Ann Acad Med Singap
-
Ann Acad Med Singap · Sep 2021
ReviewStrategies for a successful hepatic artery anastomosis in liver transplantation: A review of 51 cases.
Hepatic artery reconstruction is a critical aspect of liver transplantation. The microsurgeon faces several challenges when reconstructing the hepatic artery-the donor hepatic artery stalk is short and often a poor match for the usually hypertrophic recipient vessels. Previous inflammation impedes vessel dissection, and recipient vessels have a tendency to delaminate with manipulation. We review 51 consecutive liver transplantations to highlight these problems and propose strategies for a successful reconstruction of the hepatic artery. ⋯ Hepatic artery thrombosis after liver transplantation is poorly tolerated. The challenges of hepatic artery reconstruction in liver transplantation are related to vessel quality and length. The use of microsurgical technique, appropriate recipient vessel selection, minimisation of vessel manipulation with modified instruments, variation in anastomosis techniques, and use of radial artery interpositional grafts are useful strategies to maximise the chances of success.
-
Ann Acad Med Singap · Sep 2021
Parental perception and guideline awareness of children's lifestyle behaviours at ages 5 to 14 in Singapore.
There are limited data on the descriptive lifestyle behaviour of school-age children in Singapore. ⋯ Lifestyle behaviours were suboptimal in Singapore children compared with existing overseas guidelines, indicating a need for an integrated guideline with greater dissemination.
-
Ann Acad Med Singap · Aug 2021
Guidance on performance and reporting of high-resolution oesophageal manometry and ambulatory pH monitoring in Singapore.
We aimed to provide a practical and evidence-based guide on the indications, performance and reporting of high-resolution oesophageal manometry (HRM) and ambulatory pH monitoring (PHM) in adult patients in Singapore. ⋯ Standardising key aspects of HRM and PHM is imperative to ensure the delivery of high-quality care. We reported the development of recommendations for the performance and interpretation of HRM and ambulatory reflux monitoring in Singapore.