SURGICAL TIMING FOR BLEEDING SIGMOID COLON ADENOCARCINOMA AFTER CORONARY ARTERY BYPASS GRAFT: A DUAL CASE EXPERIENCE AND REVIEW OF LITERATURE IN PAST TWO DECADES The optimal timing of noncardiac surgery (NCS) after coronary artery bypass grafting (CABG) remains inadequately elucidated in current literature. The intricate balance between advantageous oncological outcomes associated with expeditious curative resection and the potential risk of significant post-NCS cardiac events following CABG presents a complex dilemma. This study presents a retrospective analysis of two cases involving bleeding sigmoid adenocarcinoma in the context of concomitant occlusive coronary disease. Both patients underwent CABG followed by early anterior resection. Notably, no major adverse cardiac events were observed following anterior resection procedures, and patients were discharged within a week uneventfully. A comprehensive review of literature spanning two decades was undertaken to contextualize these findings. Apparent scarcity of definitive evidence underscores the necessity for more extensive and conclusive data to establish precise guidelines for the optimal timing of NCS post-CABG.

Interventional Pain Procedures (IPPs) is a relatively new treatment modality for chronic pain in Malaysia. The Interventional Pain Service (IPS) newly set up in our institution is led by a pain neurosurgeon and provides a whole package of multimodal pain management including different range of IPPs. This clinical audit is to examine the quality of IPPs performed within the IPS in our institution since its initiation. A total of 87 IPPs were performed on 56 chronic pain patients over 3-year duration. As high as 81.8% of the procedures were effective and 81.5% of patients were satisfied. Only one minor transient complication occurred after an intradiscal procedure but none resulted in death or permanent disability. Thus, safe and effective IPPs can be provided as part of IPS in a local neurosurgical pain centre to bring more comprehensive and less fragmented care for chronic pain patients.

Endovascular treatment of wide-necked aneurysms poses a challenge for the endovascular therapist. The Y-stent–assisted technique has been used for stent-assisted coil embolisation for wide-necked bifurcation aneurysms. This technique has been described for basilar tip aneurysms and middle cerebral artery bifurcation aneurysms using Neuroform and Enterprise stents. We report 2 cases of wide-necked bifurcation aneurysms that were treated with Y-stent–assisted coil embolisation using a new, fully retrievable and detachable intracranial stent (Solitaire ABTM). We describe the advantages of a fully retrievable and detachable stent and its feasibility of forming a Y configuration.

p style=text-align: justify;strongOBJECTIVE:/strong To describe our experience in performing the lower cheek flap for access to the infratemporal fossa combined with the neurosurgical approach. br /br /strongMETHODS:/strongbr /strongDesign:/strong Case report br /strongSetting:/strong Tertiary Referral Center br /strongPatients:/strong Two br /br /strongRESULTS:/strong Two unusual tumours involving the infratemporal and middle cranial fossa were excised using this combined appoach. The infratemporal fossa tumour was accessed via the lower cheek flap while the intracranial portion was resected from above via craniotomy.br /br /strongCONCLUSION:/strong The lower cheek flap in combination with the neurosurgical approach allows optimal exposure to tumours involving the infratemporal and middle cranial fossae. It has less complications and better aesthetic outcome compared to other approaches./p
Human ; Male ; Female ; Surgical Flaps ; Surgically-Created Structures ; Cheek ; Neoplasms ; Neurosurgical Procedures ; Cranial Fossa, Middle ; Infratentorial Neoplasms