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All Journal Cerdika: Jurnal Ilmiah Indonesia Journal of Indonesia Vascular Access Folia Medica Indonesiana
Soebroto, Heroe
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Clinical outcomes of splenorenal shunts in esophageal varices patients: a literature review Putra, I Gusti Agung Made Adnyana; Hakim, Arief Rakhman; Soebroto, Heroe; Sembiring, Yan Efrata; Limanto, Danang Himawan; Rizki, Mohamad; Puruhito
Journal of Indonesia Vascular Access Vol. 4 No. 1 (2024): (Available online : June 2024)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v4i1.40

Abstract

The disease known as esophageal varices is usually caused by portal hypertension. Portal hypertension is most commonly caused by extrahepatic portal vein thrombosis and other conditions, such as cardiac problems or hepatic cirrhosis. Clinical manifestations of esophageal varices can include melena, haematemesis, and gastrointestinal bleeding. Effective venous pressure reduction is achieved via the distal splenorenal shunt. We acquired the literature for our review from PubMed and Google Scholar. The search was done in English using terms that indicated a connection between improvements in bone grafting methods and the restoration of alveolar clefts. To expand the search results, we also looked through the papers cited in the literature. Almost all of the five gathered articles demonstrated that the distal splenorenal shunt (DSRS) is a beneficial surgical treatment that effectively avoids postoperative PH issues. Finally, DSRS is presented as a surgical long-term treatment for variceal esophageal reflux disease and portal hypertension. Because DSRS selectively decompresses the venous collaterals around the stomach and lower esophagus, it is a safe and effective therapy choice for decreasing bleeding over nonselective shunting surgeries as a selective shunt.
Correlation Between Intraoperative Blood Vessel Diameter and Technical Success Rate of AV Shunt Surgery in Dr. Soetomo Hospital Surabaya Saphira, Diva; Soebroto, Heroe; Thaha, Mochammad; Hakim, Arief Rakhman; Widipriyatama, Gabriel Rio
Journal of Indonesia Vascular Access Vol. 3 No. 2 (2023): (Available online: 1 December 2023)
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v3i2.45

Abstract

Introduction: An arteriovenous (AV) shunt is an anastomosis between vein and artery made in a surgical procedure as vascular access for patients with end-stage renal disease that are projected to undergo hemodialysis. Unfortunately, AV shunt failure remains a significant clinical problem for hemodialysis patients. In general, the cause of most early AV shunt failure is still unknown, but the quality of the blood vessels is suspected as a factor. This study aimed to determine the correlation between blood vessel diameter and the success of AV shunt surgery. Methods: This study is a cross sectional study that uses a descriptive-analytic design. The samples were obtained from the patient’s medical records with the total sampling technique of all patients who have undergone AV shunt surgery from January 2019 – December 2020 at Dr. Soetomo General Hospital which matches the inclusion and exclusion criteria. Results: Patients’ blood vessel diameter measurement is divided into four categories which are <2 mm, 2 - <4 mm, 4 - <6 mm, and ≥6 mm. From a total of 62 patients, the highest successful surgery rate is carried out in patients with a vein diameter of 2 - <4 mm (77.59%) and artery diameter of 2 - <4 mm (63.79%). The results of the Chi-Square analysis found no significant correlation between vein diameter (p=0.769) or artery diameter (p=0.922) and the success of AV shunt surgery at Dr. Soetomo Hospital, Surabaya 2019-2020. Conclusions: In conclusion, this study did not find a correlation between the intraoperative blood vessel diameter and the technical success of AV shunt surgery.
Faktor Risiko Pasien Acute Limb Ischemia Admadiani, Fhahira Rizkhika; Ekoputranto, J Nugroho; Soebroto, Heroe; Subagjo, Agus
Cerdika: Jurnal Ilmiah Indonesia Vol. 2 No. 4 (2022): Cerdika: Jurnal Ilmiah Indonesia
Publisher : Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/cerdika.v2i4.376

Abstract

Acute Limb Ischemia (ALI) is a classification of peripheral arterial disease that causes decreased blood flow to the extremities, with onset within 2 weeks and characterized by 6 'P's, namely pallor, pain, perishing cold, pulseless, paralysis, and paresthesia. This can be identified through several risk factors, including: diabetes, smoking, gender, high blood pressure, age,hyperlipidemia, atrial fibrillation (AF) and diabetes. This study aims to identify risk factors in ALI patients. Hospital identification. Soetomo Surabaya Period January 2016 – March 2019. This study uses a total sampling technique. This study uses a descriptive cross sectional method with medical record instruments and direct interviews with patients. Twenty-five (25) patients were known to have ALI (14 males and 11 females), and the age of the patients ranged from 65 to 69 years (20%). The causes of risk included a history of smoking obtained from 10 subjects (40%), a history of hypertension in 7 subjects (28%), a history of stage 1 hypertension, a history of diabetes mellitus with the highest blood glucose test value > 126 mg/dl up to 10 people. . (62.5%), with a history of hyperlipidemia, with total cholesterol within normal limits of up to 4 (66.7%), LDL in the normal range of not more than 3 (60%), and HDL with 2 with low HDL values (40%). ), and the highest triglyceride levels were within the normal range. Electrocardiographic examination revealed 7 patients (28%) with atrial fibrillation. Most of the ALI patients in this study were aged between 65 and 69 years and were male. Most ALI patients in this study were 65-69 years old and males. The most common risk factors for ALI patients were hypertension, diabetes mellitus, and hypercholesterolemia.
Mortality Risk Factors in Tetralogy of Fallot Patients Undergoing Total Correction Juliana, Juliana; Sembiring, Yan Efrata; Rahman, Mahrus Abdur; Soebroto, Heroe
Folia Medica Indonesiana Vol. 57, No. 2
Publisher : Folia Medica Indonesiana

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Abstract

A total correction is a preferred treatment for Tetralogy of Fallot patients in every part of the world. However, the mortality in developing countries was as high as 6.9% to 15.3%. This was a retrospective analytic study that analyzed pre and post-operative risk factors that affected mortality on TOF patients that were performed total correction in Indonesia. A total of 47 TOF patients that were performed total correction from January 2016 to September 2019 were enrolled in this study based on the inclusion criteria. Preoperative and post-operative data were obtained from medical records. In this research, the majority of mortality was found in male patients (39.3%), while the female's rate was lower (36.8%). Overall mortality was 38.3% and one operative death was found. The average age of patients was 84.12 months (12-210 months), whereas the average height (85.56 ± 36.17cm vs. 112.93 ± 21.73) and weight (17.22kg vs. 28.21kg) were lower for mortality patients. Some significant preoperative variables were identified as mortality risk factors such as: age below 60 months (p=0.047), smaller weight and height (p=0.008; p=0.002), abnormal hematocrit (p=0.002), and oxygen saturation below 75% (p=0.018). Significant post-operative risk factors included: temperature above 38.5⁰C (p=0.000), and ventilator time of more than 48 hours (p=0.033). In conclusion, the mortality of TOF patients undergoing a total correction in developing countries was quite high. It was associated with some risk factors, such as younger age, lower weight and height, low oxygen saturation, post-operative fever, and prolonged ventilator time.
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.
Co-Authors Admadiani, Fhahira Rizkhika Danang Himawan Limanto Dillon, Jeffrey Jeswant Ekoputranto, J Nugroho Hakim, Arief Rakhman Juliana Juliana Ketut Putu Yasa MOCHAMMAD THAHA Negoro, Sri Pramesthi Wisnu Bowo Puruhito Puruhito, Ito Putra, I Gusti Agung Made Adnyana Putra2, I Gusti Agung Made Adnyanya Rahman, Mahrus Abdur Rizki, Mohamad Saphira, Diva Sembiring, Yan Efrata Subagjo, Agus Widipriyatama, Gabriel Rio Winarno, Dhihintia Jiwangga Suta