Uniportal video assisted thoracoscopic surgery right upper sleeve lobectomy- The first experience in Hospital Kuala Lumpur

@#Sleeve lobectomy is a lung sparing surgery and is the preferred alternative to pneumonectomy for centrally located tumours, which has less postoperative morbidity and mortality. Surgical approach for the technically demanding sleeve lobectomy evolved over the decades from conventional thoracotomy to video assisted thoracoscopic surgery (VATS) to uniportal VATS (uVATS) which allows for quicker recovery and less pain postoperatively. We report our very first successful uVATS sleeve right upper lobectomy performed in the Hospital Kuala Lumpur, Malaysia.

Thoracic sarcoma case series in Hospital Kuala Lumpur, Malaysia

@#Thoracic sarcomas (TS) are rare neoplasms that may present with non-specific pulmonary symptoms. Chest radiographs and computed tomography of the thorax are the investigations of choice, while pre-operative minimally invasive biopsies may not be entirely helpful with the diagnosis. The commonly identified variants of thoracic sarcomas include liposarcomas, leiomyosarcomas and synovial sarcomas. Complete excision of the tumour with clear margins remain the sole definite form of management and there is limited role with adjuvant chemotherapy and radiotherapy. In the present case series, we explore our experience with three patients who presented with TS and the management decisions that was made.

Outcome of surgery of necrotising pneumonia in immunocompromised patients: HKL experience

@#Necrotising pneumonia or lung gangrene is a challenging problem and it is diagnosed more often today, especially in tertiary hospitals. It is always a challenge to treat these patients as they are usually immunocompromised and are often ill when the diagnosis is made. We report three immunocompromised patients with necrotising pneumonia who were treated surgically. We share the outcomes of these patients and discuss the management of necrotising pneumonia in the immunocompromised.

Spontaneous massive haemothorax in the peri-partum period of an undiagnosed neurofibromatosis type 1 patient - A surgical perspective

@#Acute massive haemothorax is a life-threatening situation, which is often associated with a preceding trauma. However, spontaneous haemothorax is a rare occurrence, especially in pregnancy. Spontaneous haemothorax in the immediate post-partum period secondary to a ruptured intercostal AVM is extremely rare more so in the background of an undiagnosed neurofibromatosis. This is a report of a young lady presenting with pleuritis and breathlessness after the delivery of her 1st child. Her management is discussed.

A dedifferentiated large posterior mediastinal liposarcoma – An incidental finding successfully resected

This is a case of a posterior mediastinal mass in an asymptomatic gentleman, which was resected successfully and he has been disease free for more than a year of follow up. The histopathology findings happen to be a rare occurrence.

Mediastinal mature teratoma in a child- A case report

Mediastinal teratoma is an infrequent germ cell tumour and comprises of 1 to 5% of all mediastinal tumours. We report a case of mediastinal mature teratoma in a 12 year old boy who presented to us with persistent non-productive cough, fever and dyspnoea for the past 7 months. Computed tomographic scan of thorax revealed a large anterior mediastinal mass measuring 11.2x9.9x14cm with calcification within. He subsequently underwent a median sternotomy with left subcostal extension (L-incision) and excision of tumour. Histopathology of the tumour revealed a mature cystic teratoma. We would like to report a case of successful surgical management of a large mediastinal mature teratoma in a child.

Abdominal Stab Wound with Inferior Vena Cava Injury: A Case Report

Injury to the inferior vena cava (IVC) resulting from stab wound carries a high mortality rate. 1 Conventional open repair of the inferior vena cava is very challenging. Its morbidity and mortality ranges from 33-66%. 2 The predictors determining the outcome are the mechanism and type of injury, the initial blood pressure, the hemodynamic response to fluid resuscitation, the location of the vena caval injury, the presence of multiple other vascular and solid organ injuries.