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All Journal The New Ropanasuri Journal of Surgery
Tamba, Riana P
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology

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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 Vol. 5, No. 2
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.
Management of Internal Hernia in Neonates with Multiple Heart Diseases: A Case Report Tamba, Riana P; Wiradeni, Andi
The New Ropanasuri Journal of Surgery Vol. 6, No. 1
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Internal hernia is a rare clinical entity. In all cases, less than 1% found as the cause of intestinal obstruction. However, delayed treatment of internal hernia may lead to necrosis of the intestines. Neonates with congenital heart disease may be at increased risk of morbidity and mortality than another concurrent disease. A male infant was delivered with a Cesarean section due to a congenital disorder of umbilical hernia, ventricular septal defect, and aortic transposition. The infant was born full-term with a 2,515 g birth weight and 3, 5, 7 APGAR score, positive ventilation, and intubation proceeded. Prostaglandin E1 10 mcg/kg/minute, packed blood cell, and thrombocyte concentrate was administered preoperatively. The patient underwent laparotomy for intestinal resection on day-3; the necrotic intestine was found starting 70 cm from ligament of Treitz to midsection of the transverse colon. Postoperatively, the stoma was vital, and we noted its production. The infant died one day14 due to respiratory failure caused by hospital-acquired pneumonia. Infants with an internal hernia and multiple congenital heart diseases require prompt management to prevent intestinal necrosis and other respiratory-related complications.
Methylene Blue as an Adjuvant Analgesic Postoperative Anal Fistula: A Randomized Clinical Trial Jeo, Wifanto S.; Irsal, Muhammad FA; Tamba, Riana P; Moenadjat, Yefta; Friska, Dewi
The New Ropanasuri Journal of Surgery Vol. 9, No. 1
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Introduction. Anal fistula is a pathological condition that connects the anorectal mucosa to the perianal skin, requiring various types of surgical procedures. However, surgery often causes postoperative pain. The use of methylene blue is being studied as a potential analgetic adjuvant in anal fistula surgery. Previous studies have shown that methylene blue can effectively reduce postoperative pain in various types of anorectal surgery. This study aims to determine methylene blue's clinical efficacy as an analgetic adjuvant. Methods. A double-blind, randomized controlled trial was conducted. Subjects consisting of subjects with simple anal fistula to undergo fistulectomy were randomly allocated into two groups. The first group received adjuvant analgesics in the form of methylene blue and NSAIDs, while the second group only received NSAIDs. Methylene blue 4 mL 1% was administered subcutaneously to the edge of the wound, sprayed on the surgery site, and intravenously administered ketorolac 3 x 30 mg. Randomization was done using the double-blind method. Pain levels were evaluated on the first, second, third, and seventh postoperative days using a visual analog scale (VAS). Results. Thirty-four subjects were enrolled (17 subjects in each group). Significant differences in pain levels (VAS values) were recorded between the group receiving the combination of methylene blue and NSAIDs compared to the group receiving only NSAIDs on days 1 to 3 after surgery (p <0.05). This difference was no longer significant between the two groups on the seventh postoperative day (p >0.05). Conclusion. The use of methylene blue in subjects undergoing anal fistula surgery as an adjuvant analgesic along with NSAIDs may reduce the intensity of pain better than NSAIDs alone.
Co-Authors Dewi Friska Gunardi, Hardian Irsal, Muhammad FA Jeo, Wifanto S. Rachmawati, Asri D Susilo, Nanok E Wiradeni, Andi Yefta Moenadjat