Search PubMed⌕ Search

Biomedical subjects

Y Tekant

Publications and source records attributed to Y Tekant.

26 records · Page 2Linked to original sources
PubMed1990

The surgical treatment of squamous cell carcinoma of the oesophagus in Singapore.

In a retrospective study, we reviewed 97 consecutive cases of squamous cell carcinoma collected over a five-year period (1978-1983). Resection of the tumour was possible in 30 out of 40 patients subjected to surgery. Of these 30 patients, five died within 30 days of surgery. Eight patients who underwent oesophageal resection were still alive after five years and apparently cured. Bypass surgery for unresectable lesions in six patients were complicated by anastomotic leakage in three patients. Patients unsuitable for surgical resection were treated using Celestin tube insertion or radiation. Mean survival in 13 patients with Celestin tube insertion was 4.1 months. Of 48 patients who were treated by radiotherapy, two lived beyond five years. Surgical resection restores swallowing effectively and offers a 25% chance of cure and should be done in fit patients. In unfit patients with advanced disease, palliation from the use of radiotherapy and Celestin tube insertion were poor. Newer techniques such as endoscopic laser recanalisation and bicap hyperthermia may need to be considered for palliation in this group of patients.

Adult↗
PubMedDate not supplied

Peroral tunable-dye laser lithotripsy of intrahepatic stones in oriental cholangitis.

This case report details the use of a pulsed tunable-dye laser lithotripter in the endoscopic management of recurrent intrahepatic stones in a patient with Oriental cholangitis. A 42-year-old Chinese man had a cholecystectomy and choledochoduodenostomy in 1980. Subsequently he had three episodes of recurrent cholangitis which responded to medical treatment. The patient presented in April 1989 with a fourth attack of cholangitis. Endoscopic retrograde cholangiopancreatography (ERCP) and ultrasound demonstrated a large mass of stones in the right intrahepatic ductal system. A flexible upper gastrointestinal endoscope was passed into the right hepatic duct via the choledochoduodenostomy. The stones were fragmented with a tunable-dye laser and the residual fragments were removed endoscopically.

Adult↗
PubMedDate not supplied

Endoscopic hemostasis of bleeding peptic ulcers.

Developments in therapeutic endoscopy over the last decade have made it possible to perform endoscopic hemostasis for bleeding peptic ulcers. This review traces the developments in this field in the Department of Surgery of the National University of Singapore. A recently conducted prospective randomized controlled trial using intralesional adrenaline and heater probe demonstrated that initial hemostasis could be achieved in 100% of patients with actively bleeding ulcers or stigmata of recent hemorrhage. The rebleed rate was 6.6% compared with 20.3% in a well-matched control group. The recent advent of laparoscopic vagotomy and laparoscopic Billroth II gastrectomy offers a low-morbidity surgical option to long-term medical treatment for the follow-up management of patients with bleeding ulcers.

Duodenal Ulcer↗
PubMedDate not supplied

Elective repair of abdominal wall hernias in decompensated cirrhosis.

BACKGROUND/AIMS: Abdominal wall hernia is a common feature of decompensated cirrhosis. However, literature on elective hernia repair in these patients is limited. Here we report the experience of our center. METHODOLOGY: Eleven hernias (seven umbilical, three inguinal and one incisional) in nine patients with decompensated cirrhosis were repaired. The indication for operation was repeated incarceration in two patients and significant pain in four; three patients with umbilical hernias had ulceration and necrosis of the overlying skin. Pre-operatively, medical therapy of ascites was conducted at the hepatology unit. Umbilical hernias were treated with the classic Mayo repair; in all cases but two, this was buttressed with a prolene graft. One inguinal hernia was repaired with the plication-darn technique; the other two and the incisional hernia were repaired with prolene grafts. RESULTS: There was no mortality. One patient had a scrotal hematoma; two patients had leakage of ascites into the wound. Seven patients were followed up. Four patients died without recurrence after a median period of 12 months (range 6-22). The other patients have no recurrence at 1, 10 and 40 months post-operatively. CONCLUSIONS: Umbilical and inguinal hernias in patients with decompensated cirrhosis may be repaired safely on an elective basis. Control of ascites is vital for success.

Adult↗