1. Post-Procedure Complications Monitoring Programme 38th Review Meeting
Friday, 21 February 2014
4:00 - 6:00pm, 4/F, Arthur K C Li Surgical Library
Lui Che Woo Clinical Sciences Building, PWH

2. Attendance Present Prof. Paul Lai (Chairman)
Team 2 – Dr. Simon Wong & Dr. Sally Luk
Team 3 – Dr. S F Hon & Dr. Rachel Ko
Team 4 – Dr. Y F Yeung
NS – Dr. W K Mak & Dr. Alberto Chu
PSU – Dr. Edwin Chan & Dr. Vicky Wong
URO – Dr. C K Chan
CTS – Prof. Calvin Ng
Mr. Alfred Chan
Ms Daisy Feng
Ms Eunice Tam

3. Items discussed
Complications report – December 2013
AOB

4. 1. Complications Report – December 2013

5. December 2013 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 12 6 8 9 2 3 42 55 59 46 60 70 39 72 62
518
Complication Rate
0.00%
20.34%
10.91%
17.39%
12.86%
5.13%
2.78%
4.84%
8.11%

6. Team 1 – Hepato-biliary & Pancreatic Surgery

7. Team 2 – Upper Gastro-intestinal Surgery

8. Team 2 – Upper Gastro-intestinal Surgery ( Cont’d 2/6)
Team 2 to relate the perforation to the surgeon who performed the first operation
+ Pleural effusion requiring drainage (Dr. S Wong advised that prophylactic measure for post-op pleural effusion implemented by inserting chest drain [smallest size - 12 fr) on contra-lateral side]

9. Haematoma with bruises outside
Team 2 – Upper Gastro-intestinal Surgery ( Cont’d 3/6)
Haematoma with bruises outside
Such complication might arise if thorough search of vessels was not performed. Members should watch out for this complications.

10. Team 2 – Upper Gastro-intestinal Surgery ( Cont’d 4/6)

11. Probably pre-existing pneumonia as there was no fever on admission.
Team 2 – Upper Gastro-intestinal Surgery ( Cont’d 5/6)
Probably pre-existing pneumonia as there was no fever on admission.
+ Chest infection

12. Team 2 – Upper Gastro-intestinal Surgery ( Cont’d 6/6)

13. Team 3 – Colorectal Surgery

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

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

16. Team 3 – Colorectal Surgery (Cont’d 4/4)
Interesting pathology
Referred to Oncology

17. Team 4 – Vascular Surgery

18. Team 4 – Vascular Surgery (Cont’d 2/7)

19. Team 4 – Vascular Surgery (Cont’d 3/7)

20. Team 4 – Vascular Surgery (Cont’d 4/7)?
Very long OT (17 hours)
Very difficult anatomy
Dr. Y F Yeung to arrange D/C Summary

21. Team 4 – Vascular Surgery (Cont’d 5/7)
+ stent thrombosis

22. Team 4 – Vascular Surgery (Cont’d 6/7)
No specific Cx. listed

23. Team 4 – Vascular Surgery (Cont’d 7/7)
Dr. Y F Yeung to follow up on details (as patient died in O&T) ?
No specific Cx. listed

24. Plastic, Reconstructive and Aesthetic Surgery

25. Neurosurgery

26. NS Team should report the
Neurosurgery (Cont’d 2/7) ? ?
NS Team should report the
1o surgery

27. Neurosurgery (Cont’d 3/7)? ?

28. Neurosurgery (Cont’d 4/7)? ?

29. Neurosurgery (Cont’d 5/7)?

30. Neurosurgery (Cont’d 6/7)? ?

31. Neurosurgery (Cont’d 7/7)

32. Paediatric Surgery and Paediatric Urology

33. Paediatric Surgery and Paediatric Urology (Cont’d 2/3)

34. case already discussed in Nov. 2013 report
Paediatric Surgery and Paediatric Urology (Cont’d 3/3)
case already discussed in Nov report

35. Urology

36. Urology (Cont’d 2/2)
2o haemorrhage

37. Cardiothoracic Surgery

38. Cardiothoracic Surgery (Cont’d 2/6)
Poor EF
Pre-op renal failure
high euro score
Prof C. Ng to arrange
D/C Summary asap

39. Cardiothoracic Surgery (Cont’d 3/6)

40. Cardiothoracic Surgery (Cont’d 4/6)
- Received bone marrow transplant previously
- Suffered from pneumonia

41. Cardiothoracic Surgery (Cont’d 5/6)
Prof Calvin Ng would find out why ECMO was not used

42. Cardiothoracic Surgery (Cont’d 6/6)

43. 2. AOB

44. AOB Complications grading
All Teams should complete grading of complication for 2013 as far as possible
Complications grading must be submitted for cases from 2014 onwards
Comparison with SOMIP results
High concordance (>85%) when complications data is compared with SOMIP result
Case for discussion in M & M meeting
Nil

45. THE END