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Performance of Pre-Operative IOTA Three-Step Algorithm in Detecting Ovarian Carcinoma in a Referral Center in Indonesia Kurniadi, Andi; Permadi, Wiryawan; Kusuma, Aria Yusti; Kireina, Jessica; Andarini, Mia Yasmina; Winarno, Gatot Nyarumenteng Adhipurnawan; Harsono, Ali Budi
Indonesian Journal of Cancer Vol 18, No 1 (2024): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i1.1044

Abstract

Background: To assess the diagnostic performance of a three-step algorithm using the International Ovarian Tumor Analysis (IOTA) Group ‘simple rules’, ‘simple descriptors’, and Assessment of Different NEoplasias in the adneXa (ADNEX) model for discriminating benign and malignant adnexal masses. Methods:  This was a retrospective observational study, performed at a tertiary-care university hospital, on women diagnosed with adnexal mass on ultrasonography from January 2021 and February 2022. The examiner first classified the mass using ‘simple descriptors’ (first step) and, if not possible, using ‘simple rules’ (second step). For inconclusive masses, an assessment using the ADNEX model was done as the third step. All masses were managed surgically. Histopathology results were used as the reference standard.Results: One hundred and forty-one women were included (median age of 48 years). Histopathology results showed 104 (73.76%) mass to be malignant, and 37 (26.24%) mass to be benign. Twelve (8.51%) of 141 masses could be classified using simple descriptors, 89 (63.12%) masses were classified using simple rules, and 40 (28.37%) masses were classified using the ADNEX model. Overall accuracy, sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of the three-step algorithm were 89.36%, 94.23%, 75.68%, 91.59%, 82.35%, 3.87, and 0.08 respectively.Conclusions: The IOTA three-step algorithm, based on the sequential use of simple descriptors, simple rules, and ADNEX model, performs well for classifying adnexal masses as benign or malignant
Peran Magnetic Resonance Imaging pada Diagnosis Kanker Serviks yang Menyerupai Kanker Endometrium – Laporan Kasus Erfiandi, Febia; Harsono, Ali Budi; Soekersi, Hari; Dewayani, Birgitta Maria; Kireina, Jessica
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 1 Maret 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i1.444

Abstract

Pendahuluan: Magnetic resonance imaging (MRI) merupakan modalitas penting dalam diagnosis kanker ginekologi, terutama serviks dan endometrium. Laporan kasus ini bertujuan melihat peranan MRI dalam menentukan asal tumor, keterlibatan parametrium, dan metastasis kelenjar getah bening retroperitoneal.Presentasi Kasus: Pada laporan kasus ini pasien didiagnosis kanker serviks stadium IB3 dengan diagnosis banding kanker endometrium stadium II karena keluhan perdarahan pasca-menopause, massa di serviks bersifat endofitik, dan ukuran uterus membesar. Hasil histopatologi kuretase yaitu endometrioid endometrial carcinoma moderately differentiated Dd/adenocarcinoma cervix. Magnetic resonance imaging (MRI) dilakukan untuk melihat asal tumor dan menetukan stadium. Skor MRI menganalisis tujuh perbedaan fitur: lokasi dan perfusi tumor, penyengatan perifer, massa atau distensi rongga endometrium, invasi miometrium, dan infiltrasi jaringan sekitar; skor 10 didapatkan pada kasus dengan menggunakan sekuens T2WI sagital, DWI-ADC, dan DCE yang menyimpulkan bahwa tumor berasal dari serviks dan telah menginfiltrasi parametrium.Kesimpulan: Skor MRI bisa dijadikan pertimbangan untuk melihat asal tumor (serviks atau endometrium) selain melihat keterlibatan parametrium dan kelenjar getah bening pelvis sehingga diagnosis dan manajemen lebih baik.The Role of Magnetic Resonance Imaging in the Diagnosis of Cervical Cancer Resembling Endometrial Cancer – A Case ReportAbstractObjective: Magnetic resonance imaging (MRI) is an important modality in the diagnosis of gynecological cancer, especially cervical and endometrial cancer. This case report aims to examine the role of MRI in determining tumor origin, parametrial involvement, and retroperitoneal lymph node metastases.Case presentation: In this case report, the patient was diagnosed with stage IB3 cervical cancer Dd/ stage II endometrial cancer due to complaints of postmenopausal bleeding, endophytic cervical mass, and uterine enlargement. The histopathological results of curettage were moderately differentiated endometrioid endometrial carcinoma Dd/adenocarcinoma of the cervix. Magnetic resonance imaging (MRI) is performed to determine the origin of the tumor and its stage. MRI score was analyzed for seven distinct features: tumor location and perfusion, peripheral rim, endometrial cavity mass or distension, invasion of the myometrium, and surrounding organs infiltration; score of 10 was obtained in these cases using sagittal T2WI, DWI-ADC, and DCE sequence which concluded that the tumor was cervical origin and had infiltrated the parametrium.Conclusion: MRI score can be considered to see the origin of the tumor (cervical or endometrial) in addition look for involvement of the parametrium and pelvic lymph nodes so that diagnosis and management will be better.Key words: Magnetic Resonance Imaging, Cervical Cancer, Endometrial Cancer, Gynecological Cancer, Parametrial Infiltration
Wound Dehiscence Following Obstetrics and Gynecology Surgeries: An Observational Study at a Tertiary Hospital in Bandung Mantilidewi, Kemala Isnainiasih; Firdaus, Nur’adilah; Kurniadi, Andi; Erfiandi, Febia; Kireina, Jessica; Natasya, Windy; Harsono, Ali Budi
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 3 November 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i3.658

Abstract

Introduction: Wound dehiscence is a severe postoperative complication that disrupts an abdominal wound closure which can be caused by endogenous or exogenous flora that infect a surgical wound. Many factors are responsible for surgical site infection in obstetric and gynecology patients considering all the basic standards are ideally maintained in tertiary care hospitals. To identify the characteristics of surgical wound dehiscence (SWD) patients who underwent obstetric and gynecological surgeries at Dr. Hasan Sadikin Hospital from 2021 to 2022.Methods: This study utilized a quantitative descriptive approach with a retrospective design. Results: A total of 43 subjects were included in the study and were divided into three groups based on their surgery type: obstetrics (n=11), gynecology (n=7), and gynecological oncology (n=25). The majority of SWD cases were associated with gynecological oncology surgeries. The patients were predominantly aged 18-65 years (88%), had superficial SWD (65%), normal BMI (37%), were non-smokers (67%), had a history of steroid medication usage (63%), received prophylactic antibiotics (63%), underwent elective surgery (58%), had laparotomy surgeries (100%), with a duration of ≥180 minutes (35%), and intraoperative bleeding of ≤1500 cc (63%). The surgical wounds were primarily classified as clean type (47%), and therapeutic antibiotics were administered to the majority of patients (74%).Conclusion: Most of our findings were consistent with existing theories. However, the discrepancies observed in some outcomes can serve as an evaluative tool to assess the adherence of current practices to established guidelines. It is crucial to consider the risk factors for SWD when developing preventive strategies.Dehisensi Luka Pascaoperasi Obstetri dan Ginekologi: Sebuah Studi Observasi di Rumah Sakit Tersier Di BandungAbstrakPendahuluan: Dehisensi luka pascaoperasi merupakan komplikasi serius yang dapat mengganggu penutupan luka di perut yang disebabkan oleh adanya flora bersumber secara endogen atau eksogen yang menginfeksi luka operasi. Banyak faktor yang berperan dalam infeksi daerah operasi walaupun sudah dilakukannya semua standar operasional yang selalu dipertahankan di rumah sakit perawatan tersier. Untuk mengetahui karakteristik pasien dehisensi luka pascaoperasi obstetri dan ginekologi di RSUP Dr. Hasan Sadikin.Metode: Penelitian ini merupakan penelitian deskriptif retrospektif yang menganalisis faktor praoperatif, intraoperatif, dan pascaoperatif dari subjek penelitian. Hasil: Pada studi ini, terdapat 43 subjek yang selanjutnya dikategorikan menjadi tiga kelompok berdasarkan jenis operasinya: obstetri (n=11), ginekologi (n=7), dan onkologi ginekologi (n=25). Sebagian besar kasus berhubungan dengan operasi onkologi ginekologi, berusia 18 - 65 tahun (88%), memiliki dehisensi luka superfisial (65%), indeks massa tubuh normal (37%), bukan perokok. (67%), memiliki riwayat penggunaan obat steroid (63%), menerima antibiotik profilaksis (63%), menjalani operasi elektif (58%), menjalani operasi melalui laparotomi (100%), dengan durasi ≥180 menit (35%), memiliki luka operasi tipe bersih (47%), mengalami perdarahan intraoperative ≤1500 cc (63%), dan mendapatkan antibiotik terapeutik (74%).Kesimpulan: Sebagian besar hasil studi didapatkan sesuai dengan teori yang telah ada. Kesenjangan yang ditemukan pada luaran studi dapat menjadi alat evaluasi untuk menilai ketaatan pada praktik yang dilakukan untuk kemudian dijadikan pedoman praktik. Penting juga untuk mempertimbangkan faktor risiko dari dehisensi luka pascaoperasi ketika akan mengembangkan strategi preventif.Kata kunci: dehisensi luka pasca operasi, faktor risiko, praoperasi, intraoperasi, pascaoperasi
Bacteriological Profile and Antibiotic Sensitivity Pattern of Surgical Site Infection Following Gynecologic Oncology Surgery at Hasan Sadikin General Hospital Mantilidewi, Kemala Isnainiasih; Harsono, Ali Budi; Kireina, Jessica; Pringgowibowo, Jaeni; Al Baihaqi, Windy Natasya
Andalas Obstetrics And Gynecology Journal Vol. 6 No. 2 (2022)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.6.2.122-129.2022

Abstract

Introduction: Surgical site infection (SSI) is the most common complication of gynecologic oncology surgeries. Understanding the characteristics, bacteriological profile, and antibiotic sensitivity pattern of SSI patients can help guide patient’s management and reduce morbidity, mortality, and economic burden caused by SSI. The aim of this study is to describe the characteristics, bacteriological profile, and antibiotic sensitivity pattern of SSI patients following gynecologic oncology surgery at Hasan Sadikin General Hospital Bandung in 2021. Methods: This is a descriptive study that analyzed medical records of patients undergoing gynecologic oncology surgery at Hasan Sadikin Hospital Bandung from January to December 2021. Results: Out of 157 gynecologic oncology surgeries in 2021 that met the criteria, there were 11 incidences of SSI (7%). All SSI patients received postoperative antibiotics, with the most common type of antibiotic given being a combination of ceftriaxone and metronidazole. Ten out of the 11 specimens from SSI patients showed bacterial growth and a total of 17 bacterial isolates were found. Most specimens showed polymicrobial infection with the most common isolate being Escherichia coli Extended-Spectrum Beta-Lactamase (ESBL). Gram-positive bacteria in this study were most sensitive to Vancomycin, Tigecycline, and Gentamicin. Meanwhile, gram-negative bacteria were most sensitive to Ertapenem and Meropenem. Conclusion: Incidence of SSI following gynecologic oncology surgery at Hasan Sadikin General Hospital in 2021 is 7%. The most frequently found isolate was Escherichia coli ESBL. Gram-positive bacteria were most sensitive Vancomycin, Tigecycline, and Gentamicin; while gram-negative bacteria were most sensitive to Ertapenem and Meropenem.