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All Journal The New Ropanasuri Journal of Surgery
Gunardi, Hardian
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology

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Association between Obesity and Hormone Receptor Characteristics of Primary Breast Cancer at Cipto Mangunkusumo General Hospital, Jakarta, in 2017 Gunardi, Hardian; Kartini, Diani
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Introduction. Obesity is an independent risk factor and prognostic factor of primary breast cancer. Abundant adipose tissue would lead to increment of blood estrogen level; thus, promoting proliferation of cancer cell, especially those with positive estrogen receptor (ER) and progesterone receptor (PR). No study reported the association between obesity and hormone receptor characteristics of primary breast cancer in Indonesia. Method. We collected cases of primary breast cancer which is diagnosed and undergone immunohistochemistry examination at Cipto Mangunkusumo General Hospital in 2017. The subjects divided into obese group and non-obese group. The ER and PR characteristics of both groups were compared Results. We collected 202 cases of primary breast cancer, with 89 cases (44%) in obese group and 113 cases (56%) in non-obese group. The mean body mass index (BMI) of the subjects was 24.45±4.3. Both groups were similar in terms of age, menopausal status, stage, histopathological morphology and grade. No significant association was found between obesity and ER or PR. We analyzed correlation between BMI and the percentage of expressed hormone receptor, but no correlation was found. This finding did not conform with other Western studies. Difference in characteristics of the subjects and other hormonal factors might contribute to the outcome. Conclusion. There is no association between obesity and hormone receptor characteristics of primary breast cancer at Cipto Mangunkusumo General Hospital in 2017. Keywords: obesity, hormone receptor, estrogen, progesterone, primary breast cancer
Transanastomotic Feeding Tube in Surgical Management of Congenital Duodenal Obstruction: Case Series Gunardi, Hardian; Rachmawati, Asri D; Susilo, Nanok E; Tamba, Riana P
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Introduction. Prolonged fasting is a major concern in the postoperative management of congenital duodenal obstruction. Massive dilatation of the proximal segment would lead to diameter discrepancy and lack of propulsion, thus delaying enteral feeding. A transanastomotic feeding tube is an option to deliver early enteral feeding after surgical correction. The study evaluates the effectiveness and safety of a transanastomotic feeding tubes in the surgical management of congenital duodenal obstruction. Method. The transanastomotic feeding tube's effectiveness in cases of congenital duodenal obstruction of the newborn underwent surgical correction was evaluated. Those managed from January 2016 to December 2018 at dr. Cipto Mangunkusumo and Fatmawati General Hospital were subjected to the evaluation. Results. Ten cases were recorded, with the mean gestational age of 30.4 weeks (SD ± 2.12), with a mean bodyweight of 2.571 g (SD ± 392). Seventy percent of the cases accompanied by other anomalies. Enteral nutrition was introduced immediately after surgery. The median time of oral nutrition initiation was 13 days (3-21), and the patients were fully fed in 19.5 days (13-37). The average length of stay was 24.5 days (16-40 days). One case had a complication requiring surgery, and mortality in two cases complicated with sepsis. Conclusion: Transanastomotic feeding tube is an option to deliver early enteral feeding after surgical correction of congenital duodenal obstruction.
Anorectal Malformations in Monozygotic Twins: An Illustration of Management of Anorectal Malformations in A Tertiary Hospital in Indonesia Gunardi, Hardian; Rachmawati, Asri D; Susilo, Nanok E
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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A case of monozygotic twin boys with anorectal malformation with delayed presentation of bowel perforation. Both are managed surgically with a colostomy; after a definite diagnosis of anorectal malformation with a urethral fistula based on distal colostography, both boys underwent anoplasty with a posterior sagittal approach. Stoma closure was performed, and we found no complication during eight months of follow-up. Delay in the management of the twins was due to a lack of anal screening of the newborn. The unavailability of the neonatal intensive care unit became a significant concern. Distal colostography was performed for the definitive procedure. Despite that limitation, anorectoplasty was performed with a posterior sagittal approach. Anorectal malformations in twins are a rare case requiring thoughtful surgical care. A thorough understanding of the limitation of our resources could help in planning management for anorectal malformation, especially in twins.
Co-Authors Diani Kartini Rachmawati, Asri D Susilo, Nanok E Tamba, Riana P