Publications by authors named "Brian W C A Tian"
Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago.
World J Emerg Surg
April 2024
Article Synopsis
- This study compares two surgical methods, Hartmann's procedure (HP) and resection with primary anastomosis (RPA), for treating acute left-sided colonic emergencies among 1215 patients from 204 centers globally.
- Results showed that while HP was the more common treatment (57.3%), RPA was favored for younger patients with fewer health issues and those needing surgery sooner.
- The study concluded that although HP is still widely used, RPA might be the better option, emphasizing the importance of patient characteristics and surgeon experience in determining treatment choice.
Background: Laparoscopy is widely adopted across nearly all surgical subspecialties in the elective setting. Initially finding indication in minor abdominal emergencies, it has gradually become the standard approach in the majority of elective general surgery procedures. Despite many technological advances and increasing acceptance, the laparoscopic approach remains underutilized in emergency general surgery and in abdominal trauma.
View Article and Find Full Text PDFManagement of Intra-Abdominal Infections: The Role of Procalcitonin.
Antibiotics (Basel)
September 2023
Patients with intra-abdominal sepsis suffer from significant mortality and morbidity. The main pillars of treatment for intra-abdominal infections are (1) source control and (2) early delivery of antibiotics. Antibiotic therapy should be started as soon as possible.
View Article and Find Full Text PDFArticle Synopsis
- Diaphragmatic hernia (DH) can be life-threatening and its management raises ongoing debates.
- A CT scan is the best way to diagnose complicated DH, and timely surgical intervention is crucial for successful treatment.
- Laparoscopic repair is preferred for stable patients, while open surgery and Damage Control Surgery are necessary for unstable patients.
Many countries are facing an aging population. As people live longer, surgeons face the prospect of operating on increasingly older patients. Traditional teaching is that with older age, these patients face an increased risk of mortality and morbidity, even to a level deemed too prohibitive for surgery.
View Article and Find Full Text PDFSigmoid volvulus is a common surgical emergency, especially in elderly patients. Patients can present with a wide range of clinical states: from asymptomatic, to frank peritonitis secondary to colonic perforation. These patients generally need urgent treatment, be it endoscopic decompression of the colon or an upfront colectomy.
View Article and Find Full Text PDFNovel Low Fluence Combination Laser Treatment of Solar Lentigines in Type III Asian Skin.
J Cutan Aesthet Surg
February 2016
Objective: To demonstrate a novel low fluence combination laser technique [Erbium-doped yttrium aluminum garnet (Erb:YAG) and neodymium-doped yttrium aluminum garnet (Nd:YAG)] to effectively treat solar lentigines in type III Asian skin in a single session.
Design: A prospective study.
Setting: A Singapore-based clinic.
Objective: To demonstrate a combination laser therapy to treat Hori's nevus.
Design: A prospective study.
Setting: A Singapore-based clinic.