Colorectal Surgery

Welcome to the Colorectal Unit at University Malaya Medical Centre.

We are a tertiary colorectal centre and we receive patients from surgical units across Malaysia. We are an established centre managing colorectal diseases with a full complement of multidisciplinary specialists comprising of experienced colorectal surgeons, gastroenterologists, oncologists and radiologists in a single institution.

Our goal is to provide quality patient-centred care which is centred upon evidence and based on value. We strive to provide optimal care to our patients by continually evaluating our service delivery and develop new surgical techniques to drive research and innovation. We believe that good quality colorectal surgical care should be equitable and accessible to all.

Approximately 6000 patients present to our clinic per year for clinical assessment and treatment of a wide spectrum of colorectal related conditions. The colorectal conditions that our patients commonly consult us are listed below, and you may find the information provided helpful. We provide a full complement of radiological, endoscopic investigations, including investigations to assess the pelvic floor such as endoanal ultrasound and anal manometry.

Our colorectal surgeons perform approximately 600 elective and emergency operations on the bowel each year for benign and malignant conditions. We are in a unique position to be able to offer a patient-centred holistic approach, through close collaborations with colleagues from other fields of medicine and oncology, to ensure that we tailor our management and treatments offered to our patients.

Our Services :

The colorectal unit is a recognised and accredited national training hub for colorectal subspecialty training since 2009. Colorectal fellows who are on the national subspecialty training programme will typically be allocated to a 6-month post in our unit. Our team is also normally complemented by visiting international specialist fellows who will be attached for a period of 6 to 12 months. During the attachment period, the fellows will lead a team comprising of training medical officers and house officers and they will be responsible for the routine clinical management of patients. Fellows will be expected to perform elective and emergency colorectal procedures, both by open and minimally invasive techniques, under appropriate supervision by training consultants.

We routinely run courses and workshops to attract participants of varying levels of experience, ranging from trainees in their early years of training to expert specialist surgeons. Workshops which we deliver include:

• Laser haemorrhoidoplasty
• Laser fistuloplasty for fistula in ano
• Laparoscopic colorectal cadaveric workshop in conjunction with Silent Mentor programme, University Malaya
• Science of Tissue Management in conjunction with Johnson & Johnson
• Care of the Critically Ill Surgical Patient

Several of us are also accredited by the Royal College of Surgeons of Edinburgh to deliver the Non Technical Skills of Surgeons workshop across various training sites in Malaysia.

Training	Training
Manuscript writing workshop	Manuscript writing workshop
Surgical Education and Simulation Online conference SES2020	Webinar- Impact of COVID on Colorectal Surgery
Colonoscopy Training	FRCS Exams
PIPAC Workshop	Teaching Medical Students
Cadaveric Workshop	Cadaveric Workshop

Our research experience encompasses clinically oriented studies and basic science projects to improve our understanding of various colorectal disorders. Our objective is to conduct clinically relevant research with an emphasis on uncovering new knowledge and novel practices to improve patient outcomes. We work closely with our network of local and international collaborators to develop new ideas and to evaluate feasibility and the impact of adopting new practices in our local setting. The findings from several of our studies have been published and these are listed as featured publications below.

• Microbiota organization is a distinct feature of proximal colorectal cancers
  Proceedings of the National Academy of Sciences Dec 2014, 111 (51) 18321-18326; DOI: 10.1073/pnas.1406199111.
• Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial.
  Lancet. 2010;376(9734):23-32. DOI:10.1016/S0140-6736(10)60835-5
• Semuloparin for Thromboprophylaxis in Patients Receiving Chemotherapy for Cancer
  N Engl J Med 2012; 366:601-609. DOI: 10.1056/NEJMoa1108898.
• Prevalence and association of pks+ Escherichia coli with colorectal cancer in patients at the University Malaya Medical Centre, Malaysia
  PLoS One. 2020 Jan 28;15(1):e0228217. doi: 10.1371/journal.pone.0228217.
• Mortality of emergency abdominal surgery in high-, middle- and low-income countries
  Br J Surg. 2016 Jul;103(8):971-988. doi: 10.1002/bjs.10151.