To determine the incidence of post-operative deep vein thrombosis in general surgical patients of Hospital Universiti Sains Malaysia

Apparent rarity of post-operative DVT and pulmonary embolism in Asian patients was first reported since 1964. Very few literature and clinical studies were done for post-operative DVT in Asian population as well as in Malaysia.Compared to the Western hemisphere,low incidence 2.6% to 15.3% was reported from Japan, Hong Kong, Thailand, Singapore and Malaysian studies.Conflicting results of high incidence in orthopaedic patients was reported in two other Asian studies from Hong Kong and Malaysia.To find out the incidence of post-operative deep vein thrombosis (DVT) in our general surgical patients after major surgical procedures.To find out the subgroups of patients at special risk to post-operative DVT.To reviewthe policy of withholding routine DVT prophylaxis in Malaysian patients

REOPERATIVE THYROID SURGERY IN HOSPITAL UNIVERSITI SAINS MALAYSIA

From 1996 to 2001, 393 thyroidectomies were performed and 25 (6.4%) patients underwent reoperative thyroid surgery at Hospital Universiti Sains Malaysia. All reoperated patients had undergone one prior thyroid operation. All were females with an average age of 39.1 years (18-61 years). The most frequent indication for reoperation was cancer in resected specimen of an originally misdiagnosed carcinoma treated by partial thyroid resection. Final histological diagnosis of 25 reoperations showed thyroid carcinoma in 22 (88%) cases and multinodular goiter in 3 cases. The overall interval between the initial and the reoperative procedures ranged from 3 weeks to 15 years. There was no post-operative mortality after reoperation. Post-operative complications were discovered in 5 patients, as 3 (12%) of whom had transient hypocalcaemia, one (4%) had wound breakdown and one (4%) had permanent recurrent laryngeal nerve palsy. Reoperative thyroid surgery is an uncommon operation with high complication rate

Myxoid liposarcoma: a rare soft tissue tumour in the breast

Liposarcoma is one of the most common mesenchymal tumour in adults but it is rare to occur in the breast. Our case was a 50 year old single nulliparous woman who presented with a right breast mass for one year duration. The mass was progressively increasing in size in the last few months. Breast examination showed a huge mass measuring 5 x 8 x 6 cm occupying the entire right breast. Mammogram showed a large homogenous soft tissue mass occupying the entire right breast with foci of calcification. A trucut biopsy showed a cellular tumour which was thought to be an invasive carcinoma. The patient underwent right modified radical mastectomy with axillary clearance. Macroscopy showed a well circumscribed lobulated solid haemorrhagic yellowish tumour mass measuring 180 x 110 x 50 mm. Microscopically the tumour was heterogenous comprising cellular round nonlipogenic mesenchymal cells and loose myxoid areas containing small cells. The typical arborizing ‘chicken wire’ capillaries were observed. Vacuolated lipoblasts were seen. All eleven axillary lymph nodes sampled showed no metastasis. A diagnosis of a myxoid liposarcoma was made. To raise the suspicion of a possible mesenchymal tumour, it is very important for clinicians to relay the clinical and radiological findings to the pathologist to avoid misdiagnosis in a trucut biopsy

The incidence of post-operative deep vein thrombosis in general surgical patients of Hospital Universiti Sains Malaysia

The incidence of deep vein thrombosis is believed to be rare in Asians. During recent years, a few reports have appeared with high incidence in orthopaedic patients comparable to Western studies. This study was carried out to find out the incidence of post-operative deep vein thrombosis (DVT) after major surgical procedures in general surgical patients in an Asian population. In a prospective study of 45 consecutive Asian patients after major general surgery, colour-flow duplex scan of the legs as an initial screening was done twice within two weeks. Mean age of the patients was 54 years 5 months and 87% of patients were included in the moderate and high risk group for deep vein thrombosis. Ascending venography was used to confirm deep vein thrombosis on patients with equivocal or positive results from colour flow duplex scan. One patient showed positive evidence of post-operative deep vein thrombosis on colour flow duplex scan which was further confirmed by ascending venography; giving an incidence of 2.2%. The incidence of post-operative deep vein thrombosis in general surgical patients is lower than the Western studies