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All Journal Jurnal Ilmu Kedokteran (Journal of Medical Science) Jurnal Ners
Ismar Ismar
Universitas Riau/Arifin Achmad Hospital
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Medicine & Pharmacology Nursing Public Health

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Neutrophil Lymphocytes Ratio (NLR) of One-Step and Multi-Step Procedure for Hirschsprung Disease Patients At Arifin Achmad General Hospital Dita Kartika Sari; TB Odih Rhomdani Wahid; Ismar Ismar; Laode Burhanuddin; Yolla Fitri Elmi
Jurnal Ilmu Kedokteran Vol 18, No 1 (2024): Jurnal Ilmu Kedokteran
Publisher : Fakultas Kedokteran Universitas Riau

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26891/JIK.v18i1.2024.45-49

Abstract

Hirschsprung disease (HD) is a congenital anomaly due to intestinal aganglionosis starting from the internal anal sphincter and spreading to the proximal area with varies extension of the segment. Definitive treatment for this abnormality is to perform surgery to remove the aganglionic bowel and can be carried out in one-step and multi-step procedure. In the process of wound healing after surgery, it involves inflammatory mediators as a marker of whether there is a stress response from the endocrine system such as neutrophil-lymphocyte ratio (NLR). This study aims to compare NLR as an inflammatory biomarker in one-step and multi-step procedure of hirschsprung disease patients at Arifin Achmad Hospital. The design of this study was cross-sectional using medical records and using total sampling for number of samples. Age, gender, and method of surgery were evaluated by univariate and bivariate to determine whether there were statistical differences. Seven HD patient taken from Mei-October at Arifin Achmad Hospital taken for evaluated. The results showed that the most samples were in < 1-month-old (42.9%) and male (71,4%) for gender. The average number of NLR was in 7.33 after one-step procedure and 2.77 for multi-step procedure. This number of NLR both not statistically different neither for the post-operative examination nor the comparison between procedure.
Total Colonic Tubular Duplication Associated With Anorectal Malformation: A Case Report and Surgical Reconstruction Approach Dhon Rizal Gusnanda; Ismar Ismar; Tubagus Odih Rhomdani Wahid; Khairuli Amri; Andrea Valentino; Sinta Chaira Maulanisa
Jurnal Ners Vol. 10 No. 1 (2026): JANUARI 2026
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jn.v10i1.52465

Abstract

Total colonic duplication is an exceptionally rare subtype of gastrointestinal duplication, often associated with anorectal malformations. Diagnostic difficulty arises from variable morphology, shared mesenteric structures, and inconsistent imaging findings. Early recognition remains limited, and many cases are identified only during operative exploration. A 10-month-old male with a history of anorectal malformation previously treated with colostomy underwent evaluation for definitive repair. Intraoperative assessment, including loop colonography, identified two parallel colonic lumens extending from cecum to rectum. Exploratory laparotomy confirmed complete tubular duplication with a shared mesentery. Reconstruction was achieved through a side-to-side window anastomosis using a stapling device, followed by creation of a protective ileostomy. Postoperative recovery was uneventful, with adequate stoma perfusion and preserved bowel function. The patient remained stable during follow-up and was scheduled for staged abdominoperineal anoplasty. Complete colonic duplication may not be detected preoperatively and frequently requires intraoperative confirmation. Preservation of vascular supply and staged reconstruction are central to optimizing outcomes.Individualized surgical planning and careful anatomical delineation support favorable early recovery and functional prognosis in total colonic duplication with anorectal malformation.
Co-Authors Andrea Valentino Dhon Rizal Gusnanda Dita Kartika Sari Khairuli Amri Laode Burhanuddin Mursa Sinta Chaira Maulanisa TB Odih Rhomdani Wahid Tubagus Odih Rhomdani Wahid Yolla Fitri Elmi