Kurnia Penta Seputra
Brawijaya University, Faculty of Medicine, Department of Urology Dr. Saiful Anwar General Hospital Malang, Indonesia

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Hemodynamic Instability and Severity Grade of Kidney Trauma as The Predictor Factors for Nephrectomy Besut Daryanto; I Gusti Lanang Andi Suharibawa; Kurnia Penta Seputra; Paksi Satyagraha; Pradana Nurhadi
Brawijaya Journal of Urology Vol. 1 No. 01 (2020): Brawijaya Journal of Urology
Publisher : Department of Urology, Faculty of Medicine, Universitas Brawijaya

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Introduction: Kidney trauma occurs in presumably 1-5% of all trauma cases. Delayed surgery increases the likelihood of persistent urinary extravasation and secondary hemorrhage, whereas immediate surgery results in a high renal loss. Hence, the aims sought to evaluate whether hemodynamic instability, urea and creatinine level, anemia and severity grading of kidney trauma can be the predictor factors of nephrectomy. Materials and Methods: Retrospectively study from January 2005 to December 2016, the authors collected the data of 63 kidney trauma patients. We analyzed the hemodynamic condition, hemoglobin level, and grade of kidney injury. The association of hemodynamic instability, urea and creatinine level, anemia, grade of kidney injury to the decision of nephrectomy were analyzed using statistical software (SPSS). Results: Kidney trauma occurred mostly in first grade (40/63.5%). Only 4 (5.4%) came in high grade of renal trauma (Grade III and IV). Patients who came to the emergency department mostly in stable hemodynamic (52/82.5%). Most of them were subsequently treated uneventfully with non-operative management (60/95.2%). There was a significant association between hemodynamic instability and treatment options that unstable hemodynamic significantly increase nephrectomy rate (p=0.047). The data analysis results associated severe grade of trauma with an increase nephrectomy rate (RR: 174, 95% CI:8.62 – 315.174, p<0.01). Further, there were no significant association between anemia, urea and creatinine levels to nephrectomy rate (p>0.05). Conclusion: Severity grade of kidney trauma and hemodynamic instability increased the risk of nephrectomy. Other factors such as anemia, urea and creatinine levels do not have a significant association with the risk of nephrectomy.
Comparison Between Gemcitabine-Cisplatin Chemotherapy Outcome and Body Mass Index in Muscle Invasive Bladder Cancer Patients At Dr. Saiful Anwar General Hospital Malang, Indonesia Kurnia Penta Seputra; Besut Daryanto; Astarin Ardiani
Brawijaya Journal of Urology Vol. 1 No. 01 (2020): Brawijaya Journal of Urology
Publisher : Department of Urology, Faculty of Medicine, Universitas Brawijaya

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Introduction: Malignancy remain a worldwide challenge to overcome, one of the most common malignancy in men is bladder cancer, it represent the seventh most common cause of cancer in men worldwide. Over the past decade 6978 Indonesian were diagnosed with bladder cancer. In Dr. Saiful Anwar Hospital itself, 287 inpatient were hospitalized due to bladder cancer over the past 5 years. Bladder cancer therapy including, radical cystectomy, radiotherapy and chemotherapy depending on the tumor’s stage. Patients requiring chemotherapy, are given six course of Gemcitabine-Cisplatin regiment. Body Mass Index (BMI) acclaimed to take part in cancer treatment outcome, therefore this study aimed to compared body mass index with bladder tumor outcome in bladder cancer patients receiving six course of Gemcitabine-Cisplatin chemotherapy. Method: Fifteen bladder cancer patients with different BMI underwent (transurethral resection of bladder tumor) TURBT staging and received six course of Gemcitabine-Cisplatin Chemotherapy from 2016 to 2018 at Dr. Saiful Anwar General Hospital were recorded, we followed the patients during the six course of chemotherapy and evaluation were carried out using cystoscopy and bladder biopsy. The data then analysed using chi square and t-test to compared. Result: Fifteen patients were eligible for this study, 10 were men and 5 were women. Mean age is 66.6 years old, body mass index (BMI) include normal weight (73.3%), underweight (6.67%), overweight(13.3%) and obese (6.67%). Pathology finding including Transitional Cell Carcinoma of high grade (46,7%) and low grade (53.3%). Tumor staging start from T2 (26.67%), T3 (6.67%) and T4 (66.66%). Three patients had metastatic tumor to the liver, liver and lung and rectum respectively. Lymph node involvement were N0 40%(6),N1 33.3% (5) N2 20%(3) and N3 6.7% (1) continuously. Out of fifteen patients who underwent Gemcitabine-Cisplatin chemotherapy for six series, tumor outcome after therapy was compared with the BMI. Tumor still remain in 11 patient (73.3%), while 4 (26.7%) patients were found to be tumor free after six course of Gemcitabine-Cisplatin chemotherapy. There is no statistically significant between body mass index and chemotherapy success rate (p= 0.159) in this study. Although. there were statistically significant found in the presence of tumor before and after Gemcitabine-Cisplatin chemotherapy (p= 0.041). There are no statistically significant between sex and age when compared to chemotherapy outcome with (p=0.446) and (p=0.469) respectively. Conclusion: Body Mass Index has no relation in determining success rate of bladder cancer chemotherapy using Gemcitabine-Cisplatin.