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All Journal The New Ropanasuri Journal of Surgery
Marbun, Vania MG
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology

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How early is early…? The Role of Abdominal Reoperation Predictive Index at dr. Cipto Mangunkusumo General Hospital, Jakarta Marbun, Vania MG; Lalisang, Toar JM
The New Ropanasuri Journal of Surgery Vol. 3, No. 2
Publisher : UI Scholars Hub

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Introduction. Determining the right timing of relaparotomy has always been a challenge and hence a simple objective value is required. Abdominal reoperative predictive index (ARPI) proposed to decide when to reoperate. The study aimed to ascertain whether ARPI could be applied in decision making for relaparotomy at dr.Cipto Mangunkusumo General Hospital (RSCM), Jakarta. Method. A cross sectional study carried out on those underwent relaparotomy in Department of Surgery at RSCM during period of 2009–2015. The follow–up carried out by the residents under supervision of attending surgeons, the laboratory findings were reviewed and tabulated in accordance with clinical variables of ARPI. Eight variables of ARPI were reviewed in these subjects. Results. There were 30 subjects reviewed. In this study there were four frequent variables, i.e. persistent symptoms (for more than 4 days after relaparotomy), abdominal pain (that remains for 48 hours after relaparotomy), surgical site infection (90%), and ileus (70%). Seventy–three–point three percent carried out in more than 7 days after primary operation, while as only 10 percent underwent relaparotomy less than 4 days after primary operation. Conclusion. ARPI is practical guide and may be implemented in helping surgeons to decide relaparotomy should there required. Low compliance lead to delay in the management and associated with high mortality.
A Glimpse of Liver Resection Profile in An Indonesian Tertiary Hospital: A Retrospective Descriptive Study Vaniara, Florencia V; Lalisang, Arnetta NL; Lalisang, Toar JM; Mazni, Yarman; Putranto, Agi S; Jeo, Wifanto S; Ibrahim, Febiansyah; Syaiful, Ridho A; Sihardo, Lam; Marbun, Vania MG
The New Ropanasuri Journal of Surgery Vol. 10, No. 1
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Introduction. In-depth liver resection profile is needed for evaluation to improve the procedure’s outcome. This study aims to describe the clinical characteristics and outcomes of liver resection in HCC patients in Cipto Mangunkusumo Tertiary Hospital. Methods. This study retrospectively analyzed the clinical data of 19 HCC patients who underwent liver resection in Cipto Mangunkusumo Tertiary Hospital from 2021 to 2024. Demographic, clinical, laboratory, operative, and pathological data were collected. Postoperative complications were assessed using the Clavien-Dindo classification system within 30- and 90-day postoperative periods. Result. Nineteen patients were included, comprising 12 (63.2%) males and 7 (36.8%) females. Sixteen patients (84.2%) had Child-Pugh (CP) class A liver function with 10 (62.5%) CP A(5) patients and 6 (37.5%) CP A(6) patients; 3 (15.8%) patients had CP class B(7). There were 6 (31.6%) patients with thrombocytopenia and 4 (21.1%) patients with portal hypertension. Liver resection was done laparoscopically in 4 (21.1%) patients and with an open approach in 15 (78.9%) patients. Left hepatectomy was done in 3 patients (15.78%), right hepatectomy in 2 (10.5%), right anterior sectionectomy in 4 (21%), left lateral sectionectomy in 1 (5.26%), bisegmentectomy in 1 (5.26%), segmentectomy in 6 (31.58%), and non-anatomical resection in 2 (10.52%). Based on histopathologic examination, HCC was found in 13 (68.41%) patients. Among 19 patients, 12 (63.2%), 5 (26.3%), and 2 (10.5%) patients had 1 tumor, 2 tumors, and 3 tumors respectively (total tumors resected: n=28). About 16 (84.21%) patients had elevated alpha fetoprotein (AFP) (> 10 ng/mL). The mean intraoperative blood loss was 884 mL. No postoperative complications classified as Clavien-Dindo grade I-IV were observed. Two patients (10.5%) experienced postoperative mortality within 90 days (Clavien-Dindo grade V), both due to circulatory failure. Conclusion. This study presents a descriptive overview of liver resection in an Indonesian tertiary hospital. Comparative conclusions should be interpreted with caution due to the limited sample size.
Co-Authors Ibrahim, Febiansyah Jeo, Wifanto S Lalisang, Arnetta NL Mazni, Yarman Putranto, Agi S Sihardo, Lam Syaiful, Ridho A Toar J.M. Lalisang Vaniara, Florencia V