Ngoi, Sing Shang
Email Address
Organizational Units
SURGERY
dept
YONG LOO LIN SCH OF MEDICINE
faculty
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Publication Nitric oxide and cancer(1996) Chhatwal, V.J.S.; Moochhala, S.M.; Chan, S.T.F.; Ngoi, S.S.; SURGERYThe possibility that the overall process of carcinogenesis may be linked to the deficiency of nitric oxide in a biological cell is examined. A hypothetical model of how this might operate to produce subtle changes in a cell resulting in and/or facilitating carcinogenesis is suggested.Publication Letter to the editor(1992) Sing, Sang Ngoi; Goh, P.; Tekant, Y.; Schmit, P.J.; Thompson, J.E.; Bennion, R.S.; SURGERYPublication Combination therapy using adrenaline and heater probe to reduce rebleeding in patients with peptic ulcer haemorrhage: A prospective randomized trial(1995) Tekant, Y.; Goh, P.; Alexander, D.J.; Isaac, J.R.; Kum, C.K.; Ngoi, S.S.; SURGERYPublication Routine use of setons for the treatment of anal fistulae.(2002-06) Theerapol, A.; So, B.Y.; Ngoi, S.S.; SURGERYAIM: Anal fistula is usually treated by either fistulotomy or fistulectomy. We described the routine use of setons to treat anal fistula without any surgery. METHOD: Forty-seven consecutive patients with diagnosed anal fistulae were treated using setons alone. RESULTS: The median age of the patients was 41 (range: 18-70). Of the 47 patients, 15 had surgery previously for fistula and perianal abscess. At least two setons were inserted through each fistula. One was tied tightly to function as a cutting seton and this was sequentially tightened by the patient and another was tied loosely for drainage. Of the 47 patients, 33 (70%) had the placement of setons in the clinic without any anaesthesia. The remaining 14 patients had the setons inserted in the operating room, with one patient having a complex anal fistula and 13 patients having perianal abscess requiring drainage at the same time. There were no post procedure complications in the series. Forty-one patients had completed follow up at clinic within a median duration of 15 weeks (range: two to 67 weeks). The fistula was completely healed by this method in 37 patients (78%). The median healing time was nine weeks (range: four to 62 weeks). One patient developed recurrent fistula and was healed after another seton placement. No patient developed any faecal incontinence and all patients were satisfied with this treatment. CONCLUSION: The routine seton method is safe, cheap and effective in the treatment of anal fistula regardless of type. It does not leave an open wound and most patients are satisfied with the treatment.Publication Randomized trial of periportal peritoneal bupivacaine for pain relief after laparoscopic cholecystectomy(1996) Alexander, D.J.; Ngoi, S.S.; Lee, L.; So, J.; Mak, K.; Chan, S.; Goh, P.M.; SURGERYThe aim of this study was to determine whether injection of a long-acting local anaesthetic, in relation to the port sites at the level of the parietal peritoneum, would reduce postoperative pain following laparoscopic cholecystectomy. Patients were entered into a randomized, prospective, double-blind study comparing the effects of a standard technique, in which bupivacaine (total of 20 ml, 0.5 per cent) was injected into the subcutaneous periportal tissue around the four port sites, and a technique in which bupivacaine (total of 20 ml, 0.25 per cent) was injected into the subcutaneous periportal tissue as above with the addition of periportal parietal peritoneal injection of bupivacaine (total of 20 ml, 0.25 per cent). Two scores for pain, with the patient at rest, and on movement, were assessed 6 and 18 h after surgery using a visual analogue pain scale. Median pain score was significantly higher in patients who received standard technique; (n = 40) than in those given peritoneal injection (n = 40) at both 6 (rest = 3.0 versus 1.0, movement = 5.0 versus 2.9) and 18 h (rest = 1.9 versus 0, movement= 3.2 versus 1.2). Both opiate and oral analgesic requirements were reduced in patients administered peritoneal injection, although this was not statistically significant. The addition of periportal injection of bupivacaine at the level of the parietal peritoneum, performed under direct vision, reduces pain after laparoscopic cholecystectomy.Publication The surgical treatment of squamous cell carcinoma of the oesophagus in Singapore.(1990-11) Wong, T.H.; Tekant, Y.; Ngoi, S.S.; Ti, T.K.; Rauff, A.; SURGERYIn a retrospective study, we reviewed 97 consecutive cases of squamous cell carcinoma collected over a five-year period (1978-1983). Resection of the tumour was possible in 30 out of 40 patients subjected to surgery. Of these 30 patients, five died within 30 days of surgery. Eight patients who underwent oesophageal resection were still alive after five years and apparently cured. Bypass surgery for unresectable lesions in six patients were complicated by anastomotic leakage in three patients. Patients unsuitable for surgical resection were treated using Celestin tube insertion or radiation. Mean survival in 13 patients with Celestin tube insertion was 4.1 months. Of 48 patients who were treated by radiotherapy, two lived beyond five years. Surgical resection restores swallowing effectively and offers a 25% chance of cure and should be done in fit patients. In unfit patients with advanced disease, palliation from the use of radiotherapy and Celestin tube insertion were poor. Newer techniques such as endoscopic laser recanalisation and bicap hyperthermia may need to be considered for palliation in this group of patients.Publication Expression of nitric oxide synthase, cyclooxygenase, and p53 in different stages of human gastric cancer(2001-10-30) Rajnakova, A.; Moochhala, S.; Goh, P.M.Y; Ngoi, S.-S.; MEDICINE; SURGERYThe present study evaluated the significance of nitric oxide synthase (NOS), cyclooxygenase (COX) expression and p53 status in 55 patients with gastric adenocarcinoma and relationship of these molecular markers to tumor characteristics and metastatic potential. Immunohistochemical technique was used to identify the cellular location and distribution of the enzymes in the specific cells of gastric tumors. In gastric cancer tissue, the expression of inducible enzymes, iNOS and COX-2, increased significantly with increasing tumor stage (P = 0.015, P = 0.001, respectively), size (P = 0.025, P = 0.001, respectively) and the presence of metastases (P = 0.002, P = 0.015, respectively). The expression of constitutive enzymes, ecNOS and COX-1, followed the opposite pattern. COX-1 was significantly reduced in advanced gastric tumors (P = 0.007) and tumors larger than 5 cm (P = 0.007). Reduced expression of ecNOS was also observed in advanced gastric tumors; however, this did not reach statistical significance. 53% of gastric tumors showed accumulation of p53. This was significantly higher in advanced tumors (P = 0.004), larger than 5 cm (P = 0.015) with metastases (P < 0.001). Gastric tumors positive for accumulation of p53 had significantly stronger expression of iNOS (P = 0.018) and COX-2 (P = 0.01) enzymes than tumors negative for this nucleophosphoprotein. We conclude, that tumor-associated nitric oxide production, as well as COX-2 overexpression, may promote gastric cancer progression by providing a selective growth advantage to tumor cells with non-functioning p53. © 2001 Elsevier Science Ireland Ltd. All rights reserved.Publication Laparoscopic cholecystectomy for acute cholecystitis(1994) Kum, C.K.; Goh, P.M.Y.; Isaac, J.R.; Tekant, Y.; Ngoi, S.S.; SURGERYPublication Mutations of the tumour suppressor gene p53 in colorectal and hepatocellular carcinomas.(1995) Shi, C.Y.; Phang, T.W.; Wee, A.; Ngoi, S.S.; Lin, Y.; Li, B.; Ong, C.N.; Lee, H.P.; SURGERY; PATHOLOGY; COMMUNITY,OCCUPATIONAL & FAMILY MEDICINEPublication Endoscopic sphincterotomy for the treatment of cystic duct leak following laparoscopic cholecystectomy(1994) Isaac, J.; Tekant, Y.; Cheng, Kiong Kum; Sing, Shang Ngoi; Goh, P.; SURGERY