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

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Factors Affecting Renal Function on Ileostomy in Dr. Cipto Mangunkusumo General Hospital: a Cross-sectional study Sihardo, Lam; Putranto, Agi S
The New Ropanasuri Journal of Surgery Vol. 6, No. 2
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Introduction. Every year, about 30—60 ileostomy with various underlying diseases and indications were created in Dr. Cipto Mangunkusumo General Hospital (CMGH). There were a lot of complications attributable to these creations; one is the decline of renal function. The study goal was to find out factors influencing the renal function of ileostomy in CMGH. Method. A cross-sectional study was conducted using medical records in April – May 2021. Samples were taken using the purposive sampling method. Inclusion criteria include male or female patients who underwent ileostomy closure in CMGH in the last four years with complete BMI, ileostomy creation and closure, serum creatinine, and estimated glomerular filtration rate (eGFR). Patients with underlying renal dysfunctions were excluded. The data were analyzed using univariate and bivariate analysis. Spearman’s test was used to analyze the correlation. Results. There were 55 subjects enrolled in the study. BMI (peGFR = 0.044; pcreatinine = 0.015), time of ileostomy closure (peGFR = 0.014; pcreatinine = 0.012), and high output ileostomy (peGFR = 0.032; pcreatinine = 0.018) were statistically significant as risk factor diminishing the renal function. The correlation analysis showed that time of ileostomy closure was significantly different for eGFR and serum creatinine values with p = 0.039 (r = -0.279) and p = 0.021(r = 0.310), respectively. Conclusion. In the study, factors that affect critical renal function in ileostomy were high output ileostomy, time of ileostomy closure, and body mass index. Hydration status, underlying disease, and age did not affect the diminished renal function.
Impact of Advanced Trauma Life Support Training for Improving Mortality Outcome: A Systematic Review and Meta-analysis Putra, Afid B; Nurachman, Luthfian A; Suryawiditya, Bagus A; Risyaldi, Muftah; Sihardo, Lam
The New Ropanasuri Journal of Surgery Vol. 8, No. 2
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Introduction. The Global Burden of Disease Study has identified injuries as one of the top ten causes of death and disability worldwide. Injury is predicted to rise in the rankings by the year 2030. This study aimed to quantify the effectiveness of an Advanced Trauma Life Support (ATLS) training in improving mortality outcome after trauma injury. Method. This is a systematic review (of experimental and observational studies) and meta-analysis, reporting mortality outcome from trauma injury between ATLS-trained/certified physicians vs non-ATLS-certified. We performed literature searching through 3 electronic databases, including Cochrane (CENTRAL), MEDLINE (PubMed), and Scopus. Results. There are summarized results from 7 selected articles. The total patients included in this analysis were 11,595 patients in post-ATLS group and 21,603 patients in pre-ATLS group. There was high heterogeneity among studies (I2 = 95%) and therefore random effect model was used for analysis. Pooled analysis showed that ATLS had no significant effect in reducing the risk of mortality (OR: 0.68; 95% CI 0.39 – 1.20; p = 0.18). Although ATLS is not significantly associated with improved mortality outcomes, this meta-analysis has shown a tendency that health facilities and health workers implementing ATLS experienced lower mortality. Conclusion. ATLS is not the only aspect that contributes to patients’ survival. There are also roles in pre-emergency settings, resource availability, and experience. However, we believe that implementing the ATLS protocol in healthcare facilities will be the leading factor in improving trauma patients' management.
Navigating Wound Closure Strategies: Primary Closure vs. Delayed Primary Closure in Digestive Surgery—A Systematic Review and Meta-Analysis on Surgical Site Infections Sihardo, Lam; Lalisang, Arnetta NL; Putra, Afid B; Suryawiditya, Bagus A
The New Ropanasuri Journal of Surgery Vol. 9, No. 2
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Introduction. Surgical site infection (SSI) is a significant concern following digestive surgery, with varying incidence rates based on wound contamination levels. The choice between Primary Closure (PC) and Delayed Primary Closure (DPC) impacts SSI occurrence, making it essential to evaluate their comparative effectiveness. DPC is hypothesized superior to PC to prevent SSI or wound infection after a contaminated abdominal surgery. Methods. This systematic review study was carried out through PubMed, Scopus, and Cochrane (CENTRAL). Quality was assessed using Risk of Bias (ROB-2) tool. All results were summarized, and quantitative analysis was performed using a random-effect model. This study is reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Eligibility criteria included adult patients undergoing abdominal gastrointestinal surgery, evaluating SSI and hospital stay, directly comparing PC and DPC, and randomized controlled trials (RCT) study. Results. Of 447 published studies, there were 10 eligible RCTs, consist of 672 subjects who received DPC and 668 subjects who received PC. We found no significant difference in SSI occurrence between PC and DPC (RR=0.62, 95%CI: 0.38–1.02; p=0.06) with high heterogeneity (I2=74%, p Conclusion. DPC tend to decrease SSI risk. Our findings revealed that PC is not inferior than DPC to prevent SSI and improve hospital stay in abdominal surgery. The choice between techniques should be individualized, considering patient characteristics and surgical context. Standardized criteria and further research are crucial for refining closure method selection, ultimately enhancing patient outcomes and reducing the burden of SSI.
A Glimpse of Liver Resection Profile in An Indonesian Tertiary Hospital: A Retrospective Descriptive Study Vaniara, Florencia V; Lalisang, Arnetta NL; Lalisang, Toar JM; Mazni, Yarman; Putranto, Agi S; Jeo, Wifanto S; Ibrahim, Febiansyah; Syaiful, Ridho A; Sihardo, Lam; Marbun, Vania MG
The New Ropanasuri Journal of Surgery Vol. 10, No. 1
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Introduction. In-depth liver resection profile is needed for evaluation to improve the procedure’s outcome. This study aims to describe the clinical characteristics and outcomes of liver resection in HCC patients in Cipto Mangunkusumo Tertiary Hospital. Methods. This study retrospectively analyzed the clinical data of 19 HCC patients who underwent liver resection in Cipto Mangunkusumo Tertiary Hospital from 2021 to 2024. Demographic, clinical, laboratory, operative, and pathological data were collected. Postoperative complications were assessed using the Clavien-Dindo classification system within 30- and 90-day postoperative periods. Result. Nineteen patients were included, comprising 12 (63.2%) males and 7 (36.8%) females. Sixteen patients (84.2%) had Child-Pugh (CP) class A liver function with 10 (62.5%) CP A(5) patients and 6 (37.5%) CP A(6) patients; 3 (15.8%) patients had CP class B(7). There were 6 (31.6%) patients with thrombocytopenia and 4 (21.1%) patients with portal hypertension. Liver resection was done laparoscopically in 4 (21.1%) patients and with an open approach in 15 (78.9%) patients. Left hepatectomy was done in 3 patients (15.78%), right hepatectomy in 2 (10.5%), right anterior sectionectomy in 4 (21%), left lateral sectionectomy in 1 (5.26%), bisegmentectomy in 1 (5.26%), segmentectomy in 6 (31.58%), and non-anatomical resection in 2 (10.52%). Based on histopathologic examination, HCC was found in 13 (68.41%) patients. Among 19 patients, 12 (63.2%), 5 (26.3%), and 2 (10.5%) patients had 1 tumor, 2 tumors, and 3 tumors respectively (total tumors resected: n=28). About 16 (84.21%) patients had elevated alpha fetoprotein (AFP) (> 10 ng/mL). The mean intraoperative blood loss was 884 mL. No postoperative complications classified as Clavien-Dindo grade I-IV were observed. Two patients (10.5%) experienced postoperative mortality within 90 days (Clavien-Dindo grade V), both due to circulatory failure. Conclusion. This study presents a descriptive overview of liver resection in an Indonesian tertiary hospital. Comparative conclusions should be interpreted with caution due to the limited sample size.
Co-Authors Ibrahim, Febiansyah Jeo, Wifanto S Lalisang, Arnetta NL Marbun, Vania MG Mazni, Yarman Nurachman, Luthfian A Putra, Afid B Putranto, Agi S Risyaldi, Muftah Suryawiditya, Bagus A Syaiful, Ridho A Toar J.M. Lalisang Vaniara, Florencia V