1.EUS-FNA of the left adrenal gland is safe and useful.
Tiing Leong ANG ; Tju Siang CHUA ; Kwong Ming FOCK ; Augustine K H TEE ; Eng Kiong TEO ; Kent MANCER
Annals of the Academy of Medicine, Singapore 2007;36(11):954-957
INTRODUCTIONThere are limited data on the use of endosonography-guided fine-needle aspiration (EUS-FNA) to determine the nature of left adrenal lesions. We described our experience in performing EUS-FNA of left adrenal lesions.
CLINICAL PICTUREDuring a 20-week period, data on consecutive patients who underwent EUS with or without EUS-FNA were prospectively captured. Patients with a left adrenal mass and who underwent EUS-FNA formed our study population.
TREATMENTEUS-FNA.
OUTCOMEA total of 119 consecutive patients underwent diagnostic EUS +/- FNA, during which the left adrenal gland was routinely examined. Twelve of these patients underwent EUS as part of lung cancer staging and among these 12 lung cancer patients, 2 had left adrenal masses detected by computed tomography (CT). EUS detected left adrenal nodules in 2 other patients which were not visualised by CT. The overall prevalence of a left adrenal mass was 3.4%; in the subgroup with confirmed lung cancer, the prevalence was 33.3%. All 4 patients were male, with a mean age of 76.3 years (range, 67 to 87). The mean size of the left adrenal lesion was 30.4 mm (range, 9 to 84.8). EUS-FNA of the left adrenal lesions was performed under Doppler guidance. The mean number of needle passes was 2 (range, 1 to 4). A cellular aspirate was obtained in all patients. No procedural complications occurred. Metastatic non-small cell lung cancer was diagnosed in 2 patients, including a lesion missed on CT. For the other 2 cases, EUS-FNA revealed benign adrenal cells.
CONCLUSIONSEUS-FNA appears safe and useful for the evaluation of left adrenal masses.
Adrenal Gland Neoplasms ; diagnostic imaging ; pathology ; Aged ; Aged, 80 and over ; Biopsy, Fine-Needle ; adverse effects ; methods ; Endosonography ; adverse effects ; Humans ; Prospective Studies ; Singapore
2.Academy of Medicine, Singapore clinical guideline on endoscopic surveillance and management of gastric premalignant lesions.
Vikneswaran NAMASIVAYAM ; Calvin J KOH ; Stephen TSAO ; Jonathan LEE ; Khoon Lin LING ; Christopher KHOR ; Tony LIM ; James Weiquan LI ; Aung Myint OO ; Benjamin C H YIP ; Ikram HUSSAIN ; Tju Siang CHUA ; Bin Chet TOH ; Hock Soo ONG ; Lai Mun WANG ; Jimmy B Y SO ; Ming THE ; Khay Guan YEOH ; Tiing Leong ANG
Annals of the Academy of Medicine, Singapore 2022;51(7):417-435
Gastric cancer (GC) has a good prognosis, if detected at an early stage. The intestinal subtype of GC follows a stepwise progression to carcinoma, which is treatable with early detection and intervention using high-quality endoscopy. Premalignant lesions and gastric epithelial polyps are commonly encountered in clinical practice. Surveillance of patients with premalignant gastric lesions may aid in early diagnosis of GC, and thus improve chances of survival. An expert professional workgroup was formed to summarise the current evidence and provide recommendations on the management of patients with gastric premalignant lesions in Singapore. Twenty-five recommendations were made to address screening and surveillance, strategies for detection and management of gastric premalignant lesions, management of gastric epithelial polyps, and pathological reporting of gastric premalignant lesions.
Adenomatous Polyps
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Endoscopy
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Humans
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Precancerous Conditions/therapy*
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Singapore
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Stomach Neoplasms/therapy*
3.Chapter of Gastroenterologists professional guidance on risk mitigation for gastrointestinal endoscopy during COVID-19 pandemic in Singapore.
Tiing Leong ANG ; James Weiquan LI ; Charles Kien Fong VU ; Gim Hin HO ; Jason Pik Eu CHANG ; Chern Hao CHONG ; Tju Siang CHUA ; David Eng Hui ONG ; Benjamin Cherng Hann YIP ; Kok Ann GWEE
Singapore medical journal 2020;61(7):345-349
In this paper, we aimed to provide professional guidance to practising gastrointestinal (GI) endoscopists for the safe conduct of GI endoscopy procedures during the current coronavirus disease 2019 (COVID-19) pandemic and future outbreaks of similar severe respiratory tract infections in Singapore. It draws on the lessons learnt during the severe acute respiratory syndrome (SARS) epidemic and available published data concerning the COVID-19 pandemic. It addresses measures before, during and after endoscopy that must be considered for both non-infected and infected patients, and provides recommendations for practical implementation.
Betacoronavirus
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Coronavirus Infections
;
epidemiology
;
transmission
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Disease Transmission, Infectious
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prevention & control
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Endoscopy, Gastrointestinal
;
standards
;
Gastroenterologists
;
standards
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Humans
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Incidence
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Pandemics
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Pneumonia, Viral
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epidemiology
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transmission
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Practice Guidelines as Topic
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Risk Factors
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Singapore
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epidemiology
4.Chapter of Gastroenterologists professional guidance for management of patients with liver disease in Singapore during the COVID-19 pandemic.
Jason Pik Eu CHANG ; Yu Jun WONG ; Wei Lyn YANG ; Kieron Boon Leng LIM ; Poh Seng TAN ; Gim Hin HO ; Benjamin Cherng Hann YIP ; James Weiquan LI ; Chern Hao CHONG ; David Eng Hui ONG ; Tju Siang CHUA ; Charles Kien Fong VU ; Kok Ann GWEE ; Tiing Leong ANG ; Chee Kiat TAN
Singapore medical journal 2020;61(12):619-623
In this paper, we aim to provide professional guidance to clinicians who are managing patients with chronic liver disease during the current coronavirus disease 2019 (COVID-19) pandemic in Singapore. We reviewed and summarised the available relevant published data on liver disease in COVID-19 and the advisory statements that were issued by major professional bodies, such as the American Association for the Study of Liver Diseases and European Association for the Study of the Liver, contextualising the recommendations to our local situation.
COVID-19/epidemiology*
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Carcinoma, Hepatocellular/therapy*
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Chronic Disease
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Hepatitis B, Chronic/therapy*
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Hepatitis C, Chronic/therapy*
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Humans
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Liver Cirrhosis/therapy*
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Liver Diseases/therapy*
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Liver Neoplasms/therapy*
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Liver Transplantation
;
Singapore/epidemiology*
5.Clinical guidance on endoscopic management of colonic polyps in Singapore.
Tiing Leong ANG ; Jit Fong LIM ; Tju Siang CHUA ; Kok Yang TAN ; James Weiquan LI ; Chern Hao CHONG ; Kok Ann GWEE ; Vikneswaran S/O NAMASIVAYAM ; Charles Kien Fong VU ; Christopher Jen Lock KHOR ; Lai Mun WANG ; Khay Guan YEOH
Singapore medical journal 2022;63(4):173-186
Colonoscopy with endoscopic resection of detected colonic adenomas interrupts the adenoma-carcinoma sequence and reduces the incidence of colorectal cancer and cancer-related mortality. In the past decade, there have been significant developments in instruments and techniques for endoscopic polypectomy. Guidelines have been formulated by various professional bodies in Europe, Japan and the United States, but some of the recommendations differ between the various bodies. An expert professional workgroup under the auspices of the Academy of Medicine, Singapore, was set up to provide guidance on the endoscopic management of colonic polyps in Singapore. A total of 23 recommendations addressed the following issues: accurate description and diagnostic evaluation of detected polyps; techniques to reduce the risk of post-polypectomy bleeding and delayed perforation; the role of specific endoscopic resection techniques; the histopathological criteria for defining endoscopic cure; and the role of surveillance colonoscopy following curative resection.
Adenoma/surgery*
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Colonic Neoplasms/surgery*
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Colonic Polyps/surgery*
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Colonoscopy/methods*
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Colorectal Neoplasms/pathology*
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Humans
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Singapore
;
United States