Post-Procedure Complications Monitoring Programme 39th Review Meeting Friday, 21 March 2014 4:00 - 6:00pm, 4/F, Arthur K C Li Surgical Library Lui Che Woo Clinical Sciences Building, PWH

Attendance Present Prof. Paul Lai (Chairman) Team 1 – Dr. Charing Chong & Dr. Bear Cho Team 2 – Dr. Simon Wong & Dr. Sally Luk Team 3 – Dr. Rachel Ko Team 4 – Dr. Y F Yeung PRAS – Dr. Kevin Mo NS – Dr. Alberto Chu PSU – Dr. Edwin Chan & Dr. Sammi Wong URO – Dr. C K Chan & Dr. C H Samuel Yee CTS – Dr. Micky Kwok Mr. Alfred Chan Ms Daisy Feng Ms Eunice Tam

Items discussed Complications report – January 2014 AOB

1. Complications Report – January 2014

December 2014 Summary (case collection progress and Complication rate) Complication rate and Magnitude Team 1 Team 2 Team 3 Team 4 PRAS NS PSUR URO CTS Total No. of Complication 11 4 5 3 7 13 55 51 47 64 43 56 73 53 65 516 Complication Rate 21.57% 8.51% 7.81% 6.98% 8.93% 9.59% 7.55% 4.69% 20.00% 10.66%

Team 1 – Hepato-biliary & Pancreatic Surgery

Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 2/6) Grade 2

Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 3/6) + Septic shock

Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 4/6) + Septic shock Delete either one

Outpatient Complication Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 5/6) Outpatient Complication

Team 1 – Hepato-biliary and Pancreatic Surgery ( Cont’d 6/6) Open & closed + Septic shock + I.O

Team 2 – Upper Gastro-intestinal Surgery

Team 2 – Upper Gastro-intestinal Surgery ( Cont’d 2/4) M & M

Daisy to follow up on the length of stay Team 2 – Upper Gastro-intestinal Surgery ( Cont’d 3/4) not aware of poor renal function upon admission no renal protection before CT M & M 4 - Delay presentation Successful case with ICU support Daisy to follow up on the length of stay

Team 2 – Upper Gastro-intestinal Surgery ( Cont’d 4/4)

Team 3 – Colorectal Surgery

Team 3 – Colorectal Surgery ( Cont’d 2/4)

Team 3 – Colorectal Surgery ( Cont’d 3/4) ESBL E Coli (i.e. Still escape from prophylactic antibiotic – augmentin)

Team 3 – Colorectal Surgery ( Cont’d 4/4)

Team 4 – Vascular Surgery

Team 4 – Vascular Surgery (Cont’d 2/3)

Complication : Aspiration Team 4 – Vascular Surgery (Cont’d 3/3) No Discharge summary Poor pre-morbid status with ongoing ischaemia Complication : Aspiration

Plastic, Reconstructive and Aesthetic Surgery

Plastic, Reconstructive and Aesthetic Surgery (Cont’d 2/4) + renal failure

Plastic, Reconstructive and Aesthetic Surgery (Cont’d 3/4)

Plastic, Reconstructive and Aesthetic Surgery (Cont’d 4/4)

Neurosurgery

Neurosurgery (Cont’d 2/5) Complication of 1st OT Should update 1st OT

+ Catheter re-adjustment Neurosurgery (Cont’d 3/5) + Catheter re-adjustment

Neurosurgery (Cont’d 4/5) Post-op bleeding Remark : requiring ICP Insertion

Neurosurgery (Cont’d 5/5) No discharged summary a/v.

Paediatric Surgery & Paediatric Urology

Paediatric Surgery & Paediatric Urology (Cont’d 2/4) Grade : 1 Grade 3b Urinary leakage

Paediatric Surgery & Paediatric Urology (Cont’d 3/4) Remarks in OT record that a stricture occurred 2 months after surgery

Paediatric Surgery & Paediatric Urology (Cont’d 4/4)

Urology

Urology (Cont’d 2/3)

Urology (Cont’d 3/3) Died at ICU Patient under renal medicine

Cardiothoracic Surgery

Cardiothoracic Surgery (Cont’d 2/11)

Cardiothoracic Surgery (Cont’d 3/11) - No need for long term renal replacement therapy

Cardiothoracic Surgery (Cont’d 4/11)

Cardiothoracic Surgery (Cont’d 5/11) Pathology : Rupture of descending aorta on Day 4 Unconventional procedure (because of very small femoral artery)

Cardiothoracic Surgery (Cont’d 6/11)

Cardiothoracic Surgery (Cont’d 7/11)

Cardiothoracic Surgery (Cont’d 8/11) Index operation A mortality case

Cardiothoracic Surgery (Cont’d 9/11) Mortality due to advancement of disease Dr. Kwok to update OT record from GA -> MAC

Cardiothoracic Surgery (Cont’d 10/11) D / C on 12 Feb 14 D/C on 25 Feb 14 Dr. Kwok to follow-up on progress of patients after returning to Macau.

Cardiothoracic Surgery (Cont’d 11/11)

2. AOB - Nil

THE END