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All Journal Medical Journal of Indonesia Indonesian Journal of Urology Paediatrica Indonesiana ISM (Intisari Sains Medis) : Jurnal Kedokteran Jurnal Ilmu Bedah Indonesia Cermin Dunia Kedokteran Makara Journal of Health Research Plexus Medical Journal
Arry Rodjani
Departemen Urologi RS Cipto Mangunkusumo, Jakarta (Fakultas Kedokteran Universitas Indonesia)
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Management of grade IV blunt renal trauma in adults: Systematic review and meta-analysis Bramono, Ikhlas A; Irdam, Gampo A; Rodjani, Arry; Wahyudi, Irfan
Makara Journal of Health Research Vol. 23, No. 2
Publisher : UI Scholars Hub

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Abstract

Background: Irrespective of the high incidence of grade IV renal trauma, there is still an ongoing debate regarding the use of conservative and surgical approaches for its treatment. This study aimed to conduct pooled analyses of published studies that concluded evidences regarding the management of grade IV renal trauma. Methods: Published studies between 1995 and 2015 from Cochrane Library, EBSCO, Embase, ProQuest, PubMed, and Scopus were reviewed and pooled analysis of eligible studies was conducted using random effects model. Heterogeneity was presented with I2 and p value. Results: Eleven studies reporting on 703 adults were included in the analysis. Conservative approach was used in 611 patients (conservative group) and surgical approach in 92 patients (surgical group); success rate and morbidity were comparable between the groups (risk ratio (RR): 1.15, 95% confidence interval (CI): 0.72–1.83; RR: 0.77, 95% CI: 0.27–2.21, respectively). The trend of mortality was higher in the surgical group than the conservative group. Conclusions: A comparable success rate was observed between the groups. Mortality was higher in the surgical group than the conservative group. As advocated by many guidelines, conservative management may decrease unnecessary exploration, which can ultimately reduce reconstruction and/or nephrectomy rate without causing morbidity or mortality.
Efficacy of topical steroid therapy for phimosis treatment: a systematic review Andika Rendy; Arry Rodjani; Irfan Wahyudi
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (303.23 KB) | DOI: 10.15562/ism.v11i1.633

Abstract

Background: Circumcision is the gold standard in the management of phimosis cases. Nowadays, there is some basic science research that showed topical steroid might be used to decrease the morbidity of phimosis cases. This research aims to determine which management is more effective in treating phimosis by using a systematic evidence-based medicine approach.Methods: Literature searching was done to find journals that are deemed appropriate for these cases. We included 3 RCT studies in this review. Critical appraisal was conducted to determine the efficacy of topical steroid. We compared those two methods in managing cases of phimosis among children.Results: Topical steroids effectively cause the preputium skin be soft and comfortable to retract. In several cases, some patients had difficulty to get retracted. For these cases, circumcision is needed.Conclusion: Topical steroid is effective in reducing the phimosis signs and symptoms, especially in patients who are younger and less than 3 years old. Further study and meta-analysis should be conducted in Indonesia to determine the effectiveness of this therapy in Indonesia.
CYSTOSTOMY DIVERSION REDUCED COMPLICATIONS FOLLOWING HYPOSPADIAS REPAIR: A SYSTEMATIC REVIEW AND META-ANALYSIS Wahyudi, Irfan; Raharja, Putu Angga Risky; Situmorang, Gerhard Reinaldi; Rodjani, Arry
Indonesian Journal of Urology Vol 31 No 3 (2024)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v31i3.883

Abstract

Objective: This study aims to investigate the associations between the use of cystostomy diversion and the incidence of complications following hypospadias repair. Material & Methods: An extensive search of PubMed, ScienceDirect, Embase, and the Cochrane Library, was performed to identify studies that assessed the impact of cystostomy diversion on complication rates after hypospadias repair. To evaluate potential biases, the RoB 2 tool was applied for randomized controlled trials (RCTs), while the ROBINS-I tool was used for observational studies. Data analysis was conducted using Review Manager 5.4. Results: This review included ten studies involving 1.120 patients who underwent hypospadias repair. The overall complication was 16.9%. The meta-analysis revealed that opting against cystostomy diversion after hypospadias repair led to a notably increased risk of complications, as evidenced by a pooled odds ratio (OR) of 1.48 (95% confidence interval (CI) 1.07–2.03). The significant negative effect of not performing cystostomy on the risk of complications was consistent in sub-analysis of distal hypospadias (OR 1.97; 95% CI 1.11–3.51) and primary hypospadias repair (OR 1.80; 95% CI 1.19–2.73). In the funnel plot, there was no significant publication bias identified. Conclusion: Our meta-analysis demonstrated that cystostomy diversion reduces the incidence of complications following hypospadias repair. The positive effects were consistent in both distal hypospadias and primary hypospadias repair. Keywords: Complications, cystostomy, hypospadias.
Comparing anastomosis techniques on ischemia time in multi-arterial kidney grafts: a systematic review and meta-analysis Hernawan Rahmat Muharia, Bayu; Situmorang, Gerhard Reinaldi; Rasyid, Nur; Rodjani, Arry; Birowo, Ponco
Medical Journal of Indonesia Vol. 34 No. 1 (2025): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257527

Abstract

BACKGROUND Kidney transplants with multiple renal arteries (MRAs) address donor shortages but carry higher vascular risks than single renal arteries. This study aimed to evaluate how different anastomosis techniques affect outcomes in kidney transplants with MRAs through meta-analysis and systematic review, concluding the continuous discussion about the best reconstructive strategy. METHODS A comprehensive search across 5 databases (PubMed, ScienceDirect, Cochrane Library, Web of Science, and the Cumulative Index to Nursing and Allied Health Literature) was conducted until December 17, 2024, to find studies comparing anastomoses technique in MRA grafts. Meta-analysis was performed using Review Manager software version 5.4, generating pooled effect estimates for mean difference (MD) and risk ratio (RR), two-sided p-values, and 95% confidence intervals (CIs). RESULTS Two retrospective cohort studies were included in the meta-analysis. There was no significant difference between end-to-side and side-to-side anastomosis in warm ischemia time (MD = 15.64, 95% CI: −6.82−38.10, p = 0.17) or cold ischemia time (MD = −16.74, 95% CI: −105.61−72.14, p = 0.71). The complication rate showed no significant variation between side-to-side and end-to-side anastomosis (RR = 2.38, 95% CI: 0.41−13.70, p = 0.33). Meta-analysis on graft function and rejection was impossible due to differences in measurements and the small number of studies. CONCLUSIONS Different anastomosis techniques for MRA grafts did not result in longer ischemia times or higher complication rates. Graft function and rejection rates were comparable between side-to-side and end-to-side anastomosis, suggesting both were equally feasible for renal transplants with MRAs. Further studies are required to verify these findings.
Laparoscopic Tenckhoff catheter insertion technique with Alken telescopic metal dilator in pediatric population Situmorang, Gerhard Reinaldi; Alfarissi, Fekhaza; Raharja, Putu Angga Risky; Rodjani, Arry; Wahyudi, Irfan
Medical Journal of Indonesia Vol. 34 No. 2 (2025): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257670

Abstract

BACKGROUND End-stage renal disease (ESRD) is a major public health concern worldwide, with peritoneal dialysis (PD) offering a key alternative to hemodialysis. Flow restriction due to catheter migration is a common complication, affecting 7–26% of patients with PD. This study aimed to reduce complications in pediatric patients by examining a novel laparoscopic Tenckhoff catheter insertion technique using an Alken telescopic metal dilator. METHODS In a prospective observational study conducted between September 2018 and October 2022, 33 pediatric patients with ESRD underwent laparoscopic Tenckhoff catheter insertion using a combination of laparoscopic and Seldinger techniques with Alken dilators. This approach involves rectus sheath tunneling using a nephrostomy puncture needle, wire insertion, and dilatation of up to 15 Fr using Alken telescopic metal dilators under laparoscopic guidance. Survival analysis was used to assess catheter survival and complication rates. RESULTS The mean (standard deviation [SD]) patient age was 11.92 (3.7) years, with a median follow-up of 21.3 months. Catheter survival was 84.8%, with 5 catheter withdrawals due to infections (4 cases) or obstruction (1 case). Early and late complications, including exit-site infection, peritonitis, and catheter obstruction, occurred annually at rates of 0.10, 0.03, and 0.02 episodes per patient, respectively. No pericatheter leakage occurred. CONCLUSIONS This novel laparoscopic Tenckhoff catheter insertion technique using an Alken telescopic metal dilator become a simple and minimally invasive method, and associated with high catheter survival and low complication rates. Therefore, further comparative studies are recommended.
Reconstruction of Multiple Renal Arteries in Live Donor Kidney Transplantation: Moewardi Hospital Experience Muhammad Hilmy Labibi; Syaeful Agung Wibowo; Husein, Ali; Wibisono; Bimanggono Hernowo Murti; Suharto Wijanarko; Tusarawardaya , Setya Anton; Rodjani, Arry; Rasyid, Nur; Susanto , Agung; Putro , Prasetyo Sarwono
Plexus Medical Journal Vol. 4 No. 4 (2025): Agustus
Publisher : Fakultas Kedokteran, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/plexus.v4i4.2292

Abstract

Background: Kidney transplant is the procedure for end stage renal disease (ESRD). This treatment has longer survival advantage than dialysis. Anatomical variations in the renal vasculature like multiple renal arteries, may increase surgical difficulties and influence postoperative outcomes. Case Presentation: We report a 46-year-old female living donor with two renal arteries on the left side of kidney. The recipient was her 25-year-old daughter with end stage renal disease due to systemic lupus erythematosus. A left open donor nephrectomy was completed without complications. The two renal graft arteries were side-to-side anastomosed each other, then an end-to-side anastomosis to the external iliac artery. The kidney achieved rapid reperfusion and returned to function immediately. Doppler ultrasound examination showed the normal perfusion. The creatinine level was 1.2 mg/dL on second day postoperative and stable at 0.8 mg/dL during a three-month follow-up. Conclusion: This case highlights the feasibility of transplanting a kidney from a donor with multiple renal arteries, emphasizing the critical role of comprehensive preoperative evaluation and meticulous surgical planning in achieving optimal outcomes.
Co-Authors Agus Rizal Ardy Hariandy Hamid, Agus Rizal Ardy Hariandy Alam, Gampo Albertus Marcelino Alfarissi, Fekhaza Alfarissi, Fekhaza Andika Rendy Angling Yunanto ARIANTO, EKO Bagus Baskoro Bimanggono Hernowo Murti Bramono, Ikhlas A Chaidir A Mochtar Chaidir A. Mochtar Chaidir Arif Mochtar CHAIDIR MOCHTAR, CHAIDIR Edhi Hapsari Eko Arianto Endang Susalit Ervita Mediana Fatan Abshari, Fatan Firdaoessaleh Firdaoessaleh GAMPO ALAM IRDAM, GAMPO ALAM Gerhard Reinaldi Situmorang, Gerhard Reinaldi Ginanda Putra Siregar, Ginanda Putra H R Danarto Hani A Hendarto Harrina Erlianti Rahardjo, Harrina Erlianti Hernawan Rahmat Muharia, Bayu Hery Tiera Husein, Ali Ilham Wahyudi Irdam, Gampo A Irfan Wahyudi Irfan Wahyudi Islianti, Putri Iradita Johannes Aritonang, Johannes Jose RL Batubara Kanadi Sumadipradja Maruhum B.H. Marbun Mohammad Fariz Muhammad Hilmy Labibi NICHOLAS TAMBUNAN, NICHOLAS Nouval Shahab Nur Rasyid Nur Rasyid Nurul Akbar Pande Made Wisnu Tirtayasa Ponco Birowo Prahara Yuri Prasetyo, Dimas Tri Putra, Ida Bagus Oka Widya Putra, Prima Ciko Ade Putro , Prasetyo Sarwono Raharja, Putu Angga Risky Rahmita, Maulidina Medika Rainy Umbas Rendy Andika, Rendy Soeroto, Adhitama A. Suharto Wijanarko Susanto , Agung Syaeful Agung Wibowo Taufik Rakhman Taher Tommie Prasetyo, Tommie Tusarawardaya , Setya Anton Wibisono Widi Atmoko Widia, Fina Yonas Immanuel Hutasoit, Yonas Immanuel Yopie T Satyawan Yopie Tjandradiguna Satyawan