Objective: Spinal stenosis and degenerative spinal disorders are increasingly prevalent and have a substantial impact on quality of life. Surgical decompression, performed using either open microscopic or endoscopic approaches, remains a cornerstone of management for these conditions. This study examines evolving trends in single-level lumbar spinal decompression procedures performed at a tertiary academic hospital in Singapore. Methods: A retrospective observational study was conducted involving 588 patients who underwent single-level spinal decompression between 2021 and 2024, including endoscopic spine surgery (ESS; n=364) and microdecompression (n=224). Primary outcome measures were changes in 36-Item Short Form Health Survey (SF-36) and visual analogue scale (VAS) scores at 3 months, 6 months, and 2 years postoperatively. Secondary outcomes included length of hospital stay, reoperation rates, and operative time. Patient demographics, spinal level and pathology characteristics, surgical techniques, and postoperative outcomes were analyzed. Difference-in-differences (DID) analysis was used to compare outcomes between the 2 groups. Results: Both groups demonstrated significant postoperative improvements in SF-36 and VAS scores. At 2 years, Short Form Health Survey physical function (SFPF) scores improved in the endoscopic group (mean difference [MD], 18.6; standard deviation [SD], 21.7; p=0.064) and in the open microscopic group (MD, 36.7; SD, 20.9; p=0.007), with a non-significant DID of -18.1 (p=0.155). No DID comparisons across SF-36 domains reached statistical significance. Mean operative time for endoscopic procedures decreased from 249 minutes in 2022 to 145 minutes in 2024, reflecting a procedural learning curve. Surgeons with higher endoscopic caseloads exhibited greater improvements in functional outcomes. Conclusion Both endoscopic and open microscopic decompression achieve comparable short- and long-term clinical outcomes. ESS provides similar effectiveness while being associated with shorter recovery periods and reduced hospital stay. Further research is warranted to identify factors contributing to incomplete symptom resolution or the need for revision surgery.

In 2023, the Republic of Korea’s Korea Disease Control and Prevention Agency (KDCA) enhanced its event-based surveillance practices by using the World Health Organization’s (WHO) Epidemic Intelligence from Open Sources (EIOS) to actively screen and share information about potential public health threats to the country. This report describes the preliminary assessment of the results of implementing these enhanced event-based surveillance activities from June to October 2023. During this period, 425 (0.4%) events were detected globally by the KDCA from 99 945 media articles, with the highest frequency reported in Asia (185, 43.5%) and North America (81, 19.1%). The most frequently reported diseases or conditions were dengue fever (111, 26.1%) and mpox (32, 7.5%). Eight events were detected early by the KDCA using EIOS before being officially listed on WHO’s Event Information Site (EIS) or in Disease Outbreak News (DON), with an average interval of 20 days (range: 5–41) between the detection date and posting on EIS or DON. Thus, EIOS is efficient in aiding early detection of potential public health threats at the national level. This finding highlights the importance of sustaining international cooperation and support to enhance surveillance capabilities in resource-limited settings and expanding the scope of EIOS, including by incorporating additional sources and sources in additional languages, reducing noise. However, as the current report is based on a descriptive analysis, in the future a systematic evaluation of event-based surveillance using EIOS to identify relevant attributes will need to be conducted.

PURPOSE: The aim of this study was to assess the role of pre-operative chest computed tomography (CT) compared with abdominopelvic CT (AP-CT) and chest radiography (CXR) for detecting pulmonary metastasis in patients with primary colorectal cancer (CRC). METHODS: We retrospectively analyzed the data of 619 patients with primary CRC who simultaneously received a preoperative chest CT (chest CT group), AP-CT with hilar extension, and CXR (CXR group). RESULTS: In the chest CT group, there were 297 (48.0%) normal, 198 (32%) benign, 96 (15.5%) indeterminate, 26 (4.2%) metastasis, and two lung cancers. Eighteen patients (2.9%) in the CXR group who had no pulmonary metastasis were diagnosed with pulmonary metastasis on a chest CT. The sensitivity and accuracy were 83.9% and 99.0% in the chest CT group, respectively, and 29.0% and 91.5% in the CXR group, respectively (P < 0.0001 and P = 0.0003). CONCLUSION: Chest CT appears to improve the accuracy of pre-operative staging in patients with CRC and is useful for the early detection of pulmonary metastasis as a baseline study for abnormal lung nodules.
Colorectal Neoplasms ; Humans ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Retrospective Studies ; Thorax

PURPOSE: Pulmonary metastases occur in up to 10% of all patients who undergo a curative resection for colorectal cancer. Surgical resection is an important part in the treatment of pulmonary metastasis from colorectal cancer. We analyzed the treatment outcome and the prognostic factors affecting survival in this subset of patients. METHODS: Between October 1994 and December 2004, 59 patients underwent a curative resection for pulmonary metastases from colorectal cancer. Uncontrollable synchronous liver and lung metastasis or synchronous colorectal cancers with isolated lung metastasis were excluded from this study. A retrospective review of the patients' characteristics and of factors influencing survival was performed. Survival was analyzed by using the Kaplan-Meier method. Comparisons between the groups were performed by using a log-rank analysis and the Cox proportional hazard model. RESULTS: The 5-year overall survival rate of all patients who received a pulmonary resection was 50.3%. The number of pulmonary metastases was significantly related with survival (P=0.032). A pre-thoracotomy CEA level exceeding 5 ng/ml was related with poor survival (P=0.001). A disease- free interval of greater than 2 years did not correlate with survival after a thoracotomy (P=0.3). CONCLUSIONS: The pre-thoracotomy CEA level and the number of metastases were independent prognostic factors. Resection of a pulmonary metastasis from colorectal cancer may result in improved survival or even cure in selected patients. A pulmonary resection of colorectal cancer is regarded as a safe and effective treatment with low morbidity and mortality rates.
Colorectal Neoplasms* ; Humans ; Liver ; Lung ; Mortality ; Neoplasm Metastasis* ; Proportional Hazards Models ; Recurrence ; Retrospective Studies ; Survival Rate ; Thoracotomy ; Treatment Outcome