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All Journal Majalah Patologi Indonesia Jurnal Ilmu Bedah Indonesia
Grace Wangge
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Perbandingan antara Klasifikasi Jepang dan Sistem TNM dalam Menentukan Stadium Keganasan Sigmoid dan Rektum di RSCM-RSF (Laporan Pendahuluan) Yusak Kristianto; Agi satria Putranto; Rofi Y Saunar; diah Rini Handjari; Grace Wangge
Majalah Patologi Indonesia Vol 27 No 2 (2018): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (242.234 KB)

Abstract

Latar belakangMetastasis kelejar getah bening (KGB) pada keganasan kolorektal merupakan penentu independen faktor prognosis dan tatalaksana lanjutan. Saat ini sistem baku penentuan stadium keganasan kolorektal adalah menurut sistem TNM dengan melihat jumlah KGB yang positif anak sebar. Klasifikasi Jepang (KJ) menentukan stadium keganasan kolorektal dengan melihat distribusi metastasis KGB (parakolika/pararektal, intermediate, dan pangkal arteri mesenterika) tanpa melihat jumlah KGB nya.MetodeStudi pendahuluan ini melakukan analisis terhadap 15 pasien keganasan sigmoid dan rektum yang menjalani pembedahan di RSCM dan RSUP Fatmawati periode September-Oktober 2015. Dilakukan penilaian histopatologi terhadap spesimen tumor, aspek yang dinilai adalah jumlah KGB yang positif anak sebar dan distribusi metastasis KGB. Berdasarkan hasil tersebut dilakukan penentuan stadium menurut sistem TNM dan Klasifikasi Jepang serta dilakukan analisis kesesuaian.HasilDidapatkan ≥12 KGB dari semua sampel. Menurut sistem TNM terdapat 7 pasien stadium II, 3 pasien stadium III-b dan 5 pasien stadium IIIc, sedangkan pada Klasifikasi Jepang terdapat 7 pasien stadium II, 1 pasien stadium IIIa dan 7 pasien stadium III-b. Kecocokan antara kedua sistem klasifikasi dalam mendapatkan stadium II adalah 46,67%. Penentuan stadium III-a (KJ) dan stadium IIIa-b (TNM) dengan kecocokan sebesar 6,7% . Kecocokan sebesar 13,3% dalam menentukan stadium III-b (KJ) dan stadium III-c (TNM). Analisis kesesuaian terhadap kedua sistem klasifikasi, didapatkan nilai Kappa sebesar 49,3% (kategori sedang) dengan P value: 0,04.KesimpulanPada studi pendahuluan ini didapatkan tingkat kesesuaian antara kedua sistem klasifikasi dalam menentukan stadium keganasan sigmoid dan rektum dengan kategori sedang. Klasifikasi Jepang dapat dijadikan salah satu pertimbangan. Diperlukan sampel yang lebih besar untuk meningkatkan akurasi tingkat kesesuaian.
Risks and Benefits of Central Neck Dissection (CND) in Differentiated Thyroid Carcinoma (DTC) H.S. Wahyu Purnomo; Erwin D Yulian; Grace Wangge
Jurnal llmu Bedah Indonesia Vol. 46 No. 1 (2018): Mei 2018
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v46i1.34

Abstract

Introduction: The role of central neck dissection (CND) remains controversial in differentiated thyroid cancer (DTC). Risk and benefit of CND is necessary to be identified for judging whether CND will be performed or not. Methods: A literature search was performed in MEDLINE (pubmed) using main keywords such as differentiated thyroid carcinoma (DTC), central neck dissection (CND), total thyroidectomy. The literature had inclusion criteria english language literature with risk and benefit of CND. We used qualitative approach to summary descriptive papers result. Results: Sixteen trials were analyzed. There was no increased risk of recurrent laryngeal nerve (RLN) injury (temporary or permanent), permanent hypocalcemia, or locoregional recurrence when CND was performed in addition to TT. Postoperative temporary hypocalcemia was more common after TT with CND than after TT alone. Conclusion: TT alone results in less surgical morbidity in the immediate postoperative period and an identical locoregional recurrence rate compared with TT plus CND.
Factors Affecting Hospital Length of Stay in Patient with Diabetic Foot Ulcer Patrianef Darwis; Bakti H Simanjuntak; Grace Wangge; Deddy Pratama; Ahmad Bakri; Rizky Telaumbanua
Jurnal llmu Bedah Indonesia Vol. 47 No. 2 (2019): Oktober 2019
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v47i2.45

Abstract

Background. Foot ulcer is one of the most common complications in diabetes mellitus patients. This condition prolongs hospital length of stay (LOS) and increases hospitalization cost. This study aims to assess factors that affect the LOS in patients with the mentioned condition. Methods. This is a retrospective cohort study of diabetes mellitus patients with foot ulcer who were hospitalized in Cipto Mangunkusumo General Hospital from January 2015 to April 2016. There were 120 patients recruited and then divided into two groups according to their hospitalization duration, which was short and long. Univariate analysis was conducted in predicted factors including gender, ankle-brachial index, ulcer size, ulcer depth, leukocyte count, treatment, cardiovascular comorbidity, blood pressure, smoking history, septicemia, ketoacidosis, hypoalbuminemia, and upper respiratory tract infection. Chi-Square tests were performed to analyze the association of those factors with LOS. The odds ratio of each variable was evaluated using logistic regression analysis. Result. In this study, the mean of LOS was 26 days (2 – 87 days). Factors that significantly correlated with LOS were ankle-brachial index (p 0.041, OR 2.275, CI 95 % 1.025 – 5.041), ulcer size (p 0.044, OR 3.038, CI 95 % 1.032 – 9.942), smoking history (p 0.022, OR 2.434, CI 95 % 1.125 – 5.265), sepsis (p < 0.001, OR 4.240, CI 95 % 1.908 – 9.423), and ketoacidosis (p < 0.001, OR 8.611, CI 95 % 3.396 – 21.835) In multivariate analysis, the most significant factor was ketoacidosis (p < 0.001, OR 8.360, CI 95 % 3.209 – 21.780). Conclusion. Ketoacidosis is the most significant factor that prolonged hospital stays in a patient with diabetic foot ulcer. Keywords: Diabetic foot ulcer, Length of stay
Co-Authors Agi Satria Putranto Ahmad Bakri Bakti H Simanjuntak Deddy Pratama Diah Rini Handjari Elfrida Ratnawati H.S. Wahyu Purnomo Patrianef Darwis Rizky Telaumbanua Rofi Y Saunar Yusak Kristianto