs 80.0±9.7, P = 0.026). CONCLUSION: Laparoscopic sphin

关键词： Quality of life Rectal cancer Laparoscopic surgery Sphincter-preserving surgery European Organization for Research and Treatment of Cancer QLQ-C30 European Organization for Research and Treatment of Cancer QLQ-CR38

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Robotic surgery for rectal cancer: A systematic review of current practice

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World Journal of Gastrointestinal Oncology 2014年第6期6卷 184-193页

作者： Tony Wing Chung Mak janet fung yee lee Kaori Futaba Sophie Sok Fei Hon Dennis Kwok Yu Ngo Simon Siu Man Ng Division of Colorectal Surgery Department of Surgery The Chinese Uni-versity of Hong Kong Prince of Wales Hospital Department of Colorectal Surgery University Hospital Birmingham NHS Trust

AIM: To give a comprehensive review of current litera-ture on robotic rectal cancer ***: A systematic review of current literature via PubMed and Embase search engines was per-formed to identify relevant articles from january 2007 to november 2013. The keywords used were: "robotic surgery", "surgical robotics", "laparoscopic computer-assisted surgery", "colectomy" and "rectal resection". RESULTS: After the initial screen of 380 articles, 20 pa-pers were selected for review. A total of 1062 patients(male 64.0%) with a mean age of 61.1 years and body mass index of 24.9 kg/m2 were included in the *** of 1062 robotic-assisted operations, 831(78.2%) anterior and low anterior resections, 132(12.4%) in-tersphincteric resection with coloanal anastomosis, 98(9.3%) abdominoperineal resections and 1(0.1%) Hart-mann's operation were included in the review. Robotic rectal surgery was associated with longer operative time but with comparable oncological results and anastomotic leak rate when compared with laparoscopic rectal surgery. CONCLUSION: Robotic colorectal surgery has con-tinued to evolve to its current state with promising re-sults; feasible surgical option with low conversion rate and comparable short-term oncological results. The challenges faced with robotic surgery are for more high quality studies to justify its cost.

关键词： Rectal cancer Robotics Minimal invasive surgery Systematic review Rectal surgery

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A giant gas-filled abdominal mass in an elderly female:A case report

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World Journal of Gastroenterology 2011年第31期17卷 3659-3662页

作者： Hoi Man Deon Chong fung yee janet lee Anthony Lo Chak Man Jimmy Li Department of Surgery Prince of Wales Hospital Department of Anatomical and Cellular Pathology Prince of Wales Hospital

We report an extremely rare case of gas-filled abdominal mass caused by an ovarian teratoma fistulating to the sigmoid colon The patient was an 85-year-old female,who presented with severe abdominal distension Urgent computed tomography scan showed a huge abdominal mass with air fluid level and fecal matter inside Communication between the mass and the sigmoid colon was suspected She underwent emergency laparotomy The mass was resected with the involved segment of colon Pathology confirmed squamous cell carcinoma arising from mature cystic teratoma of the ovary.

关键词： Mature cystic teratoma Fistula Squamous cell carcinoma

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Teaching chronic obstructive airway disease patients using a metered-dose inhaler

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Chinese Medical Journal 2006年第19期119卷 1669-1672页

作者： Ho-Hoi Luk Po-May Chan Fong-Fong Lam Kit-Yu Lau Sze-yee Chiu Yuet-Ling fung janet Pang Department of Pharmacy Tung Wah Hospital Hong Kong China Department of General Out-patient Tung Wah Hospital Hong Kong China

Asthma and chronic obstructive airway disease ,（COAD） are chronic inflammatory disorders of the airways which are usually associated with widespread airway obstruction that is often relieved by treatment. β2-adrenoreceptor agonists and corticosteriods are the mainstay of the management of this disease. The preferred route of administration of these agents is by inhalation. This allows the drug to be delivered directly to the airway with more rapid relief and fewer side effects than systemic route. The main disadvantage of metered-dose inhaler （MDI） use is that the correct use requires good technique;

关键词： chronic obstructive airway disease metered-dose inhaler patient education

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Microcosm study on fate and dynamics of mangrove tannins during leaf litter leaching

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Ecological Processes 2023年第1期12卷 520-533页

作者： Hai-Chao Zhou Hui-Xing Kang Jian Wei Chang-Jun Gao Muzammil Hussain Yi-Jian Fu Ming-Dang Li Feng-Lan Li Steven Jing-Liang Xu Fred Wang-Fat lee Ming-Guo Jiang Yi-Bing Wang Xiao-Xia Chen Nora fung-yee Tam Tao Lang Greater Bay Area Coastal Mangrove Wetland Research&Development Centre MNR Key Laboratory for Geo-Environmental Monitoring of Great Bay AreaCollege of Life Sciences and OceanographyShenzhen UniversityShenzhen 518060China Institute of Ecology College of Urban and Environmental Sciences and Key Laboratory for Earth Surface Processes of Ministry of EducationPeking UniversityBeijing 100091China Guangdong Provincial Key Laboratory of Silviculture Protection and UtilizationGuangdong Academy of ForestryGuangzhou 510520China School of Science and Technology The Hong Kong Metropolitan UniversityKowloonHong Kong 999077SARChina Guangxi Key Laboratory for Polysaccharide Materials and Modifications School of Marine Sciences and BiotechnologyGuangxi Minzu UniversityNanning 530008China State Key Laboratory of Marine Pollution City University of Hong KongKowloonHong Kong 999077SARChina

Background Mangrove tannins can participate in wetland biogeochemical ***,their fate and dynamics during leaf litter leaching have yet to be elucidated in coastal aquatic *** By using a simulated microcosm experiment,changes in leaf litter mass and tannin compounds,including total phenolics(TP),extractable condensed tannins(ECT),and bound condensed tannins(BCT),were examined in the litters and leachates of four common mangrove species:Kandelia obovata(Ko),Aegiceras corniculatum(Ac),Sonneratia apetala(Sa),and Avicennia marina(Am).Results Leaching caused a notable decline in litter mass,TP,and ECT in the leaf litter of Ko,Ac,Sa,and Am,while BCT increased significantly in Ko and *** in foliar TP was higher than in leaf litter mass,and loss in foliar ECT was higher than in TP of Ko and Ac,but Sa showed the opposite *** temporal changes of TP and ECT concentrations in leachates followed a similar trend,with an initial increase followed by a *** dynamics in Ko and Ac leachates correlated with their TP concentrations,while in Sa leachate,the peak ECT occurred 72 h later than its TP *** leachate ECT concentrations were highest in Ac,followed by Ko,and significantly lower in *** peak TP and ECT proportions in leachates accounted for 9.2-23.9%and 7.7-9.4%of the total decreases in foliar TP and ECT,*** During the leaching process,tannins’fate was species-specific,while the dynamics were almost similar.

关键词： Mangrove tannins Leaf litter decomposition Leaching Total phenolics Condensed tannins

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