Garuda - Garba Rujukan Digital

Hernia Through Winslow Foramen in Cipto Mangunkusumo General Hospital, Jakarta: A Case Report Ristiyanto, Eko; Wibowo, Taufik A; Syaiful, Ridho A; Philippi, Benny; Lalisang, Toar J.M.
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Introduction. Hernias through Winslow foramen are extremely rare, occurred for 0.1% of all abdominal hernias and found during laparotomy due to strangulated bowel obstruction. This study aims to describe hernia of Winslow foramen and its management. Method. Data were retrospectively collected based on medical records. Clinical manifestations, laboratory data, supporting radiographic examinations, treatment, postoperative care, and outcomes were collected. Case summary. We report the first case of Winslow foramen hernia at Cipto Mangunkusumo General Hospital, Jakarta. A man 54 years in 2019. Ileus was the main clinical symptoms and presented epigastric pain, nausea and vomiting. Plain abdominal x-ray confirmed small bowel obstruction but the etiology was unclear. Emergency laparotomy was performed and a herniated loop of ileum was found entering the lesser sac through the Winslow foramen. The loop of ileum was reduced and viable, omental patch was put on Winslow foramen as plasty procedure. Conclusion. Symptoms, clinical examination is non-specific and laboratory findings are rarely helpful. Retrograde analysis on the plain abdominal x-ray should be considered as abdominal internal hernia through Winslow foramen. The surgical management of hernia through Winslow foramen based on surgeon preference and the viability of the herniated intra-abdominal contents.

Managing Gallstone during Pregnancy: Tatalaksana Batu Empedu pada Kehamilan Toar JM Lalisang; Fransisca J Siahaya
Indonesian Journal of Obstetrics and Gynecology Volume. 1, No. 4, October 2013
Publisher : Indonesian Socety of Obstetrics and Gynecology

Transient physiological changes in the biliary system during pregnancy increased the risk of gallbladder diseases. Nonoperative management of symptomatic cholelithiasis increases the risk of complications of biliary lithiasis, such as cholecystitis and empyema, while obstruction common bile duct stones with or without cholangitisb and biliary pancreatitis raise maternal mortality. Delay in definitive surgical treatment of biliary diseases during pregnancy increases the likelihood acute biliary pancreatitis which impact on preterm delivery until fetal lost. Laparoscopic cholesystectomy during pregnancy has advantages for the mother in that it speeds up her recovery, giving her less pain and facilitated natural birth without a cesarean section. On the fetus side, laparoscopic cholecystectomy is safe since it does not induce preterm delivery or abortion. Identification of gallbladder stone during pregnancy warrant a preventive laparoscopic cholesystectomy or endoscopic CBD exploration, both of which promise good outcomes. Keywords: adult choledochal cyst, biliary cyst, biliary dilatation, mixed type

Diagnosis and Management of Barret's Esophagus Adi Wijaya; Dharmika D; Ari F Syam; Toar JM Lalisang
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 6, ISSUE 2, August 2005
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/62200542-47

Incidence of esophageal adenocarcinoma is increasing in western countries and has poor prognosis due to late diagnosis. Barrett’s esophagus is considered as premalignant lesion in which some of squamous epithelium in distal esophagus has been replaced by metaplastic columnar ephithelium. It occurs as complication of longstanding gastroesophageal reflux. Endoscopic examination is very important for early detection especially in patients with chronic symptoms of gastroesophageal reflux disease (GERD) for more than 5 years. Aggressive antireflux treatment may reduce the risk of esophageal carcinoma. However, no single therapeutic modality had been proven superior compare to others, but until now surgery remains the most popular treatment of choice in the management of Barrett’s esophagus. Keywords: Barrett’s esophagus,GERD, premalignant lesion, management

Diagnostic Approach and Treatment of Choledocholithiasis Indah Gianawati; Ali Sulaiman; L A Lesmana; Toar JM Lalisang; Arman A Abdullah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 5, ISSUE 2, August 2004
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/52200471-75

Choledocolithiasis may cause acute cholangitis which is life-threatening condition. It has non specific clinical signs from mild to severe condition such as septicemia. Diagnostic and treatment modalities had developed a great deal recently. Therapeutic options include endoscopic retrograde cholangio pancreatography (ERCP),common bile duct exploration (CBDE), laparoscopic CBDE and stone retrieval. The important thing is to choose the appropriate method for each patient. We reported a case of choledocolithiasis in 40 years old, male patients who was clinically diagnosed as acute cholangitis. Diagnostic approach to find the etiology was done. Abdominal USG and CT were performed and showed multiple stones in gallbladder and intrahepatic biliary duct, suspected mass at caput of the pancreas and hepatomegaly. The ERCP showed dilatation of intra and extra hepatic biliary ducts with multiple stone in common bile duct (CBD), hepatic duct and gallbladder. The stent was placed for biliary drainage. The patient underwent cholecystectomy per laparoscopy, but further evaluation of the cholangiography still showed the presence of stones in intrahepatic biliary duct. Laparotomy exploration of CBD was done and it revealed multiple stones and dilatation of distal CBD. Surgical treatment selected for this case was choledocojejunostomy. Keywords: Choledocolithiasis, CBD, diagnostic approach

Characteristics of Pancreaticoduodenal Resection on Periampullary Tumor Cases by Jakarta Tertiary Hospital Team: Three Decade Report Toar JM Lalisang; Yarman Mazni; Yefta Moenadjad; Sahat Matondang
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 2 (2019): VOLUME 20, NUMBER 2, August 2019
Publisher : The Indonesian Society for Digestive Endoscopy

Background: There were only few publications related to pancreaticoduodenal resection (PDR) /Whipple procedure in Indonesia in the past decade.Method: Retrospectively report of the characteristics and outcomes of PDR performed by Cipto Mangunkusumo Hospital surgical team from 1993 to 2017 were collected.Results: PDR were performed in 213 patients, with a mean age of 50.6 years and 54.4% patients were females. Predominant preoperative clinical findings were jaundice (68.9%) and mild hypoalbuminemia (69.9%). Biliary decompression was performed in 112 (52.6%) subjects. Average surgical waiting time was 3.5 months. While PDR were performed in 84 (39.5%) subjects, pyloric preserving pancreaticoduodenal technique was predominated in 128 (59.8) and predominated, especially during the latter years. Fifteen (9.0%) cases were benign. Thirty-one (14.6%) subjects underwent relaparotomy, 16 (51.6%) of whom died post-operatively. Overall operative mortality decreased from 16.9% to 5.5% in 2016, while resection rate generally increased over time, ranging from 2 - 21/year. Less than 10% of subjects survived for 5 years, while 20% survived for 24 months. Overall morbidity was 65.1% in 177 survivors, with surgical site infection in 52.5%, pancreatic fistula in 24.2%, and post-pancreatectomy haemorrhage (PPH) as a fatal postoperative complication in 19 (8.9%) cases. Patients who died within 30 days postoperatively had significantly more relaparotomies and PPH (p 0.001).Conclusion: Prolonged jaundice and mild hypoalbuminemia are dominant characteristics in our Indonesian PDR subjects. Cipto Mangunkusumo Hospital is a high-volume PDR centre and world class hospital. Mortality rates decreased with the increasing resection rates. Relaparotomy and PPH are predictors of poor outcome.

Self-management intervention model for optimizing psychological well-being in patients with colorectal stoma Ratna Aryani; Toar JM Lalisang; Debie Dahlia; Evi Martha
Jurnal Konseling dan Pendidikan Vol 11, No 4 (2023): JKP
Publisher : Indonesian Institute for Counseling, Education and Therapy (IICET)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29210/1105700

A stoma can increase life expectancy and support health recovery but brings several physical and psychosocial issues. Psychosocial resilience is critical in dealing with these changes. This study aims to provide new insights into the interaction between self-management and psychosocial resilience in colorectal cancer stoma patients. This research employs a qualitative design with a case study approach. The study involves colorectal cancer patients with completed primary cancer-related therapies, totaling eight individuals. The informants also include family members of the patients (eight individuals) and volunteer nurses within the community (three individuals). The research instrument is an interview guide structured around five themes. Data analysis follows qualitative stages, encompassing reduction, presentation, and conclusion. Triangulation techniques are utilized to ensure the validity of the findings. The findings suggest that collaboration between family, community, and nurses can provide comprehensive support. However, a structured and focused self-management intervention model is needed to improve psychosocial consistency and resilience. Three models were proposed, namely Family Therapy, Online Community Support, and Nurse Integration in Self-Management, hoping to provide more specific guidance and support for patients. This study provides a basis for developing more varied intervention models and a comprehensive understanding of self-management of colorectal cancer stoma patients.

TARGETING ACADEMIC SURGEONS RESTORING THE DIGNITY OF SURGICAL EDUCATION-TRAINING IN INDONESIA: A MODEL OF EXCELLENCE IN PROFESSIONAL ACHIEVEMENT Lalisang, Toar Jean Maurice
Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Vol 12, No 3 (2023): September
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jpki.79785

Background: Due to the dynamic changes in the strategic environment and development of science and technology, the Indonesian national education system has undergone various adjustments, including surgeons' education training programs. To some extent, various essential changes, marginalization, and pragmatization of surgical services have degraded the dignity of surgical education-training programs in Indonesia. This study aims to analyse several causal factors appropriately to direct to an appropriate target based on the present and future situation to prevent inappropriate solutions.Methods: This narrative review is based on related articles freely downloaded, which discuss the what and why of uncertainty in the provision of education-training today and suggest how changes must be made to restore the dignity of Surgeons in Indonesia. Current Indonesian conditions are mainly based on implementation at the Surgery Department, Medicine of Faculty Universitas Indonesia and Cipto Mangunkusumo Hospital.Results: It is challenging to obtain data on evaluating the educational process and the quality of surgeon graduates. Based on observation, there are four main problems, including the recruitment of teaching staff, Ministry of Education and Culture policies, adequateness of learning materials, and the phenomenon of semester-based graduation. These problems lead to quasi-referral and case management of defensive surgery, which gradually declines the surgeon profession's dignity.Conclusion: The fundamental solution to restoring the dignity of surgeons in Indonesia is to provide an education-training which produce academic surgeons.

Konsensus Perhimpunan Dokter Spesialis Bedah Digestif Indonesia tentang Pedoman Diagnosis dan Tatalaksana Batu Saluran Empedu Rivai, Muhammad Iqbal; Lalisang, Arnetta Naomi Louise; Nugroho, Adianto; Wibowo, Agung Ary; Handaya, Adeodatus Yuda; Arifin, Fransiscus; Situmorang, Indah; Prabowo, Erik; Irwan, Irwan; Mayasari, Maria; Tendean, Michael; Rudiman, Reno; Setyadi, Kunsemedi; Niam, Muhammad Shobachun; Suprapto, Bambang; Putra, Jeffri; Lesmana, Tommy; Mazni, Yarman; Muhar, Adi Muradi; Mulyawan, I Made; Warsinggih, Warsinggih; Lalisang, Toar Jean Maurice
Majalah Kedokteran Indonesia Vol 74 No 2 (2024): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.74.2-2024-1188

Introduction: Choledocholithiasis, the presence of stones in the common bile duct (CBD), is a challenge in the field of digestive surgery due to the wide range of cases with varying levels of difficulty. Until now, the options for diagnostic and therapeutic modalities have been increasingly evolving, ranging from non-invasive to invasive procedures. Therefore, the Indonesian Society of Digestive Surgeons provides recommendations for the management of CBD stone cases in Indonesia.Method: The consensus was developed using the Delphi survey method involving digestive surgery experts from various cities in Indonesia. Several issues related to the diagnosis and management of CBD stones were formulated and answered based on current research, while also considering the opinions of the experts.Result: This consensus consists of two parts: 15 recommendations related to the selection of diagnostic modalities and 10 recommendations related to management options. Recommendations regarding diagnosis include the use of ultrasonography, abdominal CT-scan, and magnetic resonance cholangiopancreatography (MRCP). In addition to standard therapeutic procedures, this consensus also provides recommendations regarding contemporary procedures such as endoscopic retrograde cholangiopancreatography (ERCP), laparoscopic common bile duct exploration (LCBDE), and open common bile duct exploration (OCBDE).Conclusion: These recommendations are aimed to assist digestive surgery experts in providing the best management for CBD stone cases.

Availability and Distribution of Stoma Bags for Colorectal Cancer Patients: A Case Study at National Referral and Private Hospitals Aryani, Ratna; Lalisang, Toar JM; Dahlia, Debie; Martha, Evi; Hamid, Achir Yani S; Wicaturatmashudi, Sukma; Helen, Helen
Kesmas Vol. 20, No. 2
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Stoma bags are essential for colorectal cancer (CRC) patients with stomas. However, access and affordability in Indonesia remain challenging as the National Health Insurance (NHI) does not fully cover these devices. This study aimed to describe the availability and distribution of stoma bags for patients with CRC in national referral and private hospitals, focusing on outpatient access. A qualitative case study was conducted through observations and in-depth interviews with four enterostomal therapy nurses and six patients across three national referral hospitals and one private hospital in the Jakarta Metropolitan Area, Indonesia. Notably, the availability of stoma bags was limited in both hospital types, especially for outpatients. Most patients faced financial barriers, as they had to purchase stoma bags independently at high prices because of limited hospital supply and lack of NHI coverage. Moreover, hospital policies restricted the number of bags distributed, worsening access issues. These challenges increase stoma-related complication risk and negatively affect patients’ quality of life. Integrating stoma bags into NHI coverage, regulating prices, and improving distribution are recommended to reduce healthcare disparities and improve outcomes for CRC patients, aligning with Sustainable Development Goal 3.

Self-management intervention model for optimizing psychological well-being in patients with colorectal stoma Aryani, Ratna; Lalisang, Toar JM; Dahlia, Debie; Martha, Evi
Jurnal Konseling dan Pendidikan Vol. 11 No. 4 (2023): JKP
Publisher : Indonesian Institute for Counseling, Education and Therapy (IICET)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29210/1105700

A stoma can increase life expectancy and support health recovery but brings several physical and psychosocial issues. Psychosocial resilience is critical in dealing with these changes. This study aims to provide new insights into the interaction between self-management and psychosocial resilience in colorectal cancer stoma patients. This research employs a qualitative design with a case study approach. The study involves colorectal cancer patients with completed primary cancer-related therapies, totaling eight individuals. The informants also include family members of the patients (eight individuals) and volunteer nurses within the community (three individuals). The research instrument is an interview guide structured around five themes. Data analysis follows qualitative stages, encompassing reduction, presentation, and conclusion. Triangulation techniques are utilized to ensure the validity of the findings. The findings suggest that collaboration between family, community, and nurses can provide comprehensive support. However, a structured and focused self-management intervention model is needed to improve psychosocial consistency and resilience. Three models were proposed, namely Family Therapy, Online Community Support, and Nurse Integration in Self-Management, hoping to provide more specific guidance and support for patients. This study provides a basis for developing more varied intervention models and a comprehensive understanding of self-management of colorectal cancer stoma patients.

Title

Found 20 Documents
Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title Search

Found 20 Documents Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title

Found 20 Documents
Search