1.Endoscopic Findings in Patients Under the Age of 40 Years with Hematochezia in Singapore
Man Hon TANG ; Fung Joon FOO ; Chee Yung NG
Clinical Endoscopy 2020;53(4):466-470
Background/Aims:
Sigmoidoscopy is performed in most medical centers to evaluate the distal colons of young adults presenting with hematochezia who are at risk of developing proximal lesions. Colonoscopies offer more complete evaluations but are associated with a higher incidence of complications and possible low yield.
Methods:
An analysis was conducted on colonoscopies performed in our center on patients 40 years of age or younger. The study population was sub-divided into 2 age groups for analysis: <30 years of age and 30–39 years of age.
Results:
We recruited 453 patients for the study. Patients were 115 and 338 individuals that were <30 and 30–39 years of age, respectively. Hemorrhoids was identified as the cause of bleeding in the majority of cases. The overall incidence of polyps was 6.5%; this was significantly higher in the 30–39 age group (7.4% vs. 1.7%, p=0.026). There were two cases of advanced/malignant polyps. While the majority of the polyps were in the distal colon, 28% of the polyps in the older age group were found in the proximal colon. There was one case of colonic perforation.
Conclusions
Colonic polyps are more prevalent in patients aged 30–39. Colonoscopies should be considered for patients over the age of 30 with rectal bleeding.
2.The imitation game: a review of the use of artificial intelligence in colonoscopy, and endoscopists’ perceptions thereof
Sarah THAM ; Frederick H. KOH ; Jasmine LADLAD ; Koy-Min CHUE ; ; Cui-Li LIN ; Eng-Kiong TEO ; Fung-Joon FOO
Annals of Coloproctology 2023;39(5):385-394
The development of deep learning systems in artificial intelligence (AI) has enabled advances in endoscopy, and AI-aided colonoscopy has recently been ushered into clinical practice as a clinical decision-support tool. This has enabled real-time AI-aided detection of polyps with a higher sensitivity than the average endoscopist, and evidence to support its use has been promising thus far. This review article provides a summary of currently published data relating to AI-aided colonoscopy, discusses current clinical applications, and introduces ongoing research directions. We also explore endoscopists’ perceptions and attitudes toward the use of this technology, and discuss factors influencing its uptake in clinical practice.
4.An initial experience with laser haemorrhoidoplasty in addition to mucopexy for symptomatic haemorrhoids.
Ying Xin LOW ; Frederick Hong Xiang KOH ; Winson Jianhong TAN ; Sharmini Su A SIVARAJAH ; Leonard Ming Li HO ; Min Hoe CHEW ; Fung Joon FOO
Annals of the Academy of Medicine, Singapore 2022;51(4):253-254
5.Multimodal prerehabilitation for elderly patients with sarcopenia in colorectal surgery
Jingting WU ; Hannah CHI ; Shawn KOK ; Jason M.W. CHUA ; Xi-Xiao HUANG ; Shipin ZHANG ; Shimin MAH ; Li-Xin FOO ; Hui-Yee PEH ; Hui-Bing LEE ; Phoebe TAY ; Cherie TONG ; Jasmine LADLAD ; Cheryl H.M. TAN ; Nathanelle KHOO ; Darius AW ; Cheryl X.Z. CHONG ; Leonard M.L. HO ; Sharmini S. SIVARAJAH ; Jialin NG ; Winson J.H. TAN ; Fung-Joon FOO ; Bin-Tean TEH ; Frederick H. KOH
Annals of Coloproctology 2024;40(1):3-12
Sarcopenia, which is characterized by progressive and generalized loss of skeletal muscle mass and strength, has been well described to be associated with numerous poor postoperative outcomes, such as increased perioperative mortality, postoperative sepsis, prolonged length of stay, increased cost of care, decreased functional outcome, and poorer oncological outcomes in cancer surgery. Multimodal prehabilitation, as a concept that involves boosting and optimizing the preoperative condition of a patient prior to the upcoming stressors of a surgical procedure, has the purported benefits of reversing the effects of sarcopenia, shortening hospitalization, improving the rate of return to bowel activity, reducing the costs of hospitalization, and improving quality of life. This review aims to present the current literature surrounding the concept of sarcopenia, its implications pertaining to colorectal cancer and surgery, a summary of studied multimodal prehabilitation interventions, and potential future advances in the management of sarcopenia.