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Ishardyanto, Hantoro
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Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience

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Comparison between Early and Late Drain Released after Modified Radical Mastectomy Surgery through Observation over Proportion of Percutaneous Aspiration Technique of Seroma Production in Surgical Polyclinic of Dr. Soetomo Hospital, Surabaya Parlindungan, Putra Gelar; Ishardyanto, Hantoro
Folia Medica Indonesiana Vol. 56, No. 1
Publisher : Folia Medica Indonesiana

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Abstract

Surgery is the most frequent indication and major therapy in the management of malignancy of breasts. Drain is one method to drainage the seroma formed after the modified radical mastectomy surgery. The drain-release protocol varies in each hospitals. This study aimed to compare the proportion of percutaneous aspiration in patients with early drain release with late drain release in postoperative MRM patients. The present study is a prospective cohort study comparing the proportion of percutaneous aspiration in 30 patients with early drain released with 30 patients with late drain release in Dr. Soetomo hospital The recording of the proportion of aspiration actions was conducted serially on days 3, 7, 10, and 14 after drain release. Recording of age, nutritional status (BMI), tumor histopathology type, stage, shoulder mobilization time, obliterant usage, wound infections surgery, flap necrosis and hematom were analyzed to find out if there was any effect on seroma event In our study we did not find the difference in serum aspiration proportions both in the early and late drain observation group. Age factor, nutritional status (BMI), histopathology type, stage, shoulder mobilization time, obliterant use, presence of surgical wound infection, flap necrosis and hematom did not differ significantly statistically to seroma events. Statistically, there was no difference in the proportion of percutaneous aspiration in a group of observed patients with early and late drain release. Late drain release can be avoided to potentially harm the patient in decreasing the lives' quality of the patients.
The Use of Oral Antibiotics to Prevent Surgical Site Infection on Postoperative Modified Radical Mastectomy Patients in Dr. Soetomo General Hospital, Surabaya Hadi, Norman; Ishardyanto, Hantoro
Folia Medica Indonesiana Vol. 56, No. 1
Publisher : Folia Medica Indonesiana

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Surgical operations on modified radical mastectomy are considered clean procedures by the Centers for Disease Control and Prevention (CDC) wound classification system. Despite this, higher than expected Surgical Site Infection (SSI) rates are reported, varying from 1 % to 26 % across the literature. Some surgeons also prescribe postoperative prophylaxis for postoperative modified radical mastectomy patients to prevent infection despite its lack of proven efficacy. The aim of this study is to analyze the use of oral antibiotics to prevent Surgical Site Infection (SSI) on postoperative modified radical mastectomy patients in Dr. Soetomo General Hospital. This study was double-blinded randomized control trial of 60 postoperative modified radical mastectomy patients (2 groups) during the period of December 2017 to March 2018. Samples were prospectively divided into two groups (random sampling), in group A (n=30) patients received single dose prophylactic antibiotics and continued with oral antibiotics postoperative (Cefadroxil 2 x 500 mg) during 7 days and in group B (n=30) patients received single dose prophylactic antibiotics and continued without postoperative antibiotics (placebo). Both groups were evaluated clinically for surgical site infection up to 30 days. There was no statistically significant difference in both groups {p=1 (p>0.05)}. There was no incidence of surgical site infection in both groups during the 30-day follow-up period (days 3, 7, 14 and 30). There was no difference in the surgical site infection rate among those who received oral postoperative antibiotics prophylactic and without antibiotics (placebo) on postoperative modified radical mastectomy patients in Dr. Soetomo General Hospital. Because of the potential adverse events associated with antibiotic use, further evaluation of this practice is required.
High Sensitive Troponin I and Extended Range C-Reactive Protein as Markers to Predict Cardiotoxicity in Locally Advanced Breast Cancer with Neoadjuvant CAF (Cyclophoshpamide, Adriamycin/Doxorubicin, 5Fluorouracil) Therapy Hidayat, Yusfik Helmi; Ishardyanto, Hantoro; Anniwati, Leonita
Folia Medica Indonesiana Vol. 56, No. 2
Publisher : Folia Medica Indonesiana

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The limitation of echocardiography to measure chemotherapy cardiotoxicity at left locally advanced breast cancer with large ulcer is still serious problem. HsTnI and erCRP are biomarkers to detect cardiotoxicity that are cheap, easy to examine and available at Dr.Soetomo Hospital Surabaya. This study was to compare HsTnI, erCRP and echocardiography as cardiotoxicity predictors in locally advanced breast cancer with neoadjuvant CAF therapy. This study used one group pretest and posttest design among 23 locally advanced breast cancer patients. All patients underwent echocardiography, HsTnI, and erCRP examinations before and after 3 times chemotherapy and compared. The average age was 49.78±8.7. Statistically significant decrease in LVEF was found after treatment (67.98%±4.06 and 64.07%±3.53, p=0.000). HsTnI was significantly increased after treatment (0.007 µg/mL±0.004 and 0.043 µg/mL±0.051 p=0.000). erCRP was significantly decreased after treatment (1.043mg/dL±0.913 and 0.573mg/dL±0.444 p=0.044). Decreased LVEF and increased HsTnI was compared by its cardiotoxic cut-off. HsTnI was significantly better and faster to detect cardiotoxicity (0.033±0.051 p=0.002). In conclusion, strong correlation is present in the detection of cardiotoxicity between HsTnI and LVEF. HsTnI is faster than echocardiography, and could be alternative diagnostic to detect early cardiotoxicity.
Co-Authors Anniwati, Leonita Anniwati, Leonita Hadi, Norman Hidayat, Yusfik Helmi Parlindungan, Putra Gelar