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All Journal Majalah Kedokteran Bandung Jurnal Kedokteran Health Notions Manuju : Malahayati Nursing Journal Jurnal Respirasi (JR) JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Majalah Biomorfologi (Biomorphology Journal) SCRIPTA SCORE Scientific Medical Journal Cardiovascular and Cardiometabolic Journal (CCJ) JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Cerdika: Jurnal Ilmiah Indonesia Journal of Indonesia Vascular Access Jurnal Widya Medika Folia Medica Indonesiana
Soebroto, Heroe
Department Of Cardiothoracic And Vascular Surgery, Faculty Of Medicine Universitas Airlangga, Dr Soetomo General Academic Hospital, Surabaya Indonesia
Humanities Biochemistry, Genetics & Molecular Biology Dentistry Economics, Econometrics & Finance Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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Efficacy, Safety, and Clinical Outcomes of Splenorenal Shunt Surgery as a Therapeutic Intervention for Portal Hypertension Patients Sembiring, Yan Efrata; Soebroto, Heroe; Puruhito, Ito; Winarno, Dhihintia Jiwangga Suta; Putra2, I Gusti Agung Made Adnyanya; Negoro, Sri Pramesthi Wisnu Bowo; Yasa, Ketut Putu; Dillon, Jeffrey Jeswant
Folia Medica Indonesiana Vol. 59, No. 3
Publisher : Folia Medica Indonesiana

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Abstract

Highlights: 1. This study systematically reviewed the efficacy, clinical outcomes, and safety of the splenorenal shunt procedure with a comprehensive and meticulous approach. 2. The splenorenal shunt procedure is an innovative surgical intervention that offers a viable option for the management of portal hypertension. Abstract Portal hypertension is the second most common gastrointestinal bleeding in cirrhosis and non-cirrhosis patients. The splenorenal shunt surgery is a potential intervention that may be considered for portal hypertension patients with clinical symptoms such as upper gastrointestinal bleeding caused by the rupture of gastro-esophageal varices. In this study, the researchers aimed to analyze the efficacy, clinical outcomes, and safety of splenorenal shunt surgery in portal hypertension patients. The sources were obtained from electronic search databases, including PubMed, Google Scholar, and ScienceDirect, using the keywords "Efficacy," "Safety," and "Clinical Outcomes." in relation to splenorenal shunt surgery in portal hypertension patients. The researchers set specific criteria for inclusion and exclusion to select the articles. This systematic review revealed the efficacy of the splenorenal shunt procedure with favorable outcomes. The success rate of splenorenal shunt surgery in reducing the clinical symptoms of portal hypertension varied between 66% and 100%. The prevailing complications observed in this study were shunt thrombosis, rebleeding, and thrombocytopenia. However, notable improvements could be achieved with general treatment. In terms of short- and long-term clinical outcomes, the splenorenal shunt procedure demonstrated favorable results. It can be concluded that splenorenal shunt surgery provides excellent clinical outcomes and should be considered a viable treatment option for patients with both cirrhotic and non-cirrhotic portal hypertension.
Implementation of Enhanced Recovery After Surgery (ERAS) Protocols in Pediatric Cardiac Surgery: A Comprehensive Review Nugroho, Edwin Rasendriya; Heroe Soebroto; Ketut Alit Utamayasa
SCRIPTA SCORE Scientific Medical Journal Vol. 7 No. 2 (2026): SCRIPTA SCORE Scientific Medical Journal
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/scripta.v7i2.23099

Abstract

Background: Enhanced Recovery After Surgery (ERAS) represents an evidence-based, multidisciplinary approach that optimizes perioperative care, reduces surgical stress, and accelerates postoperative recovery. While ERAS protocols have been widely implemented in adult cardiac surgery, their adaptation to pediatric congenital heart disease (CHD) remains emerging and underexplored. Pediatric populations pose unique challenges due to differences in physiology, surgical complexity, and developmental status. Objectives: This review aims to provide a comprehensive overview of ERAS implementation in pediatric cardiac surgery, focusing on its key components, outcomes, and research gaps to guide future practice and investigation. Methods: A narrative literature review was conducted using PubMed and Google Scholar, targeting publications from 2010 to 2025. The search utilized the keywords “Enhanced Recovery After Surgery,” “ERAS,” “Pediatric Cardiac Surgery,” and “Congenital Heart Disease.” Relevant randomized controlled trials, cohort studies, reviews, and clinical guidelines were critically analyzed to identify core ERAS elements, perioperative strategies, and reported outcomes. Discussion: The reviewed evidence supports that ERAS protocols in pediatric cardiac surgery are feasible and associated with reduced mechanical ventilation duration, ICU stay, and hospital length of stay, without increasing complications or readmissions. However, most available studies are observational, highlighting the scarcity of randomized controlled trials specifically addressing pediatric CHD. Conclusion: ERAS offers a promising framework to enhance recovery and safety in pediatric cardiac surgery. Standardized, multicenter trials are required to establish evidence-based pediatric ERAS models and determine their long-term impact on recovery and quality of life. Keyword: cardiac surgery, congenital heart disease, ERAS, pediatric, recovery Latar Belakang: Enhanced Recovery After Surgery (ERAS) merupakan pendekatan multidisiplin berbasis bukti yang bertujuan mengoptimalkan perawatan perioperatif, mengurangi stres pembedahan, dan mempercepat pemulihan pascaoperasi. Meskipun protokol ERAS telah banyak diterapkan pada pembedahan jantung dewasa, adaptasinya pada kasus Congenital Heart Disease (CHD) pediatrik masih tergolong baru dan belum banyak diteliti. Populasi pediatrik memiliki tantangan tersendiri karena perbedaan fisiologi, kompleksitas pembedahan, serta status perkembangan. Tujuan: Tinjauan ini bertujuan untuk memberikan gambaran komprehensif mengenai penerapan ERAS pada pembedahan jantung pediatrik, dengan menyoroti komponen utama, luaran klinis, serta kesenjangan penelitian untuk panduan praktik dan penelitian selanjutnya. Metode: Tinjauan literatur naratif dilakukan dengan menggunakan basis data PubMed dan Google Scholar untuk publikasi tahun 2010 hingga 2025. Pencarian dilakukan dengan kata kunci “Enhanced Recovery After Surgery,” “ERAS,” “Pediatric Cardiac Surgery,” dan “Congenital Heart Disease.” Artikel yang relevan, termasuk randomized controlled trials, studi kohort, tinjauan pustaka, dan pedoman klinis dianalisis secara kritis untuk mengidentifikasi elemen utama ERAS, strategi perioperatif, serta luaran yang dilaporkan. Pembahasan: Bukti yang ditinjau menunjukkan bahwa penerapan protokol ERAS pada pembedahan jantung pediatrik bersifat layak dan berhubungan dengan penurunan durasi ventilasi mekanik, lama perawatan di ICU, serta lama rawat inap, tanpa meningkatkan komplikasi maupun angka readmisi. Namun, sebagian besar studi yang tersedia bersifat observasional, menyoroti keterbatasan uji acak terkontrol yang secara khusus meneliti CHD pediatrik. Kesimpulan: ERAS menawarkan kerangka kerja yang menjanjikan untuk meningkatkan pemulihan dan keamanan pada pembedahan jantung pediatrik. Diperlukan uji multicenter terstandar untuk membangun model ERAS berbasis bukti pada populasi pediatrik serta menilai dampak jangka panjangnya terhadap pemulihan dan kualitas hidup. Keyword: bedah jantung, ERAS, pediatrik, pemulihan, penyakit jantung bawaan
Changes in Nutritional Status of Children with Acyanotic Congenital Heart Disease Six Months After Repair and Intervention Siregar, Ludwina Rouli Hilary; Heroe Soebroto; Hidayat, Taufiq
Cardiovascular and Cardiometabolic Journal (CCJ) Vol. 7 No. 1 (2026): Cardiovascular and Cardiometabolic Journal - In Press
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ccj.v7i1.2026.12-24

Abstract

Background: Acyanotic congenital heart diseases (CHDs) namely, atrial septal defect (ASD), ventricular septal defect (VSD), and patent ductus arteriosus (PDA) are prevalent in children and often associated with malnutrition due to increased metabolic demands and feeding difficulties. Aims: This study evaluated the incidence, characteristics, and nutritional outcomes of paediatric patients undergoing repair for acyanotic CHD at RSUD Dr. Soetomo in 2023. Methods: A retrospective observational study included 40 children aged 1–13 years with ASD, VSD, PDA, or combinations thereof. Data on age, sex, and anthropometric parameters including weight-for-age (WAZ), height-for-age (HAZ), weight-for-height (WHZ), and BMI-for-age (BAZ) were assessed before and at 1, 3, and 6 months post-repair. Results: PDA was the most frequent diagnosis (50%), with females comprising 60% of cases and most patients (62.5%) under 5 years. Before repair, 71.4% were underweight and 60% were stunted (mean WAZ –2.58; HAZ –2.3). Nutritional recovery occurred gradually; at 6 months, normal WAZ increased to 58.8% and normal HAZ to 65%, though 38.2% remained underweight and 35% stunted. Conclusion: Repair intervention improves but does not fully normalize nutritional status. Ongoing nutritional support and long-term monitoring are essential for optimal recovery in paediatric CHD patients. -- Highlights: 1. Nutritional status among paediatric patients with acyanotic congenital heart disease (ASD, VSD, PDA) significantly improved within 6 months post-repair, especially in weight-for-age and height-for-age indicators, demonstrating the beneficial impact of surgical correction on growth recovery. 2. Despite overall improvement, over one-third of patients remained underweight or stunted six months after repair, emphasizing the need for continued nutritional monitoring and integrated dietary support in post-operative care programs.
Co-Authors Abed Nego Okthara Sebayang Admadiani, Fhahira Rizkhika Ahmed Eliaan Shaker Abuajwa Ansyori, Maz Isa Arief Rakhman Hakim Arifoel Hajat Chronica Elsa Retta Lumban Tobing Danang Himawan Limanto Dharmadjati, Budi Baktijasa Dhihintia Jiwangga Suta Winarno Dhihintia Jiwangga Suta Winarno Dillon, Jeffrey Jeswant Effendi, Wiwin Is Ekoputranto, J Nugroho Erdyanto Akbar Fhahira Rizkhika Admadiani Gerardo AK Laksono Hakim, Arief Rakhman Hartono Kahar, Hartono Heri Suroto Hermina Novida, Hermina Hildegardis Dyna Dumilah I Gusti Agung Made Adnyanya Putra I Gusti Agung Made Adnyanya Putra2 Ito Puruhito Jeffrey Jeswant Dillon Jeffrey Jeswant Dillon Juliana Juliana Juliana Juliana Ketut Alit Utamayasa Ketut Putu Yasa Ketut Putu Yasa Kusworo, Afila Reza Mahrus A Rahman, Mahrus A Marsa Hendra Utomo Mochamad Wildan MOCHAMMAD THAHA Negoro, Sri Pramesthi Wisnu Bowo Nugroho, Edwin Rasendriya Paul L Tahalele Puruhito Puruhito Puruhito Puruhito, Ito Putra, I Gusti Agung Made Adnyana Putra2, I Gusti Agung Made Adnyanya Putranto, J.Nugroho Eko Rahman, Mahrus Abdur Reido Dafa Annafis Reviano, Moses Orvin Rizki, Mohamad Salsabila Fabianca Alsaid Saphira, Diva Sembiring, Yan Efrata Setiawan, Philia Siregar, Ludwina Rouli Hilary Sony Wibisono Sri Pramesthi Wisnu Bowo Negoro Sri Pramesthi Wisnu Bowo Negoro Subagjo, Agus Taufiq Hidayat Taufiq Hidayat Taufiq Hidayat Widipriyatama, Gabriel Rio Widodo Widodo Winarno, Dhihintia Jiwangga Suta