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Article: Ligation of the Intersphincteric Fistula Tract as an Emergency Treatment for Cryptoglandular Anal Fistula.

Dualim, Diana Melissa / Wong, Michael Pak-Kai / Rusli, Siti Mayuha / Elnaim Ali, Abdel Latif Khalifa / Sagap, Ismail

The Malaysian journal of medical sciences : MJMS

2024 Volume 31, Issue 1, Page(s) 62–70

Abstract: Introduction: Ligation of the intersphincteric fistula tract (LIFT) is a sphincter-preserving procedure for treating anal fistula of cryptoglandular origin. Our prospective study aimed to determine the postoperative outcomes of patients undergoing LIFT ... ...

Abstract	Introduction: Ligation of the intersphincteric fistula tract (LIFT) is a sphincter-preserving procedure for treating anal fistula of cryptoglandular origin. Our prospective study aimed to determine the postoperative outcomes of patients undergoing LIFT in emergency and elective settings. Methods: This was a single-centre prospective observational study of the LIFT procedure for the treatment of anal fistulas. The differences in the 6-month postoperative outcomes between the emergency and elective procedures were analysed, including the healing rate, healing time, recurrence rate, recurrence time, postoperative complications and length of hospital stay. Results: Twenty-two patients were recruited for this study: 11 patients underwent LIFT as an emergency procedure (EM-LIFT), while the others underwent LIFT as an elective procedure (EL-LIFT). The healing rate for the EM-LIFT group was 90.9% ( Conclusion: EM-LIFT is a feasible and safe primary procedure for active cryptoglandular-type anal fistulas.
Language	English
Publishing date	2024-02-28
Publishing country	Malaysia
Document type	Journal Article
ZDB-ID	2197205-9
ISSN	2180-4303 ; 1394-195X
ISSN (online)	2180-4303
ISSN	1394-195X
DOI	10.21315/mjms2024.31.1.5
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Article: The Value of Cutting Seton for High Transsphincteric Anal Fistula in the Era of Its Misery.

Elnaim Ali, Abdel Latif Khalifa / Wong, Michael Pak-Kai / Sagap, Ismail

The Malaysian journal of medical sciences : MJMS

2022 Volume 29, Issue 1, Page(s) 55–61

Abstract: Objectives: We studied the outcome of cutting seton in the treatment of a high transsphincteric anal fistula in Sudan.: Methods: This was a prospective study of high transsphincteric anal fistulas at Kassala Police Hospital, Sudan, over the course of ...

Abstract	Objectives: We studied the outcome of cutting seton in the treatment of a high transsphincteric anal fistula in Sudan. Methods: This was a prospective study of high transsphincteric anal fistulas at Kassala Police Hospital, Sudan, over the course of 24 months (2016-2017). The main outcomes measured were recurrence, incontinence and primary healing rates. Results: The cases of 72 patients treated with cutting seton for high transsphincteric fistula were analysed, with 50 (70%) of the patients being male and 22 (30%) being female. Forty-eight (66.7%) patients required two sessions of seton tightening with a duration of seton treatment of 30 days and 24 (33.3%) patients required three sessions with a duration of seton treatment of 45 days. Only one patient (1.4%) had flatus incontinence. Three (4.2%) patients had minimal bleeding from the seton site and two (2.8%) patients experienced fistula recurrence. Twenty-six (36%) patients achieved complete healing within 30 days, while 36 (54.3%) patients healed within 60 days. The remaining seven (9.7%) patients healed after 60 days. Chronic pain was reported by two (2.8%) patients after complete healing. Conclusion: In Sudan, cutting seton remains relevant, as it produces minimal incontinence with a low recurrence rate in high transsphincteric fistula treatment.
Language	English
Publishing date	2022-02-23
Publishing country	Malaysia
Document type	Journal Article
ZDB-ID	2197205-9
ISSN	2180-4303 ; 1394-195X
ISSN (online)	2180-4303
ISSN	1394-195X
DOI	10.21315/mjms2022.29.1.6
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Article: A Prospective Interventional Study on LigaSure

Elnaim, Abdel Latif K / Musa, Shareef / Wong, Michael Pak-Kai / Sagap, Ismail

The Malaysian journal of medical sciences : MJMS

2021 Volume 28, Issue 5, Page(s) 102–107

Abstract: Objective: This study was designed as a prospective and interventional study that evaluated LigaSure™ haemorrhoidectomies with regional anaesthesia as a daycare procedure.: Methods: Patients with third- and fourth-degree haemorrhoids were recruited ... ...

Abstract	Objective: This study was designed as a prospective and interventional study that evaluated LigaSure™ haemorrhoidectomies with regional anaesthesia as a daycare procedure. Methods: Patients with third- and fourth-degree haemorrhoids were recruited from the clinic from January 2018 to December 2019. The procedure was performed as a day case under regional anaesthesia. Using a LigaSure Results: A total of 264 patients were enrolled. There were 153 males (57.9%) with a median age of 30 years old (range 16 years old-80 years old). A total of 142 patients (54%) had third-degree haemorrhoids, while the rest had fourth-degree haemorrhoids. The median operating time was 8 min (range 4 min-17 min) and minimal blood loss was observed. During follow-up, the complications were one case (0.3%) had anal stenosis, one case (0.3%) had minimal bleeding and one case (0.3%) had urine retention. Upon discharge, four patients (1.5%) required additional analgesia and another four (1.5%) developed post-spinal headaches. No incontinence was encountered. Conclusion: LigaSure™ excisional haemorrhoidectomy is a safe and effective daycare procedure with acceptable re-admission and complication rates.
Language	English
Publishing date	2021-10-26
Publishing country	Malaysia
Document type	Journal Article
ZDB-ID	2197205-9
ISSN	2180-4303 ; 1394-195X
ISSN (online)	2180-4303
ISSN	1394-195X
DOI	10.21315/mjms2021.28.5.10
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Article: Perineum Spindle Cell Sarcoma in Neurofibromatosis Type 1.

Sandrasecra, Sanjeev / Vasan, Senthil / Henry, Fitjerald / Abdullah, Salmi / Hashim, Mohd Nizam Md / Merican, Siti Rahmah Hashim Isa / Wong, Michael Pak-Kai

Oman medical journal

2023 Volume 38, Issue 1, Page(s) e471

Abstract: Soft tissue neoplasm is common among patients with neurofibromatosis type 1 (NF-1). We present a case of a middle-aged woman with NF-1 who presented with a painless, insidiously increasing perineal mass for the past eight months. She underwent ... ...

Abstract	Soft tissue neoplasm is common among patients with neurofibromatosis type 1 (NF-1). We present a case of a middle-aged woman with NF-1 who presented with a painless, insidiously increasing perineal mass for the past eight months. She underwent colonoscopy, computed tomography staging, magnetic resonance imaging of the pelvis, core-needle biopsy, and later wide local excision of left perineum swelling. Histopathological examination showed a high-grade spindle cell sarcoma, which is a rare association among NF-1. Spindle cell sarcoma is a group of malignant soft tissue tumors with locally destructive growth with spindle-shaped neoplastic cells. The solitary spindle cell sarcoma of the perineum is rare, and wide local resection with a clear margin is the only treatment at present-the scarcely available evidence limiting the use of adjuvant chemotherapy, immunotherapy, and radiotherapy.
Language	English
Publishing date	2023-01-31
Publishing country	Oman
Document type	Case Reports
ZDB-ID	2571431-4
ISSN	2070-5204 ; 1999-768X
ISSN (online)	2070-5204
ISSN	1999-768X
DOI	10.5001/omj.2023.08
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Article ; Online: Feasibility analysis of treating breast cancer patients with breast-conserving surgery via a periareolar incision combined with non-lipolytic suspension-type mastoscopy.

Liu, Jiaqi / He, Guijin / Zhang, Yiwen / Wong, Michael Pak-Kai / Chu, Jun / Kong, Linna / Yahya, Maya Mazuwin

Scientific reports

2023 Volume 13, Issue 1, Page(s) 12129

Abstract: The purpose is to analyze and compare postoperative recovery and complication incidence between a periareolar incision combined with Suspension-type Mastoscopic Axillary Lymph Node Dissection (SMALND) and traditional inflated Mastoscopic Axillary Lymph ... ...

Abstract	The purpose is to analyze and compare postoperative recovery and complication incidence between a periareolar incision combined with Suspension-type Mastoscopic Axillary Lymph Node Dissection (SMALND) and traditional inflated Mastoscopic Axillary Lymph Node Dissection (MALND). This was a randomized trial conducted from June 1, 2020, to April 30, 2022, in the Department of Second Breast Surgery, Shengjing Hospital of China Medical University, and the Department of Thyroid and Breast Surgery, Zibo Central Hospital, in accordance with the criteria of inclusion and exclusion. Overall, 126 patients diagnosed and treated for early-stage breast cancer were selected to undergo periareolar-incision breast-conserving surgery. Those patients who underwent periareolar-incision surgery combined with SMALND formed the observation group (SMALND Group), while those who underwent periareolar-incision surgery combined with traditional inflation became MALND Group. In the two groups, paired data "t" was used to examine, analyze, and compare the postoperative daily drainage volume and drain removal time, while paired data "χ
MeSH term(s)	Female ; Humans ; Axilla/surgery ; Axilla/pathology ; Blood Loss, Surgical ; Breast Neoplasms/surgery ; Breast Neoplasms/pathology ; Edema ; Feasibility Studies ; Lymph Node Excision ; Mastectomy, Segmental/adverse effects ; Paresthesia ; Surgical Wound/surgery
Language	English
Publishing date	2023-07-26
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-39199-y
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Article: Giant solitary juvenile polyp: from obstructed defecation syndrome to incontinence.

Teoh, Zhan Huai / Soh, Jien Yen / Mohamad, Nasibah / Zawawi, Norzaliana / Zakaria, Andee Dzulkarnaen / Zakaria, Zaidi / Wong, Michael Pak-Kai

Annals of coloproctology

2022

Abstract: Juvenile polyps (JPs) are the most common polyps in pediatric patients. We present the case of an 18-year-old male patient with a giant solitary JP resembling solitary rectal ulcer syndrome (SRUS). The presenting history was rectal bleeding and symptoms ... ...

Abstract	Juvenile polyps (JPs) are the most common polyps in pediatric patients. We present the case of an 18-year-old male patient with a giant solitary JP resembling solitary rectal ulcer syndrome (SRUS). The presenting history was rectal bleeding and symptoms of obstructed defecation syndrome. Colonoscopy revealed a polypoidal mass at the anorectal junction, with biopsy-confirmed SRUS. The symptoms worsened, and a protruding mass from the anus caused fecal incontinence. Pelvic magnetic resonance imaging showed a huge pedunculated mass occupying the low rectum with local compression of the urinary bladder. Transanal excision of the anal tumor was performed due to bleeding. A histopathological examination showed a JP with high-grade dysplasia. A histological examination to differentiate JPs and SRUS could be challenging based on a superficial forceps biopsy. Therefore, an excision biopsy is usually warranted with the understanding that adenomatous or malignant transformation is found in 5.6% to 12% of all JPs.
Language	English
Publishing date	2022-11-25
Publishing country	Korea (South)
Document type	Journal Article
ZDB-ID	2711906-3
ISSN	2287-9722 ; 2287-9714
ISSN (online)	2287-9722
ISSN	2287-9714
DOI	10.3393/ac.2022.00549.0078
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Article: Acquiring Advanced Laparoscopic Colectomy Skills - The Issues.

Amin-Tai, Hizami / Elnaim, Abdel Latif Khalifa / Wong, Michael Pak Kai / Sagap, Ismail

The Malaysian journal of medical sciences : MJMS

2020 Volume 27, Issue 5, Page(s) 24–35

Abstract: Colorectal surgery has been revolutionised towards minimally invasive surgery with the emergence of enhanced recovery protocol after surgery initiatives. However, laparoscopic colectomy has yet to be widely adopted, due mainly to the steep learning curve. ...

Abstract	Colorectal surgery has been revolutionised towards minimally invasive surgery with the emergence of enhanced recovery protocol after surgery initiatives. However, laparoscopic colectomy has yet to be widely adopted, due mainly to the steep learning curve. We aim to review and discuss the methods of overcoming these learning curves by accelerating the competency level of the trainees without compromising patient safety. To provide this mini review, we assessed 70 articles in PubMed that were found through a search comprised the keywords laparoscopic colectomy, minimal invasive colectomy, learning curve and surgical education. We found England's Laparoscopic Colorectal National Training Programme (LAPCO-NTP) England to be by far the most structured programme established for colorectal surgeons, which involves pre-clinical and clinical phases that end with an assessment. For budding colorectal trainees, learning may be accelerated by simulator-based training to achieve laparoscopic dexterity coupled with an in-theatre proctorship by field experts. Task-specific checklists and video recordings are essential adjuncts to gauge progress and performance. As competency is established, careful case selections with the proctor are essential to maintain motivation and ensure safe performances. A structured programme to establish competency is vital to help both the proctor and trainee gauge real-time progress and performance. However, training systems both inside and outside the operating theatre (OT) are equally useful to achieve the desired performance.
Language	English
Publishing date	2020-10-27
Publishing country	Malaysia
Document type	Journal Article ; Review
ZDB-ID	2197205-9
ISSN	2180-4303 ; 1394-195X
ISSN (online)	2180-4303
ISSN	1394-195X
DOI	10.21315/mjms2020.27.5.3
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Article ; Online: The effect of pre-endoscopy maltodextrin beverage on gastric residual volume and patient's well-being: a randomised controlled trial.

Zulkifli, Mohd Firdaus / Md Hashim, Mohd Nizam / Zahari, Zalina / Wong, Michael Pak-Kai / Syed Abd Aziz, Syed Hassan / Yahya, Maya Mazuwin / Wan Zain, Wan Zainira / Zakaria, Andee Dzulkarnaen / Ramely, Rosnelifaizur / Jien Yen, Soh / Othman, Muhammad Faeid

Scientific reports

2023 Volume 13, Issue 1, Page(s) 20078

Abstract: Prolonged fasting prior to oesophagogastroduodenoscopy (OGDS) could be noxious to patients' well-being. Strict fasting protocol has been used prior to OGDS with the concern of reduced visibility or suboptimal endoscopic assessment. Maltodextrin beverages ...

Abstract	Prolonged fasting prior to oesophagogastroduodenoscopy (OGDS) could be noxious to patients' well-being. Strict fasting protocol has been used prior to OGDS with the concern of reduced visibility or suboptimal endoscopic assessment. Maltodextrin beverages were also commonly used as the pre-operative carbohydrate loading in enhanced recovery after surgery (ERAS) protocol. Our study aimed to look for the effects of maltodextrin beverage 2 h before OGDS on gastric residual volume and patient's well-being scores. This was a single-blinded, stratified randomised controlled trial, comparing control group (A, received 400 ml of plain water) and carbohydrate loading group (B, received 400 ml of Carborie). The primary objectives were to measure the gastric residual volume (GRV) and patient's well-being scores using visual analogue scale (VAS) scores for hunger, thirst, anxiety, tiredness and general discomfort. Of 80 randomised patients, 78 completed the study (38 received plain water and 40 Carborie). The median (IQR) GRV was not significantly different between group A and B (5.0 ml (20) vs 4.0 ml (19), p = 0.777). Both groups showed significant reduction in VAS scores in all five parameters (p ≤ 0.001). There were no complications attributed to endoscopy in either group. Pre-endoscopy maltodextrin beverage is as safe as clear water with improved patient's well-being in both groups.Clinical Trial Registration: NCT05106933.
MeSH term(s)	Humans ; Residual Volume ; Endoscopy, Gastrointestinal/adverse effects ; Beverages ; Water
Chemical Substances	maltodextrin (7CVR7L4A2D) ; Water (059QF0KO0R)
Language	English
Publishing date	2023-11-16
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-47357-5
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Article: Multiple gastrointestinal melanoma causing small bowel intussusception.

Eng, Jian Yang / Tahkin, Salehah / Yaacob, Huzairi / Yunus, Nor Hayati / Sidek, Ahmad Shan Wani Mohamed / Wong, Michael Pak-Kai

Annals of coloproctology

2021 Volume 39, Issue 1, Page(s) 85–88

Abstract: A 61-year-old gentleman presented with small bowel intussusception from small bowel melanoma intussusceptum. He complains of intermittent abdominal distension but no history of intestinal obstruction. Apart from this, he was also symptomatic anemia which ...

Abstract	A 61-year-old gentleman presented with small bowel intussusception from small bowel melanoma intussusceptum. He complains of intermittent abdominal distension but no history of intestinal obstruction. Apart from this, he was also symptomatic anemia which required repeated transfusion for the past few months. The contrast-enhanced computed tomography of the abdomen shows an omental mass with small bowel intussusception. He then underwent an exploratory laparotomy with segmental resection of the affected segment. Histopathological examination confirmed primary gastrointestinal melanoma. Multiple small bowel malignant melanoma is a rare disease. It remains a controversial diagnosis as it may be a primary or metastasis from an unidentified or regressed primary cutaneous melanoma. Prompt surgical intervention enables us to obtain tissue diagnosis, prevent complete intestinal obstruction and strategize the goals of treatment for the patient.
Language	English
Publishing date	2021-07-21
Publishing country	Korea (South)
Document type	Case Reports
ZDB-ID	2711906-3
ISSN	2287-9722 ; 2287-9714
ISSN (online)	2287-9722
ISSN	2287-9714
DOI	10.3393/ac.2021.00143.0020
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Article: Comparing Low Volume Versus Conventional Volume of Polyethylene Glycol for Bowel Preparation during Colonoscopy: A Randomised Controlled Trial.

Othman, Muhammad Faeid / Zakaria, Andee Dzulkarnaen / Yahya, Maya Mazuwin / Md Hashim, Mohd Nizam / Wan Mokhter, Wan Mokhzani / Wan Zain, Wan Zainira / Mohamad, Ikhwan Sani / Mohd Shah, Mohd Shahrulsalam / Syed Abd Aziz, Syed Hassan / Nik Ab Kadir, Mohd Nasrullah / Zakaria, Zaidi / Wong, Michael Pak-Kai

The Malaysian journal of medical sciences : MJMS

2023 Volume 30, Issue 5, Page(s) 106–115

Abstract: Background: Polyethylene glycol (PEG) solution is widely used as a colonoscopic bowel cleaning agent, although some patients are intolerant due to the need for ingesting large solution volumes and unpleasant taste. A low-volume solution may enhance ... ...

Abstract	Background: Polyethylene glycol (PEG) solution is widely used as a colonoscopic bowel cleaning agent, although some patients are intolerant due to the need for ingesting large solution volumes and unpleasant taste. A low-volume solution may enhance patient tolerability and compliance in bowel preparation. Accordingly, this study compared the effectiveness of two difference PEG volumes for bowel preparation before colonoscopy in terms of bowel cleanliness, completeness of colonoscopy, patient tolerability and colonoscopy duration. Methods: Using a prospective randomised controlled single-blinded study design, 164 patients scheduled for colonoscopy were allocated to two groups ( Results: There were no statistically significant differences between the two intervention groups in terms of bowel cleanliness ( Conclusion: Low-volume (2 L) PEG is as effective as the standard 3 L solution in bowel cleaning before colonoscopy; however, the superiority of either solution could not be established.
Language	English
Publishing date	2023-10-30
Publishing country	Malaysia
Document type	Journal Article
ZDB-ID	2197205-9
ISSN	2180-4303 ; 1394-195X
ISSN (online)	2180-4303
ISSN	1394-195X
DOI	10.21315/mjms2023.30.5.9
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