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All Journal Jurnal Kedokteran Diponegoro Journal of Biomedicine and Translational Research Media Medika Muda
Sigit Adi Prasetyo
Department Of Surgery, Faculty Of Medicine, Diponegoro University
Biochemistry, Genetics & Molecular Biology Medicine & Pharmacology

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The Difference of Length of Stay, Surgical Site Infection, Post Surgical Pain, and Bile Leak in Laparoscopic Cholecystectomy and Open Cholecystectomy Dilla Putri; Santoso Jaeri; Agung Aji Prasetyo; Sigit Adi Prasetyo
JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL) Vol 10, No 2 (2021): JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL)
Publisher : Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dmj.v10i2.29402

Abstract

Background: The incidence of cholesistolithiasis is increased  due to the changes of diet to the western diet. The cholecystectomy is one of the treatments for cholecystolithiasis. It can be divided into laparoscopic cholecystectomy and laparotomy cholecystectomi. The previous study demonstrated that the laparoscopic cholecystectomy was better than laparotomy cholecystectomy for postoperative length of stay, surgical site infection, postoperative pain, and bile leak in cholecystolithiasis, but there is no official data  and research yet in Indonesia Objective: To determine the difference of  postoperative length of stay, surgical site infection, postoperative pain, and bile leak in laparoscopic cholecystectomy and laparotomy cholecystectomy.Methods: An analytic observational study with cross sectional design. Subject was patient who had undergone laparoscopic or laparotomy cholecystectomy from Dr Kariadi Hospital, Semarang and RSND Semarang during period of 2013 to 2019. The Mann Whitney-U test was used to determine the difference of length of stay as well the Chi Square test for determining the difference of surgical site infection, postoperative pain, and bile leak among both groups.Results: 34 (41.5%) men and 48 (58.5%) women with an age avarage of  49.84 ± 13.54 years were included. There were a significant difference between laparoscopic and laparotomy cholecystectomy in cholecystectolithiasis cases on postoperative hospital stay (p = 0.000), postoperative pain (p = 0.000), surgical site nfection (p = 0.000), and bile leak ( p = 0.013).Conclusion: Laparoscopic cholecystectomy was better than open cholecystectomy in postoperative hospital stay, surgical site infection, postoperative pain, and bile leak for cholecystolithiasis cases. Keywords: bile leak , cholecystetomy, cholecystolithiasis, laparoscopy, laparotomy
Phlebotrophic Effect of Graptophyllum Pictum (L.) Griff on Experimental Wistar Hemorrhoids Mario Sadar Bernitho Hutagalung; Bernadus Parish Budiono; Sigit Adi Prasetyo; Ignatius Riwanto; Eriawan Agung Nugroho; Yan Wisnu Prajoko; Neni Susilaningsih
Journal of Biomedicine and Translational Research Vol 5, No 1 (2019): July 2019
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jbtr.v5i1.3704

Abstract

Background : The 1st and 2nd degree hemorrhoids is managed non-operatively with the anti-inflammatory and plebothropic drugs. Graptophyllum pictum extract (GPE) has already been used widely in Indonesia to treat hemorrhoid with good result, however, the mechanism is not supported by the molecular research.Objective : This study is intended to study the phlebothropic effects of GPE by measuring the degree of edema and extravassal leucocytes of experimental wistar hemorrhoid.Methods : Experimental study with Randomized Controlled Trial Post-test only design in male wistar rats, weight around 200 gr, induced for the development of a disease-like condition of hemorrhoids by 6% croton oil on the anus for 3 days. Random allocation was performed to divide the 14 wistar rats in 2 groups. Group I as control got normal saline solution, while group II was treated with GPE 100mg/kgbw, started on day 4th for 5 consecutive days. On 9th day blood was extracted from retroorbital fossa and anus was resected up to 2 cm from anal verge and weighted. The degree of anal edema was measured by rectoanal coefficient, that is rasio between anal weight (miligrams) and body weight (grams).Results : Until the end of study, all wistar rat were still alive. The mean (±SD) of body weight   of control group was 173.84 ­(±13.37) and the treatment group was 171.70  (±13.10), and there was no significant differences (p = 0.833). The mean (±SD) of rectoanal coefficient in the treatment group was 2.46 (±0.41) and it was significantly lower than control group  (3.13 ± 0.85) (p = 0.029). The mean (±SD) of extravassal leukocytes in the treatment group was 900.14(±48.09) and it was significantly lower than the control (1003.28 ± 99.30) (p = 0.042).Conclusions : Graptophyllum pictum extract at doses of 100 mg/Kgbw have phlebotonic effect  in decreased edema and extravassal leukocytes.
FACTORS AFFECTING POST-OPERATIVE PAIN AFTER DOPPLER GUIDED HEMORRHOID ARTERY LIGATION AND RECTO-ANAL REPAIR (DGHAL-RAR) OF INTERNAL HEMORRHOID Sigit Adi Prasetyo; Ignatius Riwanto
Media Medika Muda Vol 1, No 3 (2016)
Publisher : Faculty of Medicine Diponegoro University

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Abstract

Background: DGHAL-RAR is new modality for grade II-IV internal hemorrhoid treatment. It is developed to reduce post-operative pain that mostly found in traditional hemorrhoidectomy even in Stappler hemorrhoidopexy. However, in clinical practice some patients are complaint of moderate until severe pain. This study is intended to know factors affecting the post-operative pain after DGHAL-RAR of internal hemorrhoid.Methods: A series of 61 grade II-IV internal hemorrhoid patients, underwent DGHAL-RAR in St Elizabeth Hospital, Semarang Indonesia, period of August 2012 – March 2014 were analyzed prospectively. Age, sex, grade, removing of thrombus  either internal or external, anal fissure, removing of hypertrophic anal papilla, removing skin tag, anal laceration due to procedure, were analyzed to know it relation with post operative pain in 24 hours, 48 hours and 7 days post-operatively. VAS for pain (0–10) were used to assess the degree of pain. Mann-Whitney method was used for univariate analysis, while Kruskal-Wallis and Median method were used for multivariate analysis.Results: After multivariate analysis variables that significantly influence post operative pain on 24 hours were removing of internal thrombosis, removing of anal papilla hypertrophy and anal laceration, on 48 hours were removing of external thrombosis, removing of anal papilla hypertrophy and anal laceration and  on 7 days were the same with on 24 hours.Conclusion: Factors that affecting post-operative pain after DGHAL-RAR  for grade II-IV internal hemorrhoid were removing of both internal and external thrombosis, removing of anal papilla hypertrophy and anal laceration due to DGHAL-RAR procedure. Keywords: Internal hemorrhoid, Hemorrhoid artery ligation and recto-anal repair, thrombosis, anal papilla hypertrophy, anal laceration.
Co-Authors Agung Aji Prasetyo Bernadus Parish Budiono Dilla Putri Eriawan Agung Nugroho Ignatius Riwanto, Ignatius Mario Sadar Bernitho Hutagalung Neni Susilaningsih Santoso Jaeri Yan Wisnu Prajoko