Man Fung Ho - Academia.edu (original) (raw)

Papers by Man Fung Ho

Research paper thumbnail of ASO Visual Abstract: Versatility of Retzius-Sparing Prostatectomy – Its Application in Renal Transplant Patients and En Bloc Abdominal–Perineal Resection

Annals of Surgical Oncology, 2021

Research paper thumbnail of Successful endovascular management of giant splenic artery aneurysms

Vascular, Jan 14, 2013

Giant pseudoaneurysms of the splenic artery, with a diameter of 5 cm or more, are rare surgical e... more Giant pseudoaneurysms of the splenic artery, with a diameter of 5 cm or more, are rare surgical emergencies, and conventional open surgery usually involves splenectomy. The aim of this study is to report two cases from our institution and to review the world's literature on successful endovascular treatment of patients with giant splenic artery pseudoaneurysms. A retrospective review of a prospectively entered departmental computerized database was performed for the two patients from our institution. Articles were searched electronically from PubMed and Medline, using the terms 'giant splenic artery', 'endovascular' and 'embolization'; and relevant cases were reviewed from the world's literature. We hereby report two patients with giant splenic artery pseudoaneurysms who were treated successfully with endovascular procedures. In addition to the two patients from our institution, there were five patients with giant splenic artery pseudoaneurysms in the...

Research paper thumbnail of Personalized laparoscopic resection of colon cancer with the use of indocyanine green lymph node mapping: Technical and clinical outcomes

Asian Journal of Endoscopic Surgery

Research paper thumbnail of Laparoscopic resection of a descending colon tumour in a patient with situs inversus and variant vascular anatomy – a video vignette

Colorectal Disease

Situs inversus is a rare condition in which intrathoracic and intraabdominal organs are in mirror... more Situs inversus is a rare condition in which intrathoracic and intraabdominal organs are in mirror-image orientation1 . This can pose significant difficulty in access, exposure and manipulation especially during minimally access surgery. Less than 10 cases have been reported in the literature for laparoscopic colectomy in this group of patients2 .Variation of vascular anatomy posesadditional difficulty for dissection and anastomosis3 .

Research paper thumbnail of Versatility of Retzius-Sparing Prostatectomy: Its Application in Renal Transplant Patient and En-bloc Abdominal-Perineal Resection

Annals of Surgical Oncology

Research paper thumbnail of SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

British Journal of Surgery

Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numb... more Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst ...

Research paper thumbnail of Should Transanal Total Mesorectal Excision Be Implemented in Medium-Sized Colorectal Unit? Technical and Oncological Outcome

Annals of Coloproctology

This study was performed to evaluate the outcome of implementation of transanal total mesorectal ... more This study was performed to evaluate the outcome of implementation of transanal total mesorectal excision (TaTME) for low rectal cancer in a regional hospital and in comparison to laparoscopic (Lap) TME. Methods: Consecutive patients with low rectal cancer of which the lowest border of the tumour was located beween 1 and 5 cm from the puborectalis who underwent TME at North District Hospital between January 2013 and December 2019 were included. Clinical, operative, and pathologic outcomes were compared between Lap TME and TaTME. The primary end point was complication profile. Results: Thirty-five patients underwent Lap TME and 45 patients underwent TaTME for low rectal cancer. The conversion rate of the TaTME group was significantly lower than that of the Lap TME group (4.4% vs. 20%, P = 0.029), but the operating time was longer (259 minutes vs. 219 minutes, P = 0.009). The tumour location was significantly lower in the TaTME group, but the distal resection margins were adequate and not different between both groups. The TaTME group had higher incidence rates of prolonged ileus and urinary tract infection, but the other complications were similar between the two groups. The resection margin positivity rates of the TaTME and Lap TME groups were 2.2% and 5.7%, respectively (P = 0.670). At a median follow up of 39 months, no abnormal early recurrence was detected. Conclusion: It is technically feasible and oncologically safe to perform TaTME in a medium-volume colorectal unit. Patients with difficult pelvic anatomy can benefit by reducing the risk of conversion and margin positivity rate.

Research paper thumbnail of 569 Electroacupuncture Combined with Fast-Track Perioperative Program for Reducing Duration of Postoperative Ileus and Hospital Stay After Laparoscopic Colorectal Surgery: A Randomized Controlled Trial

Research paper thumbnail of 328 Endoscopic Submucosal Dissection (Esd) Versus Transanal Minimally Invasive Surgery (Tamis) for Early Rectal Neoplasms: A Prospective Randomized Controlled Trial

Research paper thumbnail of Early transcatheter thrombectomy and thrombolytic therapy in acute non-cirrhotic and non-malignant mesenteric vein thrombosis: Case report of two cases and literature review

International Journal of Surgery Case Reports

To present two cases of acute non-cirrhotic and non-malignant mesenteric vein thrombosis (MVT) tr... more To present two cases of acute non-cirrhotic and non-malignant mesenteric vein thrombosis (MVT) treated with early transcatheter thrombectomy and thrombolysis with tissue plasminogen activator (tPA) and to review the literature on transcatheter thrombectomy and thrombolytic therapy of such condition. METHODS: Two cases of acute MVT treated with transhepatic transcatheter thrombectomy and thrombolysis in addition to systemic anticoagulation upon diagnosis are presented. In addition, a Pubmed literature search was undertaken using keywords acute mesenteric vein thrombosis, thrombolysis and thrombectomy. The inclusion criteria were studies examining the impacts of transcatheter thrombolysis and thrombectomy in the management of acute MVT. RESULTS: Early transcatheter thrombectomy and thrombolysis achieves technical success in both patients and result in nearly complete recanalization of the venous system, with no recurrent thrombosis to date in follow up. Both patients do not require extensive bowel resection despite extensive thrombus on presentation. However, both patients develop intra-abdominal bleeding requiring blood transfusion and embolization of the transcatheter tract. CONCLUSION: Catheter-directed first approach provides a minimal invasive approach for management of non-malignant and non-cirrhotic acute mesenteric thrombosis. It offers the benefits of rapid venous recanalization and avoid massing bowel resection despite extensive thrombosis. Subsequent progression into chronic MVT was also reduced. However, the procedure could lead to bleeding from puncture site and hence embolization of the catheter tract is advised during catheter removal.

Research paper thumbnail of Laparoscopic‐assisted omental patch repair of colovaginal fistula – a video vignette

Colorectal Disease

A well-recognised, but uncommon debilitating complication of diverticular disease is the developm... more A well-recognised, but uncommon debilitating complication of diverticular disease is the development of fistulae.. [1] Surgical treatment can be technically demandings.[1,2] The use of an omental patch is recommended in individual centres to prevent refistulization.[3].

Research paper thumbnail of Derivation of a Prognostic Score for Identifying Critically Ill Patients in an Emergency Department Resuscitation Room

The Journal of Emergency Medicine, 2010

Research paper thumbnail of Perforated gastric diverticulum with bleeding

Endoscopy, 2013

This document was downloaded for personal use only. Unauthorized distribution is strictly prohibi... more This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited. Fig. 2 Appearance of the gastric diverticulum: a radiological; b endoscopic; c operative.

Research paper thumbnail of Multicenter Audit of Emergency Endovascular Repair of Infrarenal Aortic Aneurysms

Annals of Vascular Surgery, 2014

Background: Emergency endovascular aneurysm repair (eEVAR) for infrarenal abdominal aortic aneury... more Background: Emergency endovascular aneurysm repair (eEVAR) for infrarenal abdominal aortic aneurysm has become widely accepted as an alternative to open repair, if the aortic anatomy is favorable and endovascular expertise is readily available. The aim of this study is to report the outcome of eEVAR in Hong Kong. Methods: This was a retrospective review of prospectively collected data from Hong Kong Hospital Authority Clinical Data Analysis and Reporting System (CDARS), Clinical Management System (CMS), and departmental prospective computerized databases. Patient demographics, clinical and biochemical parameters, perioperative complications, and outcomes were recorded and analyzed. The independent sample t-test was used for continuous variables and the Fisher's exact test was used for nonparametric variables. KaplaneMeier analysis was performed for overall survival and survival of subgroups. Binary logistic regression was performed for factors predicting perioperative mortality. SPSS software (version 15.0; SPSS Inc., Chicago, IL) was used for all statistical analyses. Results: A total of 40 patients (36 men with a mean age of 74.9 ± 1.53 years [range: 52e89 years]) underwent emergency eEVAR between January 2006 and September 2011 in 6 Hospital Authority Hospitals in Hong Kong. All patients were treated using commercially available aortoiliac endografts (including 26 bifurcated and 14 aorto-uniiliac grafts). There was 1 conversion from eEVAR to open repair. Blood loss, operating time, duration of stay in intensive care, and duration of stay in the hospital were 948 ± 495.5 mL, 194 ± 12.7 min, 4.7 ± 1.26 days, and 14.5 ± 2.19 days, respectively. The 7-day, 30-day, and 12-month mortality rates were 15%, 17.5%, and 35%, respectively. Six patients required reintervention on follow-up, and 8 patients died during hospitalization. Cox regression analysis of survival found that hypotension (P ¼ 0.001) and being >76 years of age (P ¼ 0.002) were associated with reduced overall survival. Binary logistic regression found that hypotension is associated with increased 30-day mortality (P ¼ 0.026). Conclusions: This audit shows that the results of eEVAR in Hong Kong are comparable to international standards. In the endovascular era, this may be an attractive alternative to emergency open aneurysm repair.

Research paper thumbnail of Management of mycotic femoral artery aneurysm with two resistant organisms

Asian cardiovascular & thoracic annals, Jan 16, 2013

We report the management of a case of thigh abscess with ruptured left superficial femoral artery... more We report the management of a case of thigh abscess with ruptured left superficial femoral artery mycotic aneurysm in a 91-year-old woman with significant comorbidity. The abscess culture grew Escherichia coli and Acinetobacter baumannii. Vascular reconstruction was not performed because the foot was viable with a heavily contaminated wound. The thigh wound healed with the help of vacuum-assisted closure. This is the first report of a ruptured mycotic aneurysm of the superficial femoral artery associated with Escherichia coli and Acinetobacter baumannii infection. This case demonstrates that resection of a mycotic aneurysm without vascular continuity is feasible, especially in frail patients.

Research paper thumbnail of ASO Visual Abstract: Versatility of Retzius-Sparing Prostatectomy – Its Application in Renal Transplant Patients and En Bloc Abdominal–Perineal Resection

Annals of Surgical Oncology, 2021

Research paper thumbnail of Successful endovascular management of giant splenic artery aneurysms

Vascular, Jan 14, 2013

Giant pseudoaneurysms of the splenic artery, with a diameter of 5 cm or more, are rare surgical e... more Giant pseudoaneurysms of the splenic artery, with a diameter of 5 cm or more, are rare surgical emergencies, and conventional open surgery usually involves splenectomy. The aim of this study is to report two cases from our institution and to review the world's literature on successful endovascular treatment of patients with giant splenic artery pseudoaneurysms. A retrospective review of a prospectively entered departmental computerized database was performed for the two patients from our institution. Articles were searched electronically from PubMed and Medline, using the terms 'giant splenic artery', 'endovascular' and 'embolization'; and relevant cases were reviewed from the world's literature. We hereby report two patients with giant splenic artery pseudoaneurysms who were treated successfully with endovascular procedures. In addition to the two patients from our institution, there were five patients with giant splenic artery pseudoaneurysms in the...

Research paper thumbnail of Personalized laparoscopic resection of colon cancer with the use of indocyanine green lymph node mapping: Technical and clinical outcomes

Asian Journal of Endoscopic Surgery

Research paper thumbnail of Laparoscopic resection of a descending colon tumour in a patient with situs inversus and variant vascular anatomy – a video vignette

Colorectal Disease

Situs inversus is a rare condition in which intrathoracic and intraabdominal organs are in mirror... more Situs inversus is a rare condition in which intrathoracic and intraabdominal organs are in mirror-image orientation1 . This can pose significant difficulty in access, exposure and manipulation especially during minimally access surgery. Less than 10 cases have been reported in the literature for laparoscopic colectomy in this group of patients2 .Variation of vascular anatomy posesadditional difficulty for dissection and anastomosis3 .

Research paper thumbnail of Versatility of Retzius-Sparing Prostatectomy: Its Application in Renal Transplant Patient and En-bloc Abdominal-Perineal Resection

Annals of Surgical Oncology

Research paper thumbnail of SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

British Journal of Surgery

Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numb... more Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst ...

Research paper thumbnail of Should Transanal Total Mesorectal Excision Be Implemented in Medium-Sized Colorectal Unit? Technical and Oncological Outcome

Annals of Coloproctology

This study was performed to evaluate the outcome of implementation of transanal total mesorectal ... more This study was performed to evaluate the outcome of implementation of transanal total mesorectal excision (TaTME) for low rectal cancer in a regional hospital and in comparison to laparoscopic (Lap) TME. Methods: Consecutive patients with low rectal cancer of which the lowest border of the tumour was located beween 1 and 5 cm from the puborectalis who underwent TME at North District Hospital between January 2013 and December 2019 were included. Clinical, operative, and pathologic outcomes were compared between Lap TME and TaTME. The primary end point was complication profile. Results: Thirty-five patients underwent Lap TME and 45 patients underwent TaTME for low rectal cancer. The conversion rate of the TaTME group was significantly lower than that of the Lap TME group (4.4% vs. 20%, P = 0.029), but the operating time was longer (259 minutes vs. 219 minutes, P = 0.009). The tumour location was significantly lower in the TaTME group, but the distal resection margins were adequate and not different between both groups. The TaTME group had higher incidence rates of prolonged ileus and urinary tract infection, but the other complications were similar between the two groups. The resection margin positivity rates of the TaTME and Lap TME groups were 2.2% and 5.7%, respectively (P = 0.670). At a median follow up of 39 months, no abnormal early recurrence was detected. Conclusion: It is technically feasible and oncologically safe to perform TaTME in a medium-volume colorectal unit. Patients with difficult pelvic anatomy can benefit by reducing the risk of conversion and margin positivity rate.

Research paper thumbnail of 569 Electroacupuncture Combined with Fast-Track Perioperative Program for Reducing Duration of Postoperative Ileus and Hospital Stay After Laparoscopic Colorectal Surgery: A Randomized Controlled Trial

Research paper thumbnail of 328 Endoscopic Submucosal Dissection (Esd) Versus Transanal Minimally Invasive Surgery (Tamis) for Early Rectal Neoplasms: A Prospective Randomized Controlled Trial

Research paper thumbnail of Early transcatheter thrombectomy and thrombolytic therapy in acute non-cirrhotic and non-malignant mesenteric vein thrombosis: Case report of two cases and literature review

International Journal of Surgery Case Reports

To present two cases of acute non-cirrhotic and non-malignant mesenteric vein thrombosis (MVT) tr... more To present two cases of acute non-cirrhotic and non-malignant mesenteric vein thrombosis (MVT) treated with early transcatheter thrombectomy and thrombolysis with tissue plasminogen activator (tPA) and to review the literature on transcatheter thrombectomy and thrombolytic therapy of such condition. METHODS: Two cases of acute MVT treated with transhepatic transcatheter thrombectomy and thrombolysis in addition to systemic anticoagulation upon diagnosis are presented. In addition, a Pubmed literature search was undertaken using keywords acute mesenteric vein thrombosis, thrombolysis and thrombectomy. The inclusion criteria were studies examining the impacts of transcatheter thrombolysis and thrombectomy in the management of acute MVT. RESULTS: Early transcatheter thrombectomy and thrombolysis achieves technical success in both patients and result in nearly complete recanalization of the venous system, with no recurrent thrombosis to date in follow up. Both patients do not require extensive bowel resection despite extensive thrombus on presentation. However, both patients develop intra-abdominal bleeding requiring blood transfusion and embolization of the transcatheter tract. CONCLUSION: Catheter-directed first approach provides a minimal invasive approach for management of non-malignant and non-cirrhotic acute mesenteric thrombosis. It offers the benefits of rapid venous recanalization and avoid massing bowel resection despite extensive thrombosis. Subsequent progression into chronic MVT was also reduced. However, the procedure could lead to bleeding from puncture site and hence embolization of the catheter tract is advised during catheter removal.

Research paper thumbnail of Laparoscopic‐assisted omental patch repair of colovaginal fistula – a video vignette

Colorectal Disease

A well-recognised, but uncommon debilitating complication of diverticular disease is the developm... more A well-recognised, but uncommon debilitating complication of diverticular disease is the development of fistulae.. [1] Surgical treatment can be technically demandings.[1,2] The use of an omental patch is recommended in individual centres to prevent refistulization.[3].

Research paper thumbnail of Derivation of a Prognostic Score for Identifying Critically Ill Patients in an Emergency Department Resuscitation Room

The Journal of Emergency Medicine, 2010

Research paper thumbnail of Perforated gastric diverticulum with bleeding

Endoscopy, 2013

This document was downloaded for personal use only. Unauthorized distribution is strictly prohibi... more This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited. Fig. 2 Appearance of the gastric diverticulum: a radiological; b endoscopic; c operative.

Research paper thumbnail of Multicenter Audit of Emergency Endovascular Repair of Infrarenal Aortic Aneurysms

Annals of Vascular Surgery, 2014

Background: Emergency endovascular aneurysm repair (eEVAR) for infrarenal abdominal aortic aneury... more Background: Emergency endovascular aneurysm repair (eEVAR) for infrarenal abdominal aortic aneurysm has become widely accepted as an alternative to open repair, if the aortic anatomy is favorable and endovascular expertise is readily available. The aim of this study is to report the outcome of eEVAR in Hong Kong. Methods: This was a retrospective review of prospectively collected data from Hong Kong Hospital Authority Clinical Data Analysis and Reporting System (CDARS), Clinical Management System (CMS), and departmental prospective computerized databases. Patient demographics, clinical and biochemical parameters, perioperative complications, and outcomes were recorded and analyzed. The independent sample t-test was used for continuous variables and the Fisher's exact test was used for nonparametric variables. KaplaneMeier analysis was performed for overall survival and survival of subgroups. Binary logistic regression was performed for factors predicting perioperative mortality. SPSS software (version 15.0; SPSS Inc., Chicago, IL) was used for all statistical analyses. Results: A total of 40 patients (36 men with a mean age of 74.9 ± 1.53 years [range: 52e89 years]) underwent emergency eEVAR between January 2006 and September 2011 in 6 Hospital Authority Hospitals in Hong Kong. All patients were treated using commercially available aortoiliac endografts (including 26 bifurcated and 14 aorto-uniiliac grafts). There was 1 conversion from eEVAR to open repair. Blood loss, operating time, duration of stay in intensive care, and duration of stay in the hospital were 948 ± 495.5 mL, 194 ± 12.7 min, 4.7 ± 1.26 days, and 14.5 ± 2.19 days, respectively. The 7-day, 30-day, and 12-month mortality rates were 15%, 17.5%, and 35%, respectively. Six patients required reintervention on follow-up, and 8 patients died during hospitalization. Cox regression analysis of survival found that hypotension (P ¼ 0.001) and being >76 years of age (P ¼ 0.002) were associated with reduced overall survival. Binary logistic regression found that hypotension is associated with increased 30-day mortality (P ¼ 0.026). Conclusions: This audit shows that the results of eEVAR in Hong Kong are comparable to international standards. In the endovascular era, this may be an attractive alternative to emergency open aneurysm repair.

Research paper thumbnail of Management of mycotic femoral artery aneurysm with two resistant organisms

Asian cardiovascular & thoracic annals, Jan 16, 2013

We report the management of a case of thigh abscess with ruptured left superficial femoral artery... more We report the management of a case of thigh abscess with ruptured left superficial femoral artery mycotic aneurysm in a 91-year-old woman with significant comorbidity. The abscess culture grew Escherichia coli and Acinetobacter baumannii. Vascular reconstruction was not performed because the foot was viable with a heavily contaminated wound. The thigh wound healed with the help of vacuum-assisted closure. This is the first report of a ruptured mycotic aneurysm of the superficial femoral artery associated with Escherichia coli and Acinetobacter baumannii infection. This case demonstrates that resection of a mycotic aneurysm without vascular continuity is feasible, especially in frail patients.