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Sudirman, Taufik
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Medicine & Pharmacology Public Health

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Comparison of Post Operative Pain Score between Doppler-Guided Hemorrhoidal Artery Ligation and Recto Anal Repair with Open Hemorrhoidectomy on Internal Hemorrhoid Grade III-IV at Siloam Hospitals Lippo Village Sudirman, Taufik; Kosasih, Joanna Audricia
Medicinus Vol 11, No 1 (2021): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v9i2.4701

Abstract

Background: Hemorrhoids are a common lesion affecting 5% of the general population. Open hemorrhoidectomy has been considered a gold standard. However, this method has a significant score of postoperative pain Because of this side effect, another alternative method to treat hemorrhoids has been invented which can reduce post-operative pain. One of these methods is doppler-guided hemorrhoidal artery ligation and rectoanal repair (DGHAL-RAR). This study aims to know the comparison of the postoperative pain score between doppler-guided hemorrhoidal artery ligation and rectoanal repair compared with open hemorrhoidectomy.Method: The sample population of this study is internal hemorrhoid grade III-IV patients at Siloam Hospitals Lippo Village from 2018-2020. Visual analog scale data are taken from medical records. Sample data is obtained using a consecutive sampling method until 64 samples are met. The data obtained will be processed with the Mann U-Whitney test.Results: Incidence of postoperative pain more than VAS 3 occurred in DGHAL-  RAR and open hemorrhoidectomy is 81,3% and 96,9% with a p-value of 0,104. The average score of Visual Analogue Scale score in DGHAL-RAR and open hemorrhoidectomy are 1,97 and 3,13 with a p-value of 0,001.Conclusion: This study shows that the comparison of pain scores in DGHAL-RAR and open hemorrhoidectomy is not statistically significant. The mean score of the Visual Analogue Scale Score in the DGHAL-RAR group is statistically significantly lower than the mean score in the open hemorrhoidectomy group.
Postoperative Pain Comparison Between Open Hemorrhoidectomy and Stapled Hemorrhoidopexy on Internal Hemorrhoid at Siloam Hospitals Lippo Village Sudirman, Taufik; Wiguna, Alvin Leonard
Medicinus Vol 12, No 2 (2023): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v10i3.7038

Abstract

Background: Hemorrhoids have a prevalence of 4,4%. Surgery is one of the modalities for treating hemorrrhoids. The method accepted as the "golden standard" is open hemorrhoidectomy. Although considered effective, open hemorrhoidectomy is still often associated with a significant rate of morbidity and pain symptoms that are a complaint of most patients. Therefore, another method is an alternative, namely, stapled hemorrhoidopexy. Some studies showed that stapled hemorrhoidopexy has a lower occurrence of postoperative pain, and others offer the opposite.Methods: This study was conducted at Siloam Hospitals Lippo Village between February and March 2019. Samples were taken as many as 70 patients by taking secondary data from medical records. Patients diagnosed with third or fourth degree hemorrhoids and undergoing open hemorrhoidectomy or stapled hemorrhoidopexy will be taken the pain score from the visual analogue scale. Data is then tabulated using Microsoft Excel and analysed using SPSS.Result: the occurrence of postoperative pain in the stapled hemorrhoidopexy and open hemorrhoidectomy group, respectively, are 80% and 97%, with a p-value of 0,055. The average visual analogue scale score for open hemorrhoidectomy and stapled hemorrhoidopexy was 3±1,39 and 2±1,39, respectively, with a p-value of 0.003.Conclusions: the result showed that the occurrence of postoperative pain was not statistically significant. And the average visual analogue scale score was lower in the stapled hemorrhoidopexy group.
Comparison of Post-Operative Pain Score Between Open Appendectomy and Laparoscopic Appendectomy on Acute Appendicitis Patient in Siloam Hospital Lippo Village Elsa, Mary Christina; Sudirman, Taufik
Medicinus Vol 12, No 3 (2023): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v11i1.7362

Abstract

Background: Appendicitis is inflammation of vermiform appendix which can be caused by luminal obstruction. Appendicitis is one of the most common causes of emergency abdominal surgery, with 11 cases per 10.000 person per year. Until today, open appendectomy is still the gold standard for appendicitis treatment although laparoscopic appendectomy has significantly lower post-operative pain.Methods: This study uses cross-sectional study design with post-open appendectomy and laparoscopic appendectomy patients in Siloam Hospital Lippo Village as the sample population. The Visual Analogue Scale (VAS) is taken from patient’s medical record and processed using Mann-U-Whitney test.Result: From 70 acute appendicitis patients, 36 underwent open appendectomy and 34 underwent laparoscopic appendectomy. The result showed the median score of VAS 1 day post open appendectomy surgery (median = 3, min/max = 2/6 [95% CI = 2,55 – 3,14]) is higher than post laparoscopic appendectomy (median = 2,25, min/max = 0/4, [95% CI = 1,97 – 2,59]), with adjusted p value against age and surgery duration is 0,024. In pediatric patients, median score of VAS 1 day post open appendectomy surgery is the same with laparoscopic appendectomy (median = 3, p value = 0,863). Multivariate analysis showed that surgery duration affects VAS 1 day post appendectomy surgery in pediatric patients (p value = 0,042).Conclusions: This study shows that the median score of VAS 1 day post open appendectomy surgery is higher than laparoscopic appendectomy. This result is statistically significant. However, in pediatric patients the median score of VAS 1 day post open appendectomy surgery and laparoscopic appendectomy is the same. VAS 1 day post appendectomy surgery in pediatric patients is affected by surgery duration.
Strangulated Left Lateral Inguinal Hernia in a 54-Year-Old Woman: A Case Report Sudirman, Taufik; Surya, Clarissa; Marina, Sinta
Medicinus Vol 13, No 1 (2023): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v11i2.7532

Abstract

Introduction: Around 20 millions of hernia repairs were done annually with women presenting least cases. The occurrence of inguinal hernia in female patients is 3-6%, which is lower than men (27-43%). Inguinal hernia itself may present as a bulge in the groin in which the definitive treatment is through surgery. Although many research were done for hernia repair in men, guidelines for women are still currently observed with less favourable outcomes.Case illustration: A 54-year-old woman came to the ED complaining of pain of protruding bulge in the groin area for two hours. The patient has had a history of bulging for three years, which was previously reducible. Examination of the inguinal region revealed a lump with a diameter of +/- 4 cm and painful when palpated. Abdominal USG showed a left inguinal hernia consisting intestinal tissues. Open herniotomy with mesh grafting was performed and the patient got discharged after 4 days of hospitalisation.Conclusion: Lifetime risk for development of inguinal hernia is higher in men compared to women, but the rate of emergency procedures in women is 3 to 4-fold higher than in men. Guidelines for hernia repair in women show less favourable results than in men. Therefore, special steps must be taken in the repair of inguinal hernia in women.
The Relationship of Body Mass Index with Length of Stay in Acute Appendicitis Patients Who Have Undergoing Open Appendectomy at RSUS Lippo Village Karawaci Hospital Christianto, Putra Niko Laksamana Oceano; Sudirman, Taufik
Medicinus Vol. 14 No. 1 (2024): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i1.9194

Abstract

Background : Appendicitis is an inflammation that occurs in the veriform appendix. The Indonesian Ministry of Health announced that the number of inpatients with appendicitis is the fourth most common disease in Indonesia. Open appendectomy is a procedure for treating appendicitis. Patients who have an open appendectomy procedure require hospitalization for the wound to heal. Various studies have been conducted to find a relationship between body mass index and length of stay in patients with appendicitis but have different results, besides that research on this topic is still minimal in Indonesia. Therefore, this study was conducted to analyze the relationship between body mass index and length of stay in acute appendicitis patients who had undergone open appendectomy. Methods : This study used a cross-sectional study design with a sample population of acute appendicitis patients at Lippo Village Hospital Karawaci. 182 samples were selected using a purposive sampling technique. The research sample data was taken from the patient's medical records and will be tested for analysis using SPSS 25 with the Kruskal Wallis ANOVA method. Result : From 182 research samples, it was found that the median length of stay of patients with different body mass indexes was 3 days. Based on the Kruskal Wallis ANOVA test, there was no significant elationship between gender and length of stay (p > 0.05). Conclusions : This study shows that there is no relationship between body mass index and length of stay in acute appendicitis patients who have undergone open appendectomy.
Abses Psoas Tuberkulosis Sudirman, Taufik
Medicinus Vol. 5 No. 2 (2016): February 2016 - May 2016
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v5i2.1167

Abstract

Psoas abscess is a rarely found abscess located in the iliopsoas compartment. It characterized by fever, back pain, and limitation of hip movements. Psoas abscess is hard to diagnose due to only 30% of classic symptoms and signs are found. In this study we discussed tuberculous psoas abscess in patient 26 years old male. Anamnesis, physical examination, and supporting medical tests were done to diagnose tuberculous psoas abscess. Therefore we performed abscess incision and drainage, followed by continuous tuberculous therapy.Keywords: tuberculous psoas abscess 
Patogenesa Dan Pemilihan Terapi Hemorrhoid Sudirman, Taufik
Medicinus Vol. 5 No. 3 (2016): June 2016 - September 2016
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v5i3.1174

Abstract

Therapy of hemorrhoids ranges from dietary and lifestyle modification to  surgery, depending on degree and severity of symtoms. While debate continues as to which is the best surgical method for the therapy of hemorrhoids, none of the currently available surgical methods approach the ideal surgical option, which is one that effective while being safe and painless. In reality, the less painful the procedure, the more likely it is to be associated with recurrence post-op. A fuller understanding of the pathophysiology will help to make choices.Keywords: hemorrhoids, pathophysiology, therapy.
Comparison of Post Operative Pain Score between Doppler-Guided Hemorrhoidal Artery Ligation and Recto Anal Repair with Open Hemorrhoidectomy on Internal Hemorrhoid Grade III-IV at Siloam Hospitals Lippo Village Sudirman, Taufik; Kosasih, Joanna Audricia
Medicinus Vol. 11 No. 1 (2021): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v9i2.4701

Abstract

Background: Hemorrhoids are a common lesion affecting 5% of the general population. Open hemorrhoidectomy has been considered a gold standard. However, this method has a significant score of postoperative pain Because of this side effect, another alternative method to treat hemorrhoids has been invented which can reduce post-operative pain. One of these methods is doppler-guided hemorrhoidal artery ligation and rectoanal repair (DGHAL-RAR). This study aims to know the comparison of the postoperative pain score between doppler-guided hemorrhoidal artery ligation and rectoanal repair compared with open hemorrhoidectomy.Method: The sample population of this study is internal hemorrhoid grade III-IV patients at Siloam Hospitals Lippo Village from 2018-2020. Visual analog scale data are taken from medical records. Sample data is obtained using a consecutive sampling method until 64 samples are met. The data obtained will be processed with the Mann U-Whitney test.Results: Incidence of postoperative pain more than VAS 3 occurred in DGHAL-  RAR and open hemorrhoidectomy is 81,3% and 96,9% with a p-value of 0,104. The average score of Visual Analogue Scale score in DGHAL-RAR and open hemorrhoidectomy are 1,97 and 3,13 with a p-value of 0,001.Conclusion: This study shows that the comparison of pain scores in DGHAL-RAR and open hemorrhoidectomy is not statistically significant. The mean score of the Visual Analogue Scale Score in the DGHAL-RAR group is statistically significantly lower than the mean score in the open hemorrhoidectomy group.
Postoperative Pain Comparison Between Open Hemorrhoidectomy and Stapled Hemorrhoidopexy on Internal Hemorrhoid at Siloam Hospitals Lippo Village Sudirman, Taufik; Wiguna, Alvin Leonard
Medicinus Vol. 12 No. 2 (2023): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v10i3.7038

Abstract

Background: Hemorrhoids have a prevalence of 4,4%. Surgery is one of the modalities for treating hemorrrhoids. The method accepted as the "golden standard" is open hemorrhoidectomy. Although considered effective, open hemorrhoidectomy is still often associated with a significant rate of morbidity and pain symptoms that are a complaint of most patients. Therefore, another method is an alternative, namely, stapled hemorrhoidopexy. Some studies showed that stapled hemorrhoidopexy has a lower occurrence of postoperative pain, and others offer the opposite.Methods: This study was conducted at Siloam Hospitals Lippo Village between February and March 2019. Samples were taken as many as 70 patients by taking secondary data from medical records. Patients diagnosed with third or fourth degree hemorrhoids and undergoing open hemorrhoidectomy or stapled hemorrhoidopexy will be taken the pain score from the visual analogue scale. Data is then tabulated using Microsoft Excel and analysed using SPSS.Result: the occurrence of postoperative pain in the stapled hemorrhoidopexy and open hemorrhoidectomy group, respectively, are 80% and 97%, with a p-value of 0,055. The average visual analogue scale score for open hemorrhoidectomy and stapled hemorrhoidopexy was 3±1,39 and 2±1,39, respectively, with a p-value of 0.003.Conclusions: the result showed that the occurrence of postoperative pain was not statistically significant. And the average visual analogue scale score was lower in the stapled hemorrhoidopexy group.
Comparison of Post-Operative Pain Score Between Open Appendectomy and Laparoscopic Appendectomy on Acute Appendicitis Patient in Siloam Hospital Lippo Village Elsa, Mary Christina; Sudirman, Taufik
Medicinus Vol. 12 No. 3 (2023): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v11i1.7362

Abstract

Background: Appendicitis is inflammation of vermiform appendix which can be caused by luminal obstruction. Appendicitis is one of the most common causes of emergency abdominal surgery, with 11 cases per 10.000 person per year. Until today, open appendectomy is still the gold standard for appendicitis treatment although laparoscopic appendectomy has significantly lower post-operative pain.Methods: This study uses cross-sectional study design with post-open appendectomy and laparoscopic appendectomy patients in Siloam Hospital Lippo Village as the sample population. The Visual Analogue Scale (VAS) is taken from patient’s medical record and processed using Mann-U-Whitney test.Result: From 70 acute appendicitis patients, 36 underwent open appendectomy and 34 underwent laparoscopic appendectomy. The result showed the median score of VAS 1 day post open appendectomy surgery (median = 3, min/max = 2/6 [95% CI = 2,55 - 3,14]) is higher than post laparoscopic appendectomy (median = 2,25, min/max = 0/4, [95% CI = 1,97 - 2,59]), with adjusted p value against age and surgery duration is 0,024. In pediatric patients, median score of VAS 1 day post open appendectomy surgery is the same with laparoscopic appendectomy (median = 3, p value = 0,863). Multivariate analysis showed that surgery duration affects VAS 1 day post appendectomy surgery in pediatric patients (p value = 0,042).Conclusions: This study shows that the median score of VAS 1 day post open appendectomy surgery is higher than laparoscopic appendectomy. This result is statistically significant. However, in pediatric patients the median score of VAS 1 day post open appendectomy surgery and laparoscopic appendectomy is the same. VAS 1 day post appendectomy surgery in pediatric patients is affected by surgery duration.
Co-Authors Alvionitan, Chellya Fanny Christianto, Putra Niko Laksamana Oceano Elsa, Mary Christina Kosasih, Joanna Audricia Marina, Sinta Surya, Clarissa Wiguna, Alvin Leonard