Letter to the Editor
An initial experience with laser haemorrhoidoplasty in addition to mucopexy for symptomatic haemorrhoids
Dear Editor,
Symptomatic haemorrhoids is the most common anorectal disorder, where up to 75% of people experience symptoms sometime in their lives.1
The current gold standard...
Others
Mesothelial Splenic Cyst—A Case Report
Non-parasitic cystic lesions of the spleen are unusual. They are classified essentially as primary (true, epithelial) and secondary (pseudo, non-epithelial) based on the presence...
Original Article
Computed Tomographic and Magnetic Resonance Imaging Findings in Paranasal Sinus Involvement in Nasopharyngeal Carcinoma
Nasopharyngeal carcinoma (NPC) is an aggressive infiltrative neoplasm. Spread into the paranasal sinuses is often seen but the frequency is documented in only a...
Original Article
Abdominal Surgery in Human Immunodeficiency Virus (HIV) Infected Patients—Early Local Experience
The prevalence of human immunodeficiency virus (HIV) infection is rising at an exponential rate in Singapore. The surgical experience with this disease remains limited.
This...
Original Article
The Surgical Management of Colorectal Complications from Irradiation for Carcinoma of the Cervix
Radiation bowel injury is a significant clinical problem because of the technical difficulties of surgery. Among the more common causes is radiation of carcinoma...
Original Article
Ambulatory Anorectal Surgery—Is it Feasible Locally?
Economic and social pressures are compelling surgeons to modify their practice. An increasing number of procedures are being done in an outpatient setting.
This article...
Review Article
Continuous Renal Replacement Therapy: Continuous Blood Purification in the Intensive Care Unit
The last decade has seen a progressive change in the style of management of severe acute renal failure (acute renal failure which requires the...
Original Article
Phyllodes Tumour: An Update of 40 Cases
First described by Johannes Muller in 1838 as a large, benign tumour of the breast. Phyllodes tumour is a rare pathological entity, accounting for...
Original Article
The Investigation and Management of Thyroid Nodules—A Retrospective Review of 183 Cases
Thyroid nodule is a common problem in surgical practice. In 1994, more than 350 thyroid operations were performed in our department, of which 183...
Others
Medicine and Surgery—History, Change and Challenge
Mr Koh Yong Guan, guest-of-honour; Dr Tan Ser Kiat, Master, Academy of Medicine; Dr K C Tan, Chairman, Chapter of Surgeons; Dr Robert Jalleh...
Review Article
Overview of Imaging in Rheumatologic Diseases
Since the discovery of X-rays over a century ago, radiology has played a pivotal role in rheumatology and diseases of the joints. The innovations...
Others
Haemorrhage into Non-functioning Adrenal Cysts—Report of Two Cases and Review of the Literature
Doran, in 1903, reported the first case of adrenal cyst described by Greiselius in 1670. It was not until 1966 that Foster reported the...
Original Article
Video-assisted Thoracoscopy: Role in the Management of Intrathoracic Pathology
Thoracoscopy was first introduced by Jacobaeus nearly a century ago. With the development of endoscopic equipment and the recent surge of interest in minimally...
Original Article
Outcome of Tunnelled Central Venous Haemodialysis Catheters Inserted by Radiologists
In end-stage renal failure patients, maintaining adequate vascular access continues to be an ongoing challenge. Native arteriovenous fistulas or synthetic arteriovenous grafts are satisfactory...
Original Article
Focused Abdominal Sonography for Trauma (FAST)
The multiply injured patient presents a challenge to even the most experienced surgeon. These patients often present in shock and require a rapid diagnostic...
Others
Life-threatening Perineal Gangrene from Rectal Perforation Following Colonic Hydrotherapy: A Case Report
Alternative medicine has become widely publicised throughout the world. Alternative medicine practitioners (AMPS), which include Oriental medicine doctors, traditional Chinese medicine practitioners, naturopaths and...
Others
A Case Series of Falciparum Malaria-induced Acute Renal Failure
Predominantly a disease of hot and humid climates, malaria affects 270 million people worldwide annually, and has a mortality rate of 1%. The increasing...
Original Article
Renal Cell Carcinoma in Patients with Chronic Renal Failure
Dunnil and associates first described the association of renal cell carcinoma (RCC) with acquired cystic kidney disease (ACKD) and end stage renal disease. The...
Original Article
Inferior Vena Cava Thrombectomy for Renal Cell Carcinoma with Thrombus
A characteristic feature of renal cell carcinoma is the development of tumour thrombus extending into the inferior vena cava (IVC). This takes place in...
Review Article
Diagnosing and Managing Faecal Incontinence
Faecal incontinence is the inability to control the passage of gas, liquid or solid through the anus. Its severity varies from infrequent passage of...
Others
1998 Distinguished Academician Lecture: Hepatic Resection— A Western Perspective
Although debridement of portions of liver that prolapsed through war wounds was recorded from distant times, attempts at resection of a solid liver tumour...
Review Article
Current Therapeutic Strategies in Glomerulonephritis
Twenty years ago, the therapy of glomerulonephritis (GN) was relatively simple as it was believed that treatment with prednisolone should be confined to patients...
Original Article
Preliminary Results of Heart-beating and Non-heart-beating Donor Kidney Transplants—The Singapore Experience
End stage renal failure (ESRF) is the most common end stage organ disease treated with transplantation in Singapore. Though renal transplantation is the preferred...
Commentary
A Practical Technique of Colour Image Analysis: Applications in Experimental Research
Colour image analysers have been extensively used in medical research since 1970 for histomorphometric studies. Image analysis gives more information and a better understanding...
Review Article
Immunological Consequences of Trauma and Shock
Despite intensive research and intervention, trauma continues to be the leading cause of death during the first three decades of life in the USA,...
Original Article
The Viability of Liver Graft for Transplantation After Prolonged Warm Ischaemia
Liver transplantation (LTx) is the treatment of choice for many patients with end stage liver disease. However liver allograft availability prevents its widespread application.
This...
Original Article
Extended Resection of Locally Advanced (T4) Stomach Cancer
Cancer is the most common cause of death in Singapore. Although there is a gradual decline in incidence of stomach cancer over the years,...
Others
Laparoscopic Totally Extraperitoneal Inguinal Hernioplasty: An Audit of the Early Postoperative Results of 100 Consecutive Repairs
Inguinal hernia is one of the commonest surgical pathologies in the world. Laparoscopic totally extraperitoneal repair has been gaining popularity in recent years.
This article...
Original Article
Perioperative Deaths: A Further Comparative Review of Coroner’s Autopsies with Particular Reference to the Occurrence of Fatal Iatrogenic Injury
Beginning in 1991, the Department of Forensic Medicine (DFM), which undertakes all Coroner’s casework locally, embarked on an on-going review of Coroner’s perioperative autopsies...
Others
The Role of Cytokines and Cytokine Gene Polymorphism in T-cell Activation and Allograft Rejection
Cytokines are peptide molecules that are responsible for intercellular signalling during immune activation events. Cytokines are responsible, in large part, for the regulation of...
Others
Proteinuria and Angiotensin Converting Enzyme (ACE) Gene Polymorphism
Proteinuria is considered a marker of renal disease. Traditionally it has been thought that proteinuria is the result of diseased glomeruli.
This article is available...
Others
Genetics of Immunoglobulin A Nephropathy
Immunoglobulin (Ig) A nephropathy is the most common primary glomerulonephritis in various parts of the world, and it was detected in 25% of biopsy...
Original Article
Microdochectomy for Single-duct Nipple Discharge
Nipple discharge is a common disturbing symptom for many women and often leads to a surgical referral. It accounts for 3% to 5% of...
Original Article
Perioperative and Rehabilitative Outcomes after Amputation for Ischaemic Leg Gangrene
In the last century, Sir William Ferguson said: “amputation—one of the meanest and yet one of the greatest operations in surgery: mean, where resorted...
Original Article
Adverse Operative Risk Factors for Perforated Peptic Ulcer
Although there has been a significant decline in elective surgery for peptic ulcer disease with the introduction of H-2 blocker, the incidence of peptic...
Others
10th Chapter of Surgeons’ Lecture: The Challenges in Surgery—Past, Present and Future, and in Search of the 4Cs
Firstly may I thank the Academy of Medicine and the Chapter of Surgeons for giving me this great privilege and honour to deliver the...
Original Article
Results of Surgical Resection of Oesophageal Carcinoma in Singapore
Although the incidence of oesophageal carcinoma is declining, it still remains a common cancer in Singapore. From 1988 to 1992, it was the ninth...
Others
Bilateral Synchronous Renal Oncocytoma: A Case Report and Review
Oncocytomas are neoplasms characterised by large epithelial cells with finely granular eosinophilic cytoplasm called oncocytes. They were first described by Zippel in 1942 and...
Others
Case Report: Follicular Adenoma in a Thyroglossal Duct Remnant Arising Entirely within the Hyoid Bone
Thyroglossal duct remnant is one of the most common lesions of the anterior midline neck. It occurs in 7% of adults1 and carcinoma is...
Original Article
Digital Hand-held Sonography Utilised for the Focused Assessment with Sonography for Trauma: A Pilot Study
On a global basis, the use of ultrasonography to assist clinicians in obtaining timely diagnoses in abdominal trauma is not particularly new. The first...
Original Article
The Alvarado Score and Acute Appendicitis
Acute appendicitis is a common surgical emergency. However, it is often difficult to make an accurate preoperative diagnosis, especially during the early stage of...
Others
Case Reports of Low Dose Cyclosporine A Therapy in Adult Minimal Change Nephrotic Syndrome
There have been many reports on the use of conventional doses of cyclosporine A (CsA) in inducing remission among adults with minimal change nephrotic...
Review Article
Intra-abdominal Hypertension—Implications for the Intensive Care Physician
Although the detrimental effects of raised intra-abdominal pressure have been known for over 100 years, it is only in the last two decades that...
Original Article
Perioperative Treatment with Bactericidal/Permeability-Increasing Protein (rBPI21) in Major Liver Surgery: A Concise Summary
Primary and secondary hepatic malignancies constitute a major health problem. Hepatocellular carcinoma accounts for 90% of all primary hepatic malignancies in the world. While...
Others
Mucinous Cystadenoma of the Appendix—An Unusual Cause of Intestinal Obstruction
Mucinous cystadenoma of the vermiform appendix is an uncommon entity. It is a benign lesion but may disseminate and lead to the development of...
Others
A Case Report of Primary Hyperparathyroidism with Severe Bony Involvement and Nephrolithiasis
Primary hyperparathyroidism is said to have evolved from a disease of “bones, stones and groans”, to one that is largely asymptomatic with a relatively...
Original Article
A Prospective Evaluation of Surgeon Performed Sonography as a Screening Test in Blunt Abdominal Trauma
Over the past decade, sonography as a screening tool in the evaluation of abdominal trauma has been thoroughly investigated. This modality was first used...
Editorial
Stapled Haemorrhoidectomy—The Evidence For and the Facts Against
Surgeons as well as patients have recently shown much interest in stapled haemorrhoidectomy. This is a new technique, which is claimed to result in...
Others
12th Chapter of Surgeons Lecture: Shifting Paradigms in the Management of Breast Cancer—A Surgical Perspective
The recorded history of breast cancer management spans four millennia. This story about breast cancer management is also one about change, about resistance to...
Others
Double Omental Hernia—Case Report on a Very Rare Cause of Intestinal Obstruction
Internal hernia is defined as the protrusion of a viscus through a normal or abnormal opening within the confines of the abdominal cavity. This...
Others
The Course of Pregnancy in a Patient with Nail-Patella Syndrome
The nail-patella syndrome (NPS) is a rare autosomal dominant disorder defined by the association of nail dysplasia, bone abnormalities and, frequently, renal disease. We...
Original Article
Pregnancy after Renal Transplantation: Experience in Singapore General Hospital
Successful renal transplantation significantly improves the sexual and reproductive functions of women with end-stage renal disease and offers the best hope for those who...
Others
Adrenal Myelolipoma Presenting with Spontaneous Retroperitoneal Haemorrhage Demonstrated on Computed Tomography and Angiogram—A Case Report
Adrenal myelolipoma is a rare, benign tumour, usually an incidental finding. Spontaneous retroperitoneal haemorrhage resulting from this tumour is rare.
This article is available only...
Original Article
Emergency Laparoscopic Surgery—The Changi General Hospital Experience
Today, laparoscopic surgery has achieved widespread acceptance among surgeons as well as the general public. Emergency laparoscopic procedures (ELPs) have been performed since the...
Original Article
Surgical Management and Outcome of Carotid Body Tumours
The carotid body was first described by von Haller in 1743. It is often a small ovoid or irregular mass composed of compact pinkish...
Original Article
Hepatolithiasis —A Case Series
Intrahepatic biliary stone or hepatolithiasis is an uncommon entity worldwide, with a higher incidence in East Asia in comparison to the West. As yet,...
Others
Acute Embolic Occlusion of the Superior Mesenteric Artery: A Case Report and Discussion of Management
Acute ischaemia of the bowel is a devastating condition. Recently published figures on mortality range from 30% to 60%.
This article is available only as...
Others
Imaging of Paediatric Mediastinal Masses
A review of mediastinal masses in children, emphasising imaging features, is important for several reasons. Firstly, the mediastinum is the most common location for...
Original Article
Hepatic Resection for Colorectal Metastases to the Liver: The National Cancer Centre/Singapore General Hospital Experience
Colorectal carcinoma is the fourth most common malignancy and the second leading cause of death worldwide. Although surgical resection in combination with adjuvant chemotherapy...
Review Article
Current Status in Imaging of Colorectal Liver Metastases
Colorectal cancer is a common primary that metastasizes to the liver. About 20% of patients with colorectal cancer will have detectable metastases at the...
Review Article
Practical Issues in Adjuvant Therapy for Rectal Cancer
This article is available only as a PDF. Please click on “Download PDF” on top to view the full article.
Review Article
Total Mesorectal Excision (TME) – Twenty Years On
In 1982, Heald et al1 at the Basingstoke District General Hospital introduced the concept of total mesorectal excision (TME) as a means of performing...
Original Article
Flat and Depressed Lesions of the Colon and Rectum: Pathogenesis and Clinical Management
It was previously thought that the vast majority of colorectal cancers were derived from polypoid adenomas. However, several investigators have noted that most colorectal...
Others
Inflammatory Fibroid Polyp of the Caecum in a Patient with Neurofibromatosis
Inflammatory fibroid polyp is an uncommon nonneoplastic lesion found in the gastrointestinal tract. It is a benign, non-encapsulated submucosal lesion, composed mainly of loose...
Original Article
Seasonal Variations of Clinical and Biochemical Parameters in Chronic Haemodialysis
Seasonal variations in the general population in some body functions and diseases incidences have been well-established (e.g., vitamin D levels, allergic rhinitis, blood pressure,...
Others
15th Chapter of Surgeons Lecture: Surgeon of the New Millennium – Surgeon, Scientist and Scholar
Next year, we celebrate a hundred years of medical education in Singapore. We have come a long way since 1821 – from a small,...
Others
Littoral Cell Angioma of the Spleen
The littoral cells line the vascular channels of the red pulp of the spleen and have characteristics of endothelial and histiocytic cells. In 1991,...
Others
A Case of Cystic Leiomyoma Mimicking an Ovarian Malignancy
Uterine leiomyomas are the most common gynaecological tumour. Typical appearances of leiomyomas are easily recognised on imaging.
This article is available only as a PDF....
Review Article
Molecular Adsorbent Recirculating System (MARS)
Liver failure is clinically heterogeneous in aetiology, pathophysiology, clinical severity and prognoses. It can be divided into the following categories: acute liver failure (ALF),...
Original Article
Hand-assisted Laparoscopic Living Donor Nephrectomy
Minimally invasive donor nephrectomy using laparoscopic techniques has become a very attractive method of procuring kidneys from live donors, compared to the traditional standard...
Editorial
Positron Emission Tomography – A Vital Component of Molecular Imaging
Contemporary medical imaging is progressing towards quantification of tissue function in addition to merely providing anatomical information, as illustrated by the rising use of...
Others
3rd College of Physicians’ Lecture – Translational Research: From Bench to Bedside and From Bedside to Bench; Incorporating a Clinical Research Journey in IgA Nephritis (1976 to 2006)
In our quest to pursue knowledge regarding a patient’s illness or seek a cure for the disease, as doctors we have to derive the...
Others
Cutaneous and Subcutaneous Metastases of Adenocarcinoma of the Colon and Rectum
Cutaneous metastasis from colorectal adenocarcinoma is an interesting condition not only because of its rarity, it occurs in less than 4% of patients with...
Original Article
Role of Ultrasound Biomicroscopy (UBM) in the Detection and Localisation of Anterior Segment Foreign Bodies
The presence of an intraocular foreign body (IOFB) is a common complication of ocular trauma. For surgical planning, the localisation of IOFBs has to...
Original Article
Infected Pancreatic Necrosis – An Evaluation of the Timing and Technique of Necrosectomy in a Southeast Asian Population
The management of necrotising pancreatitis has improved significantly over the last 2 decades, with a corresponding improvement in mortality rates. This improvement is largely...
Others
Complications Relating to Intravenous Buprenorphine Abuse: A Single Institution Case Series
Buprenorphine, more commonly known as Subutex (Reckitt Benckiser Pharmaceuticals), has been released in Singapore since 2002. Initially marketed as an opiate substitute to help...
Others
Guidelines on Cardiac CT in Singapore (2006)
The heart is difficult to image because of its complex wall motion and variability of the cardiac cycle. Recent advances in 16 and 64-slice...
Editorial
Commercial Renal Transplantation – Body Parts for Sale
A 45-year-old Singaporean was seen for review by a nephrologist at a restructured hospital. She had been on follow up by a private nephrologist...
Others
Gastric Pneumatosis after Endoscopic Argon Plasma Coagulation
Argon plasma coagulation (APC) is a major haemostatic modality for large surface bleeding areas.1 It effects thermal coagulation with limited and controlled tissue depth...
Others
Parathyroid Carcinoma: A Case Series
Parathyroid carcinomas account for 1% to 3% of patients with primary hyperparathyroidism (PHPT).1 Patients usually present with a severe form of hyperparathyroidism at diagnosis,...
Original Article
Implementation and Evaluation by Formal Assessments and Term End Student Feedback of a New Methodology of Clinical Teaching in Surgery in Small Group Sessions
In clinically-oriented subjects such as surgery, specific guidelines for conducting small group teachings are lacking. Different methods are being practiced and researched in different...
Letter to the Editor
Successful Management of an Iatrogenically-ingested Sharp Foreign Body
A 37-year-old man with no significant medical history underwent dental treatment. An injection dental needle used in the course of root canal treatment came...
Letter to the Editor
Assessment of Medical Graduates Competencies
Medical professional proficiency comprises a set of skills, knowledge, and attitudes necessary to efficiently accomplish the practice of medicine. The major aim of undergraduate...
Original Article
Angiotensin-Converting Enzyme Inhibitor versus Angiotensin 2 Receptor Antagonist Therapy and the Influence of Angiotensin-Converting Enzyme Gene Polymorphism in IgA Nephritis
Angiotensin converting enzyme inhibitors (ACEI) and angiotensin II receptor antagonists (ATRA) are both well established drugs utilised to help retard the progression of chronic...
Letter to the Editor
Advanced Burkitt’s Lymphoma Presenting With Jejunal Perforation
Burkitt’s lymphoma (BL) is a high grade B-cell neoplasm under the umbrella of non-Hodgkin’s lymphomas. It is predominantly seen in children but may also...
Others
Angioplasty in Critical Limb Ischaemia: One-year Limb Salvage Results
Critical limb ischaemia (CLI) is the most severe form of peripheral vascular disease where there is inadequate blood flow to a limb to maintain...
Original Article
Obturator Hernia in an Ageing Society
Obturator hernia is often seen in elderly, thin females and is usually manifested by recurrent bouts of intestinal obstruction and thigh or knee pain...
Original Article
Multimodal prehabilitation before major abdominal surgery: A retrospective study
Ageing is one of the biggest public health concerns of the 21st century, presenting a challenge to the practice of medicine globally. As the...
Letter to the Editor
ANCA-negative Pauci-immune Crescentic Glomerulonephritis with Thrombotic Microangiopathy
Pauci-immune crescentic glomerulonephritis (Pauci-immune CGN) is the most common cause of CGN. Thrombotic microangiopathy (TMA) defines a clinicopathological syndrome consisting of intraluminal platelet thrombosis...
Others
Hepatocellular Carcinoma Peritoneal Metastases: Report of Three Cases and Collective Review of the Literature
Peritoneal dissemination of hepatocellular carcinoma (HCC) is a rare presentation, with an incidence of 2% to 6% detected during autopsy or laparoscopy. Although uncommon,...
Review Article
Colorectal Cancer Liver Metastases – Understanding the Differences in the Management of Synchronous and Metachronous Disease
Colorectal cancer (CRC) is one of the commonest cancers worldwide with age standardised incidence rates of 22.8 to 64.2 and 19.0 to 46.7 per...
Original Article
Urotensin 2 and Retinoic Acid Receptor Alpha (RARA) Gene Expression in IgA Nephropathy
IgA nephropathy (IgAN) is the most common primary glomerulonephritis in Singapore1 and in many parts of the world, contributing significantly to the pool of...
Original Article
Epidemiology and Management of Surgical Upper Limb Infections in Patients with End-stage Renal Failure
Hand infections are common in the general population, and their management is usually uncomplicated. Several papers have noted that patients with diabetes mellitus have...
Original Article
Surgical Metastasectomy in AJCC Stage IV M1c Melanoma Patients with Gastrointestinal and Liver Metastases
The prognosis of patients with stage IV melanoma or recurrent melanoma is poor with an estimated median survival period of 6 months. The recent...
Letter to the Editor
Emergency Surgery for a Ruptured Intra-abdominal Desmoid Tumour
Desmoid tumours are fibrous benign tumours that are often indolent until local symptoms evolve. We highlight a rare case of a ruptured intra-abdominal desmoid...
Review Article
Novel Trends in Haemodialysis: Where Are We Heading?
Despite advances in haemodialysis technology over the past 40 years and rapid proliferation of clinical guidelines over the last decade promoting evidence-based practices, the...
Images in Medicine
Triplicate Ureter with Contralateral Duplicate Ureter
What do you see in this intravenous urogram?
1. Left lower ureteric calculus with proximal hydroureteronephrosis
2. Left duplicated ureter with lower ureteric calculus
3. Right triplicate...
Original Article
Profile of Hospitalisation and Death in the First Year after Diagnosis of End-stage Renal Disease in a Multi-ethnic Asian Population
End-stage renal disease (ESRD) is reaching epidemic proportions and is increasingly a public health issue due to the cost of providing care to these...
Images in Medicine
Primary Hyperoxaluria
An 18-year-old male presented with complaints of abdominal pain. He had history of previous episodes of renal colic and passage of stones in urine....
Images in Medicine
Lower limb nodules
A 45-year-old Chinese woman with no medical history or regular medications presented with painful nodules on her left shin that progressed to involve her...
Images in Medicine
A pedunculated mass of the thigh
A 61-year-old Chinese woman presented to the general surgery clinic for a long-standing lump over her proximal medial right thigh. The painless lump was...
Letter to the Editor
Acute Marjolin’s Ulcer: A Forgotten Entity
Marjolin’s ulcers are malignancies that arise from areas of chronic irritation or injury that undergo malignant transformation after a period of many years. Such...
Original Article
Kidney Cancer and Diabetes Mellitus: A Population-Based Case-Control Study in Taiwan
Kidney cancer accounts for 3% to 4% of all cancers. In a systematic review by Mathew and et al,2 the incidence of kidney cancer...
Commentary
200 years of surgery at the General Hospital, Singapore
Western medicine in Singapore began with Sir Stamford Raffles’ arrival on 28 January 1819 with a sub-assistant surgeon, Dr Thomas Prendergast, providing medical care...
Letter to the Editor
Low-Grade Fibromyxoid Sarcoma of the Thyroid: A Case Report
Dear Editor,
Low-grade fibromyxoid sarcoma (LGFMS) is a rare form of neoplasm that usually occurs in the deep soft tissue of the lower limbs with...
Original Article
Prevalence of Chronic Kidney Disease in Adults with Type 2 Diabetes Mellitus
According to the National Health Survey, the percentage of Singapore residents with diabetes mellitus (DM) aged between 18 and 69 years has risen from...
Original Article
Dietary Protein Intake in a Multi-ethnic Asian Population of Healthy Participants and Chronic Kidney Disease Patients
Clinical practice guidelines recommend different amounts of dietary protein intake for chronic kidney disease (CKD) patients. The recommended daily protein intake varies according to...
Original Article
Assessment of Age in Ulcerative Colitis Patients with Ileal Pouch Creation—An Evaluation of Outcomes
A total proctocolectomy is considered the standard of care in patients with ulcerative colitis (UC). The indications for this operation in patients with UC...
Images in Medicine
Avulsed Tip of a Systemic Iceberg
An 18-year-old male presented to the emergency
department of Khoo Teck Puat Hospital with knee pain
and swelling while playing basketball. He was unable to
bear weight....
Original Article
Evolution and trends in the adoption of laparoscopic liver resection in Singapore: Analysis of 300 cases
Over the past few decades, the introduction of laparoscopic surgery has been the biggest game changer in abdominal surgery.1 However, although the first laparoscopic...
Editorial
Laparoscopic liver resection: Global diffusion and learning curve
Laparoscopic liver resection (LLR) is being utilised with increasing frequency worldwide, as initial concerns about the safety and feasibility of LLR, such as the...
Commentary
Prehabilitation and Its Role in Geriatric Surgery
The population in Singapore is ageing rapidly. According to statistics, by 2030, 1 in 2 adults in Singapore will be >65 years old. As...
Original Article
New-onset cardiovascular risk factors following liver transplantation: A cohort analysis in Singapore
Malnutrition is well described in liver cirrhosis. The hyperdynamic circulation and altered metabolism in cirrhosis result in a hypercatabolic state which accelerates tissue breakdown....
Original Article
Outcomes of oesophageal cancer treated with neoadjuvant compared with definitive chemoradiotherapy
Oesophageal cancer is the 7th most common cancer in the world, with 572,034 new cases diagnosed in 2018, and is the 6th most common...
Letter to the Editor
Congenital adhesion band causing recurrent subacute intestinal obstruction in a virgin abdomen
Intestinal obstruction (IO) caused by malignancy and adhesion bands from previous surgery is common among adults. However, IO caused by congenital adhesion bands (CAB)...
Review Article
Endovenous cyanoacrylate ablation for chronic venous insufficiency and varicose veins among Asians
In the past 2 decades, the management of chronic venous insufficiency (CVI) has been revolutionised by the introduction of minimally invasive endovenous techniques, which...
Editorial
Transcatheter Aortic Valve Implantation in Singapore: Reflecting on the First Decade
Transcatheter aortic valve implantation (TAVI) has markedly changed the way aortic valve stenosis is treated. It is 18 years since the first patient was...
Letter to the Editor
Circulatory collapse from rupture of splenic artery aneurysm: A case study
Splenic artery aneurysms (SAAs) are uncommon and often asymptomatic. However, ruptured SAAs can be rapidly fatal. We reviewed the literature on SAAs and highlighted...
Letter to the Editor
Penile preserving surgery in penile cancer management
Penile cancer is a condition that accounts for approximately 0.4% of cancers among Singapore males. Overall, this is an uncommon cancer with higher rates...