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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

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

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

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

Current and future molecular diagnostics in colorectal cancer and colorectal adenoma

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World Journal of Gastroenterology 2014年第14期20卷 3847-3857页

作者： Andy Hin-Fung Tsang Ka-Ho Cheng Apple siu-Ping Wong simon siu-man ng Brigette Buig-Yue Ma Charles Ming-Lok Chan Nancy Bo-Yin Tsui Lawrence Wing-Chi Chan Benjamin Yat-Ming Yung Sze-Chuen Cesar Wong Department of Health Technology and Informatics Faculty of Health and Social SciencesHong Kong Polytechnic University Department of Surgery Prince of Wales Hospital State Key Laboratory in Oncology in South China Sir Y K Pao Centre for CancerDepartment of Clinical OncologyHong Kong Cancer Institute and Prince of Wales HospitalThe Chinese University of Hong Kong

Colorectal cancer(CRC)is one of the most prevalent cancers in developed *** the other hand,CRC is also one of the most curable cancers if it is detected in early stages through regular colonoscopy or *** CRC develops slowly from precancerous lesions,early detection can reduce both the incidence and mortality of the *** occult blood test is a widely used non-invasive screening tool for *** fecal occult blood test is simple and cost-effective in screening CRC,there is room for improvement in terms of the accuracy of the *** dysregulations have been found to play an important role in CRC *** better understanding of the molecular basis of CRC,there is a growing expectation on the development of diagnostic tests based on more sensitive and specific molecular markers and those tests may provide a breakthrough to the limitations of current screening tests for *** this review,the molecular basis of CRC development,the characteristics and applications of different non-invasive molecular biomarkers,as well as the technologies available for the detection were *** review intended to provide a summary on the current and future molecular diagnostics in CRC and its pre-malignant state,colorectal adenoma.

关键词： Colorectal cancer Colorectal adenoma Molecular diagnostics Fecal occult blood test Non-invasive

Indications of pro-inflammatory cytokines in laparoscopic and open liver resection for early-stage hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 257-264页

作者： Kevin Tak-Pan ng Li Pang Jia-Qi Wang Wong Hoi She simon Hing-Yin Tsang Chung Mau Lo Kwan man Tan To Cheung Department of Surgery HKU-SZH&School of Clinical MedicineLi Ka Shing Faculty of MedicineThe University of Hong KongHong KongChina State Key Laboratory of Liver Research The University of Hong KongHong KongChina

Background:Our clinical practice of laparoscopic liver resection(LLR)had achieved better short-term and long-term benefits for patients with hepatocellular carcinoma(HCC)over open liver resection(OLR),but the underlying mechanisms are not *** study was to find out whether systemic inflammation plays an important ***:A total of 103 patients with early-stage HCC under liver resection were enrolled(LLR group,n=53;OLR group,n=50).The expression of 9 inflammatory cytokines in patients at preoperation,postoperative day 1(POD1)and POD7 was quantified by Luminex Multiplex *** relationships of the cytokines and the postoperative outcomes were compared between LLR and ***:Seven of the circulating cytokines were found to be significantly upregulated on POD1 after LLR or OLR compared to their preoperative *** to OLR,the POD1 levels of granulocytemacrophage colony-stimulating factor(GM-CSF),interleukin-6(IL-6),IL-8,and monocyte chemoattractant protein-1(MCP-1)in the LLR group were significantly *** POD1 levels of these cytokines were significantly correlated with longer operative time and higher volume of blood loss during *** levels of these cytokines were positively associated with postoperative liver injury,and the length of hospital ***,a high level of IL-6 at POD1 was a risk factor for HCC recurrence and poor disease-free survival after liver ***:Significantly lower level of GM-CSF,IL-6,IL-8,and MCP-1 after liver resection represented a milder systemic inflammation which might be an important mechanism to offer better short-term and long-term outcomes in LLR over OLR.

关键词： Laparoscopic liver resection Open liver resection Hepatocellular carcinoma Postoperative cytokines Inflammatory responses

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

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

A Nonstandard Lévy-Khintchine Formula and Lévy Processes

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Acta Mathematica Sinica,English Series 2008年第2期24卷 241-252页

作者： siu Ah ng School of Mathematical Sciences University of KwaZulu-Natal Pietermaritzburg 3209 South Africa

We use methods from nonstandard analysis to obtain a short and simple derivation of the Levy-Khintchine formula via an explicit construction of certain laws of the infinitesimal increments. Consequently, any arbitrary... 详细信息

关键词： Levy processes Levy-Khintchine formula nonstandard analysis infinitesimal hyperfinite