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All Journal The New Ropanasuri Journal of Surgery
Angkoso, Heru
Unknown Affiliation
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology

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Review: Conventional Thrombectomy with Intraoperative Fluoroscopy in Acute Limb Ischemia Rutherford IIb Angkoso, Heru; Pratama, Dedy
The New Ropanasuri Journal of Surgery Vol. 7, No. 1
Publisher : UI Scholars Hub

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Introduction. Acute limb ischemia (ALI) is a severe condition affecting the extremities and the patient’s survival that requires immediate treatment. It can be treated with either surgical or endovascular revascularization or both (hybrid procedure). It is crucial to evaluate the defect using intraoperative fluoroscopy or angiography in each case. The review aimed to find out the outcomes of the thrombectomy with intraoperative fluoroscopy for ALI Rutherford IIb. Method. According to the PRISMA protocol, the literature search proceeded in online databases, i.e., Cochrane, Scopus, PubMed, and EBSCOhost, with no year limitation on the publication. All articles were screened and critically appraised. Five eligible articles enrolled in this study with 269 patients ALI Rutherford IIb. All selected articles are cohort studies, including prospective and retrospective. Results. The endovascular intervention (with intraoperative fluoroscopy assistance) showed lower mortality and morbidity than open thrombectomy – however, no difference between open and hybrid thrombectomy in mortality rate. In addition, morbidities such as amputation and limb salvage showed no difference significantly between these interventions. Open thrombectomy has a high risk of mortality and amputation. Meanwhile, the endovascular intervention likely showed a risk of reocclusion, thus, requiring a conversion to open thrombectomy. Conclusion. Intraoperative angiography during open thrombectomy may reduce complications of postintervention reocclusion.
Prognostic Factors for Mortality of Pediatric Burn Injury in a National Tertiary Referral Center Angkoso, Heru; Kekalih, Aria
The New Ropanasuri Journal of Surgery Vol. 7, No. 2
Publisher : UI Scholars Hub

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Introduction. In Indonesia, burn injuries cause about 195,000 deaths annually. Data from the Ministry of the Health Republic of Indonesia showed the incidence of burns predominated at 1-4 years old. The mortality of pediatric burn patients in a tertiary hospital was 37.26%. This study aimed to find an association between known and unknown prognostic factors of mortality in Indonesian-specific characteristics. Method. A retrospective analytical study included all pediatric burns admitted to Dr. Cipto Mangunkusumo General Hospital (CMGH) from 1998 to 2010. Variables within a period of the first 72 hours of admission were the focus of interest and were extracted from the medical record. Results. Of 609 pediatric burns, the mortality rate is 37.8%. Some contributing variables significantly associated with the mortality were TBSA, inhalation injury, length of hospitalization, hemoglobin 0-h level, hematocrit 24-h, and 48-h level, INR 0-h, and 48-h, fluid balance 24-h, base deficit, serum lactate, pulmonary edema, systemic inflammatory response syndrome (SIRS) + multiorgan failure (MOF), and acute coronary syndrome (ACS) (p <0.05). On multivariate analysis, the significant variable was length of hospitalization <14 days, SIRS+MOF, abnormal hematocrit 0-h level, and abnormal serum lactate level. Conclusion. The more identified prognostic factors a patient finds, the more the mortality risk. In addition, excessive fluid resuscitation leads to a high likelihood of pulmonary edema, SIRS+MOF, and ACS complications, followed by increased mortality risk
Co-Authors Aria Kekalih Dedy Pratama