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All Journal Majalah Patologi Indonesia The New Ropanasuri Journal of Surgery Jurnal Ilmu Bedah Indonesia Indonesian Journal of Cancer MEDICINUS The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Agi Satria Putranto
Division Of Vascular Surgery, Department Of Surgery, Faculty Of Medicine, Universitas Indonesia, Dr.Cipto Mangunkusumo General Hospital, Jakarta
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Risk Factors of Colorectal Carcinoma Incidence in Young Adults: A Meta-Analysis Putranto, Agi Satria; Julistian, Julistian
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. The incidence and mortality of colorectal cancer (CRC) in young adults (below the age of 50 years) has been increased. However, there’s no screening method for these cancer in those group of age because there isno scientifically proven risk factor. Thus, a meta-analysis carried out to find out the risk factor for CRC in young adults. Method. A Meta-analysis study was conducted in January 2017. Literature search addressed to the articles published during a period of 2007– 2017 in Cochrane and PubMed using keywords: “young” AND “risk factor” AND “colorectal cancer” OR “colon cancer” or “rectal cancer”. Inclusion criteria were the CRC prevalence, risk factor analysis for CRC incidence and young population (below 50 years old). The meta-analysis carried out through qualitative and quantitative approach. Results. In the last 10 years, there were twelve published articles met the criteria. Those were cohort study (an article), case–control study (four articles), and cross–sectional study (seven articles). Twenty–five risk factors were noted. The meta–analysis showed that gender (males) with OR = 1.66, 95% CI = (1.04–2.64); I2 = 93%), family history with OR = 2.01, 95% CI = (1.11–3.67); I2 = 78%), metabolic syndrome with OR = 1.80, 95% CI = (1.49–2.16), I2 = 0%), and smoking with OR = 1.57, 95% CI = (1.40–1.77), I2 = 4%) were the significant risk factors with the association of CRC. Conclusion. Young adults of males, with a family history of CRC, metabolic syndrome, and smoking were at the risk to have colorectal cancer
Factors Related with Complication Following Gastrectomy: Retrospective Analysis based on the Clavien–Dindo Classification System Putranto, Agi Satria; Siahaya, Fransisca Janne
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Introduction. Surgical resection is the only curative treatment option in the management of gastric cancer. A study carried out and aimed to retrospectively analyze all complications following gastrectomy in accordance with severity of Clavien–Dindo classification, in addition to identify the related factors to postoperative complications. Method. The cross-sectional study enrolling a total of 35 patients with complete medical records who underwent gastrectomy in Cipto Mangunkusumo General Hospital Jakarta between January 2007 and December 2017. The complications and related factors were evaluated. Statistical analysis was employed to find out the correlation. Results. Of the 35 patients underwent gastrectomy at Cipto Mangunkusumo General Hospital Jakarta, the median age was 67, and 51.4% were female. Median of preoperative albumin was 3.0 g/dL, intraoperative blood transfusion was 217 mL and intraoperative blood loss was 500 mL. A total of 32 out of 35 subjects (91.4%) underwent partial gastrectomy and three total gastrectomy (8.6%). The incidence of severe complications (stage ≥IIIa) was 25.7% (n = 9). Those requiring surgical intervention caused by pneumothorax (5.7%), intra-abdominal bleeding (2.9%), anastomotic leakage (5.7%), duodenal stump leak (2.9%). Septic shock/death also found (8.5%). Age, intraoperative blood loss, and intraoperative blood transfusion were positively correlated with complication (p
Hiperbilirubinemia sebagai Prediksi terhadap Appendisitis Perforasi Siregar, Sun Parkuseg; Putranto, Agi Satria; Kekalih, Aria
Jurnal llmu Bedah Indonesia Vol 47 No 1 (2019): Artikel Penelitian
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v47i1.22

Abstract

Latar Belakang: Penegakkan diagnosis apendisitis perforasi sebelum tindakan operasi akan berpengaruh terhadap morbiditas pasien. Dengan anamnesis, pemeriksaan fisik dan pemeriksaan penunjang sederhana berupa peningkatan nilai lekosit, dan netrofil segmen dan peningkatan nilai bilirubin total pre-operatif diharapkan dapat memprediksi diagnosis apendisitis perforasi. Metode: Dari 128 pasien apendisitis akut yang dating ke IGD dilakukan pemeriksaan penunjang tambahan nilai bilirubin total dan dilakukan apendektomi dikumpulkan secara retrospektif dari Januari – Juli 2016. Data dasar karateristik pasien, hasil penunjang laboratorium darah dan laporan operasi diambil dari rekam medik, lalu dilakukan analisis multivariate untuk melihat korelasinya. Hasil: Dari 128 pasien yang didiagnosis awal sebagai apendisitis akut sebanyak 68,8% dan apendisitis perforasi sebanyak 31,3% didapatkan temuan intra operatif apendisitis non perforatif sebanyak 46,9% dan apendisitis perforasi sebanyak 53,1% dengan nilai rata-rata bilirubin total adalah 1,19 mg/dL dan nilai cut off adalah 1,00 mg/dL. Laki-laki dengan apendisitis perforasi 66,1% dan perempuan 33,9% .Dengan lama sakit di rumah sebelum dating ke IGD rata-rata 3,5 hari. Dengan nilai sensitivitas 77,94%; spesifitas 76,67%, nilai prediktif positif 79,1% dan nilai prediksi negative 75,41%. Pada uji analisis multivariate didapat kan nilai bilirubin total ( odds ratio 5,016; 95% confidence interval 2,092-12,026; P = < 0,0001), leukosit ( odds ratio 1,993; 95% confidence interval 0,893-4,451; P = 0,092) dan alvarado score ( odds ratio 3,193; 95% confidence interval 1,542-6,611; P = 0,002) yang secara statistic signifikan untuk memprediksi diagnosis apendisitis perforasi pre-operatif. Simpulan: Hiperbilirubinemia secara satitistik signifikan untuk memprediksi diagnosis apendisitis perforasi pre-operatif.
Evaluasi Angka Kejadian Komplikasi Pasca Kolostomi Serta Faktor-Faktor Yang Berhubungan Di RSUPN Cipto Mangunkusumo Tahun 2012-2014 Hendy, Alldila; Putranto, Agi Satria
Jurnal llmu Bedah Indonesia Vol 47 No 1 (2019): Artikel Penelitian
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v47i1.24

Abstract

Latar Belakang: Tindakan pembuatan kolostomi, telah menjadi bagian prosedur penting dalam penatalaksanaan pembedahan pada beberapa penyakit yang melibatkan saluran gastrointestinal. Sehingga perlu dicari faktor-faktor yang mempengaruhi terjadinya komplikasi. Metode: Studi potong lintang retrospektif analitik, di RSUPN Cipto Mangunkusumo dengan mencatat rekam medis pasien pasca kolostomi dari bulan Januari 2012 hingga Desember 2014 di Rumah Sakit Umum Pusat Cipto Mangunkusumo Jakarta Departemen Ilmu Bedah divisi Bedah Digestif. Hasil: Dari 136 kasus pasca kolostomi, 66 pasien mendapatkan komplikasi pasca kolostomi, 14 kasus komplikasi awitan dini dan 52 awitan lambat. 70 kasus tindakan pasca kolostomi adalah tanpa komplikasi. Komplikasi terbanyak adalah dermatitis, yaitu 31 pasien (22.8%), kasus infeksi/abses/fistula dan obstruksi usus, yaitu 13 pasien (9.6%) dan 5 pasien (4.4%). Komplikasi yang jarang terjadi adalah retraksi stoma sebanyak 2 pasien (1.5%), prolaps stoma dan nekrosis/gangren, yaitu hanya 3 pasien (2.2%). Operasi cito memiliki resiko lebih besar terjadinya komplikasi pasca kolostomi daripada operasi yang dilakukan secara elektif (p 0.007, OR 2.85), Berdasarkan operator yang melakukan pembuatan kolostomi, konsulen memiliki resiko lebih kecil terjadinya komplikasi kolostomi dibandingkan trainee maupun residen (p < 0.0001). faktor usia, dimana usia sekitar 50 tahun (mean±SD,50.94±14) memiliki resiko terjadinya komplikasi pasca kolostomi (p 0.018). Simpulan: Faktor-faktor berdasarkan jenis operasi (cito atau elektif), faktor usia, dan operator pembuat kolostomi memiliki hubungan bermakna dengan peningkatan angka kejadian komplikasi pasca kolostomi di RSCM.
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)

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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.
Multimodality Treatment of Bile Duct Stone Arief Hakiki; Marcellus Simadibrata; Agi Satria Putranto; Nur Rasyid
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 10, ISSUE 1, April 2009
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/101200918-22

Abstract

Gallstone and bile duct stone is a common disease and affects people from every society, race, age and gender. Advance in medicine has led us to a new paradigm of bile duct stone treatment. Endoscopic procedures for bile duct stone by means of Endoscopy Retrograde Cholangio-pancreatography (ERCP), sphincterotomy, balloon dilation, basket extraction, and lithotripsy, and even using laser as well as the shockwave-has brought a lot of novel innovation with high success rate. Appropriate indication and the ability to recognize various risk factors of complication are the keys to successful treatment, in order to decrease morbidity and mortality rate. Multimodality treatment of bile duct stone includes endoscopy, surgery, and drugs are a treatment approach which has always to be carried out in bile duct stone management. Difficult bile duct stone cases such as large stone, impacted stone, biliary stone in pregnancy, and recurrent stone can be treated by endoscopy with excellent success rate particularly if it is accomplished using multimodality treatment.   Keywords: bile duct stone, endoscopy, ERCP, sphincterotomy, mechanical lithotripsy, laser lithotripsy, shockwave, cholecystectomy laparoscopy, precut sphincerotomy
Kualitas Hidup Penderita Adenokarsinoma Kolorektal Pascaoperasi di RSUPN dr. Cipto Mangunkusumo Maida Tanara; Agi Satria Putranto
Jurnal llmu Bedah Indonesia Vol. 49 No. 2 (2021): Desember 2021
Publisher : Ikatan Ahli Bedah Indonesia

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Latar Belakang. The risk of venous thromboembolism (VTE) associated with malignancy is 4.1-fold greater compared to patients without malignancy. Malignancy patient have greater risk of bleeding with the commonly used anticoagulant therapy. Inferior Vena Cava Filter (IVCF) have been recommended as an controversial alternative. This study aimed to find the highest evidence in the safety, benefit, and clinical outcome of the IVCF for managing VTE associated with malignancy. Metode. Studi dilakukan dengan desain deskriptif, populasi penderita adenokarsinoma kolorektal pascaoperasi sejak Januari 2017-Desember 2020 dan bersedia serta mampu menjawab kuesioner diinklusi dalam penelitian. Luaran yang dievaluasi adalah kualitas hidup dihubungkan dengan usia, jenis kelamin, familial, stadium dan jumlah terapi adjuvant. Hasil. Terdapat 304 subjek penderita adenokarsinoma kolorektal pasca operasi , 123 pasien dinyatakan meninggal, 98 subjek yang menjawab kuesioner dalam penelitian ini, dengan 56 laki-laki dan 42 perempuan. 83 subjek (84.69%) tidak memiliki riwayat familial. Mayoritas penderita stadium IV sebanyak 71 subjek (72,44%), stadium III 23 subjek (23.46%) dan stadium II hanya 4 subjek (4.08%). Kualitas hidup menunjukkan sebaran data yang tidak normal dengan median 70 (50-90) pada semua domain. Ditemukan dua subjek yang menunjukkan nilai kurang pada domain kesehatan fisik. Pada domain psikologis, hubungan sosial dan lingkungan didapatkan seluruh subjek mendapatkan skor kualitas hidup diatas dari 60 dengan median secara berturut-turut 70(70-90), 70(60-90), dan 70(60-92). Didapatkan asosiasi yang bermakna secara statistik antara kualitas hidup dengan jenis kelamin, usia, stadium, dan jumlah terapi adjuvan yang memiliki p sebesar 0,011; 0,015; 0,002; dan 0,005. Tidak ditemukan asosiasi yang bermakna secara statistik antara kualitas hidup dengan familial. Kesimpulan. Terdapat hubungan antara kualitas hidup penderita adenokarsinoma kolorektal di RSUPN dr. Cipto Mangukusumo apabila dihubungkan dengan usia, jenis kelamin, stadium kanker, dan jumlah terapi adjuvan.
Manajemen Kanker Kolorektal Agi Satria Putranto
MEDICINUS Vol. 35 No. 3 (2022): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/medicinus.v35i3.99

Abstract

Colorectal cancer was infrequently diagnosed few decades ago, but the number of cases increased dramatically until it becomes the third most prevalent malignancy after breast and lung cancer. Population aging and on top of unhealthy lifestyle were major contributor to the significant rise of the disease. Management of colorectal cancer has markedly evolved, allowing improvement in terms of survival and advance in quality of life. Nevertheless, the rate of survival could be boosted by raising public awareness over colorectal cancer, education program that may lead to better health behaviour, as well as health system policy that support disesase screening, considering the characteristic of the disease that is often asymptomatic, particularly in the early development.
Low Anterior Resection Syndrome (LARS) and Related Factors Variation Pattern in Indonesian Tertiary Hospital: Case-Controlled Study Jeo, Wifanto Saditya; Mazni, Yarman; Putranto, Agi Satria; Primadhani, Wendy; Ananti, Anggini T.; Yoladifa, Safira Farah
Indonesian Journal of Cancer Vol 19, No 2 (2025): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i2.1318

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Background: Dysfunctional bowel movement, also referred to as low anterior resection syndrome (LARS), is a regular issue correlated with rectal cancer, which significantly impacts overall wellbeing. Thisstudy intended to look for the LARS incidence in patients with colorectal cancer where rectal preservation was not possible and identify factors affecting major LARS incidence in Indonesia. Method: This study follows a case-control design. Patients with rectal cancer over 18 years old who underwent tumour removal with mesorectal excision and colorectal anastomosis at Dr. Cipto Mangunkusumo General Hospital, Indonesia, from January to March 2019. The control group includes patients of eligible age who had anal sphincter preservation, stoma closure, and fall into the No LARS or Minor LARS category. Data were collected from medical records and scored with a validated LARS questionnaire. Results: Among 40 patients included, 42.5% had major LARS. The surgical procedure of low anterior resection (LAR) was significantly associated with 31.7% of major LARS patients (p = 0.04). Preoperative radiotherapy [OR 0.1 (0.02–0.49)] and anastomosis levels [OR 0.07 (0.01–0.39)] were associated with major LARS. The ROC curve revealed an AUC of 0.77, indicating significant results with the threshold for anastomosis level was 5 cm. Biofeedback revealed group differences in resting anal and maximal squeeze pressures, indicating sphincter impairment and preoperative treatment impact LARS progression. Conclusion: Major LARS development was heightened by surgical methods, preoperative radiotherapy, and lower anastomotic levels, emphasizing the role of sphincter dysfunction and preoperative interventions in LARS development.
Co-Authors Ananti, Anggini T. Aria Kekalih Arief Hakiki Diah Rini Handjari Grace Wangge Hendy, Alldila Jeo, Wifanto Saditya Julistian, Julistian Maida Tanara Marcellus Simadibrata Marcellus Simadibrata Mazni, Yarman Nur Rasyid Nur Rasyid Primadhani, Wendy Rofi Y Saunar Siahaya, Fransisca Janne Siregar, Sun Parkuseg Yoladifa, Safira Farah Yusak Kristianto