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All Journal BALI MEDICAL JOURNAL (BMJ) Majalah Kedokteran Bandung Althea Medical Journal The Indonesian Biomedical Journal Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Medica Hospitalia Contagion: Scientific Periodical Journal of Public Health and Coastal Health Medika Kartika : Jurnal Kedokteran dan Kesehatan Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Jurnal Instrumentasi Jurnal Ilmu Bedah Indonesia Bioscientia Medicina : Journal of Biomedicine and Translational Research Lex Scientia Law Review Klinik: Jurnal Ilmiah Kedokteran dan Kesehatan
Reno Rudiman
Department Of Surgery, Faculty Of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Chemistry Dentistry Education Electrical & Electronics Engineering Engineering Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

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Correlation between Albumin, Colon Leakage Score (CLS), and Anastomotic Leakage after Colorectal Cancer Resection Reno Rudiman; Putie Hapsari; Novi Christina Indrajaya
Majalah Kedokteran Bandung Vol 54, No 4 (2022)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v54n4.2666

Abstract

Anastomotic leakage is still the most undesirable complication of colorectal surgery. The reported incidence of anastomotic leakage after colorectal surgery varies from 1.8% to 15.9%. The impact of anastomotic leakage is increased morbidity, mortality (12–30%), length of stay, and cost of hospitalization; hence, this complication should be prevented as much as possible.Several studies have shown a correlation between low albumin levels and increased anastomotic leakage.The Colon Leakage Score (CLS) is a standard score for predicting anastomotic leakage, but this score does not include the albumin level as a parameter of anastomotic leakage despite the importance of the albumin level’s contribution on the anastomotic leakage. Therefore, this study sought to analyze the correlation between the albumin level, CLS, and the incidence of anastomotic leakage after anastomotic resection surgery in colorectal cancer (CRC) patients at Dr. Hasan Sadikin General Hospital Bandung, Indonesia. This study was a cross-sectional retrospective analytical study on medical records of CRC patients over the age of 18 who underwent intestinal anastomotic resection surgery between 2016–2020. There were thirty-two patients with colorectal cancer underwent anastomotic resection during the study period, with two patients experienced anastomotic leakage. Correlation analysis showed that the correlation coefficient for the albumin level and anastomotic leakage was 0.209, while the correlation coefficient between CLS and anastomotic leakage was 0.110. There is no correlation between albumin level, CLS, and the incidence of anastomotic leakage after anastomotic resection surgery in CRC patients treated at Dr. Hasan Sadikin General Hospital Bandung, Indonesia
Correlation Analysis of Lactic Acid Level as A Predictor of Severity of Patients with Acute Appendicitis Reno Rudiman; Tommy Ruchimat; Cytra Givanni Rossy
Majalah Kedokteran Bandung Vol 55, No 1 (2023)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v55n1.2816

Abstract

Perforated appendicitis is a leading cause of morbidity and mortality in all appendicitis cases, both for adults and children. Delay in preoperative diagnosis is the main reason for perforation. In previous studies, it was revealed that diagnostic modalities such as radiological examination and the current scoring system have not been able to predict the onset of perforated appendicitis. Serological biomarkers of lactic acid are associated with intestinal obstruction and ischemia. The increase in the serological value of lactic acid in perforated appendicitis compared to acute one was shown to increase significantly by 0.25 mmol/L (p<0.05) according to a previous study. This study aimed to determine the correlation between lactic acid level and the severity of appendicitis in patients visiting Dr. Hasan Sadikin General Hospital. This was a cross-sectional prospective analytic observational study on adult patients diagnosed with appendicitis who were admitted to the emergency room of Dr. Hasan Sadikin General Hospital from January 1, 2021 to June 1, 2021. Data analysis was performed using bivariate analysis and correlation tests of difference. This study involved 54 subjects with a mean lactic acid level of 2,5093 mmol/L (0.9 mmol/L - 11.8 mmol/L). In the complicated appendicitis group, 20 subjects (37%) was found to experience an increase in lactic acid (OR 1.07; 95% CI: -0.03-0.22; p=0.14). The correlation analysis showed the direction of negative correlation. Thus, it is concluded that there is no significant correlation between lactic acid level and the severity of appendicitis in patients with appendicitis.
SURGICAL EDUCATION AND TRAINING ADAPTATION IN RESPONSE TO THE COVID-19 PANDEMIC: A LITERATURE REVIEW Rudiman, Reno; Hapsari, Putie
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.76235

Abstract

Background: As a global health emergency, the COVID-19 pandemic has affected all medical education and training, including surgical specialities. The number of elective surgeries dropped significantly as both an impact of the pandemic and a way of limiting the spread of the disease. There was confusion about continuing surgical education and training at the beginning of the pandemic. However, as the pandemic continued, we adapted to the new conditions and regulations. Social distancing, testing, and quarantine were promoted. The study aimed to show how surgical education and training adapt to the COVID-19 pandemic worldwide and share how we do it in Indonesia.Methods: The authors gathered relevant literature from several publications sites, using the keywords “surgical education,” “surgical adaptation,” and “COVID-19.”Results: In order to decrease contacts, the number of people in the operating room was reduced, clinical rounds were cancelled, and face-to-face training and lectures were moved to online platforms, namely Zoom and Google Meet. The number of residents on clinical duties was decreased to limit the transmission. They are encouraged to study using different models by themselves to keep up with the required skills. They were required to learn and then be tested or reviewed by the supervisor. The use of simulation models and online learning platforms provided by several worldwide institutions has become popular.Conclusion: We learn that surgical education and training from the pandemic can develop into a more modern way of learning, consisting of a virtual learning strategy and simulation model. This hybrid learning of offline and online courses can aid the growth of not only the residents but also the experienced surgeon.
Lactic Acid Level as A Predictor of Severity in Patients with Acute Appendicitis Aditya, Raka; Rudiman, Reno; Hapsari, Putie
Majalah Kedokteran Bandung Vol 56, No 1 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v56.3086

Abstract

Perforated appendicitis is the leading cause of morbidity and mortality of all appendicitis cases in adults and children, with delayed preoperative diagnosis as the main reason. In previous studies, diagnostic modalities such as radiological examination and the current scoring system have been demonstrated as unable to predict the onset of perforated appendicitis. Serological biomarkers of lactic acid are associated with intestinal obstruction and ischemia. The serological value of lactic acid in identifying perforated appendicitis compared to acute one was shown to increase significantly by 0.25 mmol/L (p<0.05) in a previous study. This study aimed to determine the correlation between lactic acid and the severity of appendicitis. This was a cross-sectional prospective analytic observational study in patients treated in Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Subjects were adult patients diagnosed with appendicitis during the period of 2021 in the Emergency Room of the hospital. Data were analyzed using the bivariate analysis and correlation test of difference. This study involved 54 subjects, divided into the complicated appendicitis (study) and control groups, with a mean of lactic acid level of 2,5093 mmol/L (0.9 mmol/L–11.8 mmol/L). In the complicated appendicitis group, 20 subjects (37%) demonstrated an increase in lactic acid level (OR 1.07; 95% CI: -0.03–0.22; p=0.14). The correlation analysis resulted in a negative correlation. This study concluded that there is no significant correlation between lactic acid levels and the severity of appendicitis in these patients.
Vitamin D Supplementation and Colorectal Cancer Patients Outcomes Mulyadi, Noeray Pratiwi; Rudiman, Reno; Purnama, Andriana
Majalah Kedokteran Bandung Vol 56, No 4 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v56.3823

Abstract

Colorectal cancer is the third most encountered malignancy worldwide in 2018. Some earlier studies indicate a significant influence of vitamin D supplementation on the 5-year survival rate and the rate of metastasis progression in colorectal cancer patients. Studies investigating the effects of vitamin D supplementation on the outcomes of colorectal cancer patients are limited in Indonesia. Therefore, a double-blinded Randomized Controlled Trial (RCT) of the effect of vitamin D supplementation on the outcome of colorectal cancer patients was conducted from April 2022 to March 2023 at the digestive surgery outpatient clinic of Dr. Hasan Sadikin General Hospital Bandung, Indonesia. In this study, 36 patients received vitamin D and 34 patients received a placebo. Data analysis performed using the multivariate analysis with multiple regression revealed no significant relationship between vitamin D supplementation and colorectal cancer patient outcomes. Furthermore, ANOVA analysis indicated no relationship between the analyzed independent and dependent variables in this study.  No relationship was found between vitamin D supplementation and the outcomes of metastasis, mortality, and Karnofsky scores in colorectal cancer patients. Further research with a larger population is still needed to determine the benefits of vitamin D supplementation on the outcomes of colorectal cancer patients.
Comparison of CONUT Score, SGA Score, and GLIM Score as Gold Standard for Colorectal Cancer Patients Marcella, Marcella; Rudiman, Reno; Yohana, Raden
Majalah Kedokteran Bandung Vol 57, No 1 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v57.3846

Abstract

Malnutrition in colorectal cancer increases toxicity, worsens quality of life, and reduces body functions. Early identification of malnutrition is crucial to determine treatments. This study compared the Global Leadership Initiative on Malnutrition (GLIM) score as the standard nutritional status screening tool to the Controlling Nutritional Status (CONUT) and Subjective Global Assessment (SGA) scores. This study expected to identify a new nutritional status screening tool for colorectal cancer patients. This was a cross-sectional diagnostic study on 60 colorectal cancer patients treated at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia from August 16, 2022 to July 16, 2023. Results revealed that the CONUT score had a sensitivity, specificity, accuracy, and effectiveness values of 80.4%, 0.0%, 85%, and 85%, respectively, in detecting malnutrition. The SGA score had a sensitivity value of 100%, a specificity value of 21.95%, an accuracy value of 85%, and an effectiveness of 85% in detecting malnutrition. When compared with the GLIM score as the gold standard, which is assumed to have a sensitivity and specificity values of 100%, the SGA score was better than the CONUT score for detecting malnutrition in colorectal cancer patients. The SGA score is closest to the GLIM score as the gold standard for assessing malnutrition in colorectal cancer patients.
Correlation Between ERCP Implementation Time and Outcomes of Patients with Acute Cholangitis Due to Choledocholithiasis Ayundra, Muhammad Hilmy; Rudiman, Reno; Hapsari, Putie
Majalah Kedokteran Bandung Vol 57, No 2 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v57.3965

Abstract

Acute cholangitis is a serious condition, and timely ERCP is essential for effective management. This prospective cohort study was conducted at Dr. Hasan Sadikin Hospital in Bandung, Indonesia, from June 2023 to April 2024, to evaluate the feasibility of performing ERCP beyond 48 hours in the presence of various limitations. The study included patients with acute cholangitis caused by common bile duct stones. The ERCP timing was categorized into three groups: less than 48 hours, 48-72 hours, and more than 72 hours. Outcomes measured were hospital stay duration, ICU admission, and 30-day mortality. Of these patients, 52.8% underwent ERCP at 48-72 hours, 27.8% after 72 hours, and 19.4% before 48 hours. The median hospital stay was 7.5 days (IQR 3-15). ICU admissions occurred only in patients receiving ERCP after 72 hours (30.0%), a significantly higher rate compared to the other groups (p=0.014). A strong correlation was found between delayed ERCP and longer hospital stays (r=0.711, p<0.01), as well as ICU admission (r=0.405, p=0.014), though no significant correlation with mortality was observed (r=-0.021, p=0.905).
PENGEMBANGAN ALAT UKUR TEKANAN BERBASIS PNEUMATIK UNTUK PENGUJIAN IN VITRO KEKUATAN MEKANIK SPESIMEN USUS HEWAN Putra, Narendra Kurnia; Lawrence, Christoph; Risangtumi, Ayu Gareta; Nugraha, Prapanca; Rudiman, Reno; Suprijanto, Suprijanto
Instrumentasi Vol 48, No 2 (2024)
Publisher : National Standardization Agency of Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31153/instrumentasi.v48i2.732

Abstract

Studi menggunakan organ usus hewan telah sering dilakukan sebagai prosedur evaluasi metode terapi baru pada prosedur pembedahan digestif seperti pada kasus pembedahan kanker dan anastomosis usus. Namun, proses evaluasi keberhasilan prosedur pembedahan ini biasa dilakukan melalui uji laboratorium patologi klinis yang biasanya memakan waktu yang panjang, pengkondisian khusus, serta biaya yang tidak sedikit. Oleh karena itu, kebutuhan akan adanya alat ukur in vitro pembanding uji performa kuantitatif kekuatan usus hewan pasca terapi.amatlah besar Penelitian ini mengembangkan sistem alat ukur berbasis pneumatik untuk pengukuran tekanan maksimum usus hewan berdasarkan metode burst pressure test yang terdiri atas rangkaian pompa udara, pengontrol pneumatik, dan sensor tekanan. Eksperimen  didahului dengan uji coba kerja sistem menggunakan spesimen uji balon, yang kemudian dilanjutkan dengan uji akhir menggunakan spesimen usus halus dari hewan uji babi ternak. Penelitian berhasil mengukur nilai tekanan maksimal spesimen usus halus babi ternak yang belum pernah diukur sebelumnya yaitu sebesar 20 kPa.
Comparison of Sensitivity and Specificity between B.I.L.E. Criteria and Tokyo Guidelines 2018 (TG18) for Diagnosing Acute Cholangitis Pratomo, Nugroho Rizky; Rudiman, Reno; Sulthana, Bambang Am am Setya
Majalah Kedokteran Bandung Vol 57, No 3 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v57.4132

Abstract

Acute cholangitis is an inflammatory condition of the biliary system due to bacterial infection associated with biliary stasis or obstruction. Diagnosis is made using the Tokyo Guidelines 2018 (TG18) criteria. The biliary imaging abnormality, inflammatory test abnormality, liver test abnormality, and exclusion of cholecystitis/pancreatitis (B.I.L.E.) criteria are relatively new, with limited studies evaluating their sensitivity, specificity, and validation. This study aimed to compare the sensitivity and specificity of B.I.L.E. and TG18 criteria for the diagnosis of acute cholangitis. This is an observational analytic study with prospective cohort design during May 2023–May 2024. Data were obtained from patients who came to the Emergency Department of Dr. Hasan Sadikin General Hospital Bandung, Indonesia, with clinical symptoms of fever and jaundice, suspected of acute cholangitis. There were 95 subjects in this study. Based on B.I.L.E. criteria, 57 (60%) patients were categorized as high probability and 38 (40%) patients were categorized as unlikely acute cholangitis, while the TG18 criteria resulted in 61 (64.2%) patients classified as definite and 34 (35.8%) patients classified as suspected acute cholangitis. The sensitivity of the B.I.L.E. criteria was 92.1%, with a specificity of 94.73%. Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of B.I.L.E. criteria were 92.1% and 94.73%, respectively. In contrast, the sensitivity and specificity of TG18 criteria in this study were 82.35% and 83.6%, respectively. The PPV of TG18 reached 73.68% while the NPV of TG18 reached 89.47%. In conclusion, B.I.L.E. criteria have higher sensitivity and specificity than TG18 criteria in diagnosing acute cholangitis patients.
Sleeve Gastrectomy And Liver Cyst Unroofing In Morbid Obesity With Multiple Liver Cysts: A Case Report Abdul Mughni; Bella Renata; Dimas Erlangga Nugrahadi; Tjokorda Gde Dalem Pemayun; Reno Rudiman; Ignatius Riwanto
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 2 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i2.1110

Abstract

Background: Obesity has become a major global health issue which leads to various complications, including hepatic diseases. However, we found a rare case of morbid obesity and symptomatic multiple liver cysts. Aim: This article aims to represent a rare case of morbid obesity and multiple liver cysts surgically managed by sleeve gastrectomy and liver cyst unroofing which were performed in a single surgery. Case report: 41-year-old female presented with morbid obesity and blunt intermittent abdominal pain in the right upper quadrant. Stage II hypertension, tenderness on the right upper quadrant of the abdomen and epigastrium were found in clinical assessment. Lipid profiles were shown to be elevated. Abdominal CT revealed fatty liver and multiple cystic lesions in all hepatic segments. Discussion: Non-parasitic liver cysts affect 2-18% of the global population, with a higher prevalence in females possibly due to hormonal factors. Obesity is associated with hormonal alterations, potentially leading to increased secretion of FSH and LH. Conclusion: Sleeve gastrectomy and liver cyst unroofing may be considered as a treatment strategy for patients with morbid obesity and multiple liver cysts.
Co-Authors Abdul Mughni Adeodatus Yuda Handaya Adi Muradi Muhar Adianto Nugroho Aditya, Raka Agung Ary Wibowo Ahmad Bahrudin Akhsan, Alfie Barkah Alfie Barkah Akhsan Alma Wijaya Andriana Purnama Andriana Purnama Andriana Purnama Andriana Purnama Andriana Purnama, Andriana Arnetta Naomi Louise Lalisang Ayundra, Muhammad Hilmy Bambang Am&#039;am Setya Sulthana Degrees Bambang Suprapto Barr, Tubagus Izzul Bella Renata Benita Putri Permata Cytra Givanni Rossy Desyanti Suka Asih K.Tus Dewi Bunga Dimas Erlangga Nugrahadi Edwin Saleh Siregar, Edwin Saleh Eko Nur Febrianto Erik Prabowo Fransiscus Arifin Gema Putra Lesmana Gisela Karina Hapsari, Putie Harry Galuh Nugraha Hendrik Stevanus I Made Mulyawan Ignatius Riwanto Indah Situmorang Irwan Irwan Jeffri Putra Kendry Savira Kiki Lukman Kiki Lukman Kunsemedi Setyadi Kuswinarti Kuswinarti Lawrence, Christoph Maman Wastaman Rodjak Marcella, Marcella Maria Mayasari Michael Tendean Mohamad Romdhoni Muhammad Iqbal Rivai Muhammad Shobachun Niam Mulyadi, Noeray Pratiwi Narendra Kurnia Putra Ni Made Rai Kristina Nova Octoria Novi Christina Indrajaya Nugraha, Prapanca Nurhayat Usman Nurhayat Usman Octoria, Nova Prapanca Nugraha Prapanca Nugraha Pratomo, Nugroho Rizky Putie Hapsari Putu Kussa Laksana Utama Raden Lyana Sulistyanti Raden Yohana, Raden Rani Septrina Risangtumi, Ayu Gareta Rizky, Kiki A Rodjak, Maman Wastaman Silalahi, Fonda R.P Singarimbun, Wilner Stevanus, Hendrik Sulistyanti, Raden Lyana Sulthana, Bambang Am am Setya Suprijanto, Suprijanto Suraya Adnyana, Ida Bagus Budhi Tjokorda Gde Dalem Pemayun Toar J.M. Lalisang Tommy Lesmana Tommy Ruchimat Tommy Ruchimat Tommy Ruchimat Tommy Ruchimat Tommy Ruchimat Usman, Nurhayat Vandra Bina Riyanda Warsinggih Warsinggih Wilner Singarimbun Yan Aditya Yarman Mazni Yossi Andila Yunia Sribudiani Zuldi Erdiansyah