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All Journal Journal of Agromedicine and Medical Sciences Majalah Obstetri dan Ginekologi JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Tomy Lesmana
Department Of Surgery, Faculty Of Medicine, Universitas Airlangga, Dr Soetomo Hospital, Surabaya
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Abdominal skin metastasis in endometrial cancer Eccita Rahestyningtyas; Pungky Mulawardhana; Tomy Lesmana
Majalah Obstetri dan Ginekologi Vol. 27 No. 2 (2019): August
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (542.307 KB) | DOI: 10.20473/mog.V27I22019.84-89

Abstract

Objectives: Surgical wound metastases in stage 1 endometrial cancer are possible, with a variety of different pathophysiological possibilities. Comprehensive management is needed to keep the patient on the possibility of a good prognosis.Cases Report: During January 2015 – January 2018 at dr. Soetomo Hospital, there were 2 cases of metastatic endometrial cancer in the laparotomy wounds by which the condition is very rare. Case 1, The patient was diagnosed with endometrial carcinoma following the results of curettage. Anatomical pathology examination was done and obtained grade 2 endometrioid adenocarcinoma. In Case 2, the patient underwent Total Abdominal Hysterectomy and Bilateral Salpingo-Oophorectomy in 2013 at Mojokerto General Hospital, indicating Uterine Fibroids and Ovarian Cysts. The results of anatomical pathology examination were unknown. On April 2017, the patient complained abdominal swelling since 3 months ago.Conclusion: In January 2015 - January 2018, 2 cases of metastatic endometrial cancer was found in a former laparotomy operation where this condition is very rare in endometrial cancer cases with low grade ,so that follow-up, monitoring and more vigilance are required in patients with low-grade endometrial Ca who have finished undergoing a surgery and chemotherapy. Rapture or mass resection, followed by external radiation, may be performed in patients with recurrence in the laparotomy wound area or in patients with high risk factors for endometrial cancer such as a history of estrogen use, tamoxifen, nullipara, obesity, diabetes mellitus, and family history of endometrial cancer. Currently, there is no fixed procedure (guideline) in RS. Dr. Soetomo to overcome recurrences especially in the scars of cancer surgery.
Diagnostic Accuracy of Clinical Features, Laboratory Features, and Ultrasound Imaging Compared to Intraoperative Findings in Patients with Obstructive Jaundice Yudith Meityana Hernandita; Tomy Lesmana; Alphania Rahniayu
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 14 No. 1 (2023): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V14I12023.21-25

Abstract

Highlights:1. Patients with obstructive jaundice have either benign or malignant underlying etiologies.2. Ultrasound imaging had the highest accuracy in diagnosing the etiology of obstructive jaundice among other examinations, such as clinical signs and laboratory tests. AbstractIntroduction: Jaundice due to biliary obstruction can be caused by a diverse group of diseases, including both benign and malignant etiologies. This study aimed to evaluate the accuracy of clinical features, laboratory features, and ultrasound imaging in diagnosing the etiology of obstructive jaundice with intraoperative findings as the gold standard.Methods: This was an observational cross-sectional analytic study conducted on 49 subjects by obtaining patients’ data from medical records in the Medical Record Center Dr. Soetomo General Academic Hospital, Surabaya. Collected data were statistically analyzed using a diagnostic test.Results: In this study, sensitivity (Sn), specificity (Sp), and accuracy of each feature in differentiating masses and stones as the etiology of obstructive jaundice were obtained. Progressive jaundice had Sn 88.2%, Sp 37%, and accuracy 56.8%. Complaints of fever had Sn 73.9%, Sp 90.9%, and accuracy 79.4%. Courvoisier’s law had Sn 61.5%, Sp 61.5%, and accuracy 61.5%. Serum CA 19-9 had Sn 75%, Sp 58.3%, and accuracy 67.9%. Ultrasound imaging had Sn 81.8%, Sp 100%, and accuracy 93.3%.Conclusion: Ultrasound imaging had the highest accuracy in diagnosing the etiology of obstructive jaundice, followed by complaints of fever, serum CA 19-9, Courvoisier’s law, and progressive jaundice, respectively.
The Forgotten Stoppa Procedure: An Alternative Approach for Incarcerated Groin Hernia Following Prior Anterior Repair Unsuitable for Laparoscopic Surgery – Case Series Normasari, Rena; Fardiansyah, Mochamad Syahroni; Lesmana, Tomy
Journal of Agromedicine and Medical Sciences Vol. 11 No. 3 (2025)
Publisher : Faculty of Medicine, Universitas Jember

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19184/ams.v11i3.53739

Abstract

Incarcerated and recurrent inguinal hernias present complex surgical challenges, particularly in patients with a history of multiple anterior repairs or contraindications to laparoscopic approaches. Although minimally invasive techniques such as Transabdominal Preperitoneal (TAPP) and Totally Extraperitoneal (TEP) repair have become standard practice, not all patients are ideal candidates due to altered anatomy, dense adhesions, or comorbidities that preclude general anesthesia. In such cases, the Stoppa procedure—a classical open posterior approach with wide preperitoneal mesh placement—offers a safe and effective alternative. This case series describes two elderly male patients with incarcerated recurrent inguinal hernias following multiple prior anterior mesh repairs. Both presented in emergency settings with significant comorbidities, making laparoscopic surgery unfeasible. Surgical repair was performed using a lower midline incision and extensive preperitoneal dissection, followed by the placement of a large polypropylene mesh without extensive fixation. In both cases, the incarcerated ileal segments were viable and successfully reduced without bowel resection. Postoperative recovery was uneventful, with both patients discharged within three days and showing no recurrence or major complications during a one-year follow-up. These outcomes demonstrate that the Stoppa technique remains a valuable option in complex cases where anterior or laparoscopic approaches are unsuitable. Its anatomical logic, broad coverage, and reduced risk of chronic pain support its continued role in modern hernia surgery. Surgeons should retain proficiency in this underutilized yet highly effective method, particularly when managing high-risk or reoperative groin hernias.
Co-Authors Alphania Rahniayu Eccita Rahestyningtyas Fardiansyah, Mochamad Syahroni PUNGKY MULAWARDHANA, PUNGKY Rena Normasari Yudith Meityana Hernandita