Adeodatus Yuda Handaya
Digestive Surgery Division, Department Of Surgery, Faculty Of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia

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Detecting miRNAs expression as the early prognostic factor for patients with colorectal cancer in Dr. Sardjito Hospital Yogyakarta : A preliminary study Adeodatus Yuda Handaya; Didik Setyo Heriyanto; Hendra Susanto; Yudi Susanto; Kamal Agung Yudayana; Ida Ayu Setyawati Sri Krisna Dewi; Aditya Rifqi Fauzi; Joshua Andrew; Kevin Radinal; Azriel Farrel Kresna Aditya
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 14, No 2, (2023)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol14.Iss2.art9

Abstract

Background: Colorectal cancer (CRC) is the third highest-ranked cancer and causes high mortality in patients with a low survival rate. The lack of sensitivity and specificity of clinical and other diagnostic modalities results in a higher mortality rate. Therefore, the exploration of potential early biomarkers for CRCs is necessary.Objective: We aimed to evaluate the local expressions of potential tumor suppressor and oncogenic miRNAs in CRC patients in Indonesia. Methods: This retrospective cohort study involving thirty-one colorectal carcinoma patients at Dr. Sardjito Hospital Yogyakarta from January 2014-December 2017. Total RNA was isolated, and the expressions of miR-21, miR-92a, miR-96, miR-26b, miR144, and miR-195 were measured by real-time quantitative PCR. The correlation between miRNAs and other predictors was determined by Spearman correlation, and the association of miRNA expression and other clinical parameters used logistic regression.Results: The local expression of miR-195 decreased significantly in the tumor sites. In contrast, miR-21 activity tends to increase in the local tumor. Meanwhile, the expressions for miR-92a, miR-96, miR26b, and miR-144 in the same subjects were non-significant. MiR-195 was also significantly associated to cancer stage (r=-0.570, p=0.001) with significant odds ratio (OR=0.892, 95% CI=0.804–0.990, p=0.031).Conclusion: Our study was the first to report aberrant expressions of miRNA-21, miRNA-195, miRNA-92a, miRNA-26b, miRNA-96, and miRNA-144 in Indonesian CRC patients. The tumor suppressor miRNA-195 expression was superior among others to serve as an early biomarker in detecting and predicting CRC disease progression.
Transcystic versus transcholedochal laparoscopic common bile duct exploration: Choosing the right approach – A Case Series Singgih Annas Fuadhi; Adeodatus Yuda Handaya; Agus Barmawi; Imam Sofii; Nurcahya Setyawan
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 14, No 2, (2023)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol14.Iss2.art15

Abstract

Laparoscopic common bile duct exploration (LCBDE) is a relevant therapeutic option in managing cholecysto-choledocholithiasis. The success of this procedure is highly dependent on selecting an appropriate method, either transcystic or transcoledocal. Intraoperative choledochoscopy proves its importance in evaluating the condition of the choledochal duct and sphincter of Oddi. In this case series, we report 2 cases of patients with complaints of right upper abdominal pain and jaundice. Both patients were diagnosed with multiple cholecysto-choledocholithiasis at Dr. Sardjito Hospital, Yogyakarta. The interventional measures applied to both patients were transcystic and transcoledocal exploration. In the first patient, the transcystic method was chosen because the cystic duct was widening up to 9 mm in diameter. While in the second patient, the transcoledocal method was taken because the diameter of the cystic duct was still within normal limits. The duration of surgery in transcystic surgery was shorter than in transcoledocal surgery, with a time ratio of 129 minutes versus 162 minutes. Postoperatively, both patients were discharged on the second day after the procedure, and both experienced recovery without any significant complications. Overall, LCBDE has been shown to be safe to perform. The one-stage surgical approach has been shown to reduce the risk of complications, cost, and duration of treatment required. The choice between the transcystic or transcoledocal method should be based on each patient’s clinical condition.
Choledochal Cysts in Female Adult: Diagnostic Pitfall and Conservative Therapy for Bile Leak Singgih Annas Fuadhi; Agus Barmawi; Imam Sofii; Nurcahya Setyawan; Adeodatus Yuda Handaya
Smart Medical Journal Vol 6, No 2 (2023): August
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v6i2.72426

Abstract

Introduction: Choledochal cysts that are accompanied by obstructive jaundice are a rare case. These cysts can cause intrahepatic or extrahepatic ductal dilatation. Their diagnosis is difficult, particulary in adults. Proper management can prevent further complications.Methods: A serial case report of a patient with a choledochal cyst.Results: 2 female patients aged 21 years and 22 years have a painful and fixed lump in the upper right abdomen. The first patient also complained jaundice. Laboratory results showed an increase in total bilirubin and direct bilirubin. The second patient didn’t complaint about jaundice or increased bilirubin, and she had a cholecystectomy when she was ten. The diagnosis was confirmed by a contrast abdominal CT scan, showing type 1A Todani choledochal cysts in both patients. Management of the first patient was cyst excision, cholecystectomy, and Roux n Y hepaticojejunostomy. In the second patient, adhesiolysis, cyst excision, and Roux n Y hepaticojejunostomy were performed. The second patient had no postoperative complications.Conclusion: Choledochal cysts are a rare congenital condition in adulthood. n both cases, two patients were manage surgically. Bile leakage complications can be manage conservatively. Diagnostic and management of choledochal cysts must be correct to prevent pitfall and complications.
Neutrophil to Hemoglobin Lymphocyte Ratio (NHLR) as a Novel Biomarker is Superior to Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) as Predictors of Advanced Colorectal Cancer Purnomo, Heri; Handaya, Yuda; Setyawan, Nurcahya
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.v18i1.1099

Abstract

Background: Neutrophils, Hemoglobin, and Lymphocytes are biological markers that may be related to the colorectal cancer stage. Neutrophils to Hemoglobin-Lymphocytes Ratio (NHLR) is a new biomarker that will be tested with Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) as common biomarkers that have been shown to have predictive value with colorectal cancer stage. This study aims to prove NHLR as a new biomarker that can predict advanced colorectal cancer in terms of staging and site of cancer compared to NLR and PLR. Methods: This is a retrospective cross-sectional study. Data obtained from the medical records of colorectal cancer patients undergoing surgery at Dr Sardjito Hospital from 2020 until 2022. Results: 386 patients enrolled in the study, and 62 patients met the inclusion criteria. Twentyeight patients (45.16 %) were male, and 34 (54.84 %) were female. The mean age is 58.82 years. Bivariate analysis showed a significant relationship between NHLR, NLR, and PLR with colorectal cancer stage and significant differences between NHLR and NLR with early and advanced colorectal cancer, but not with PLR. There are also significant differences between NHLR, NLR, and PLR with colorectal cancer sites in the colon and rectum. Still, in locally advanced stages of colorectal cancer, there is no significant association between NLR and cancer sites. On the contrary, there are significant differences between colon and rectal cancer sites with NHLR and PLR. Conclusions: NHLR is superior to NLR and PLR in predicting the stage and site of advanced colorectal cancer.
Paper-Based versus Mobile Apps for Colorectal Cancer Screening in COVID-19 Pandemic Setting Handaya, Adeodatus Yuda; Hardianti, Mardiah Suci; Rinonce, Hanggoro Tri; Werdana, Victor Agastya Pramudya; Fauzi, Aditya Rifqi; Andrew, Joshua; Hanif, Ahmad Shafa; Tjendra, Kevin Radinal; Aditya, Azriel Farrel Kresna
Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Education Vol. 11 No. 1 (2023): Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Educatio
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jpk.V11.I1.2023.19-25

Abstract

Background: The incidence of colorectal cancer (CRC) in Asia has kept increasing in the last decade. The morbidity and mortality for CRC can be reduced with early detection; however, mass CRC screening with imaging modalities such as colonoscopy, CT scan, or MRI is unfeasible in developing countries such as Indonesia. Asia Pacific Colorectal Screening (APCS) is utilized to stratify individual CRC risk. Online screening via mobile application is an alternative method to ensure the continuity of community screening without risking COVID-19 transmission. Objective: We conducted a descriptive study to evaluate CRC risk using APCS in two different villages. Methods: This is a cross-sectional study involving 925 and 207 subjects in 2019 and 2020, respectively. The APCS survey in 2019 was done before the COVID-19 pandemic with paper-based questionnaires and direct assessment by door-to-door approach. Meanwhile, the APCS survey in 2020 was done during the COVID-19 pandemic using websites and mobile apps available for Android and iOS. We gathered participants' characteristics and the APCS score in both groups and tabulated them. Results: In 2019, out of 925 subjects; 472 (51%) have been classified an average risk of CRC, 370 (40%) have been classified as having a moderate risk of CRC, and 83 (9%) have been classified as in high risk of CRC. In 2020, out of 207 subjects; 106 (51.2%) have been classified as the average risk of CRC, 86 (41.5%) have been classified as the moderate risk of CRC, and 15 (7.3%) have been classified as high risk of CRC. Conclusion: Although there was a decrease in the participation of the screening program with mobile applications in the pandemic era compared with paper-based questionnaires before the pandemic era, online screening using APCS in mobile applications is a preferred alternative for an effective screening method in this pandemic and possibly in the future in Indonesia.
Konsensus Perhimpunan Dokter Spesialis Bedah Digestif Indonesia tentang Pedoman Diagnosis dan Tatalaksana Batu Saluran Empedu Rivai, Muhammad Iqbal; Lalisang, Arnetta Naomi Louise; Nugroho, Adianto; Wibowo, Agung Ary; Handaya, Adeodatus Yuda; Arifin, Fransiscus; Situmorang, Indah; Prabowo, Erik; Irwan, Irwan; Mayasari, Maria; Tendean, Michael; Rudiman, Reno; Setyadi, Kunsemedi; Niam, Muhammad Shobachun; Suprapto, Bambang; Putra, Jeffri; Lesmana, Tommy; Mazni, Yarman; Muhar, Adi Muradi; Mulyawan, I Made; Warsinggih, Warsinggih; Lalisang, Toar Jean Maurice
Majalah Kedokteran Indonesia Vol 74 No 2 (2024): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.74.2-2024-1188

Abstract

Introduction: Choledocholithiasis, the presence of stones in the common bile duct (CBD), is a challenge in the field of digestive surgery due to the wide range of cases with varying levels of difficulty. Until now, the options for diagnostic and therapeutic modalities have been increasingly evolving, ranging from non-invasive to invasive procedures. Therefore, the Indonesian Society of Digestive Surgeons provides recommendations for the management of CBD stone cases in Indonesia.Method: The consensus was developed using the Delphi survey method involving digestive surgery experts from various cities in Indonesia. Several issues related to the diagnosis and management of CBD stones were formulated and answered based on current research, while also considering the opinions of the experts.Result: This consensus consists of two parts: 15 recommendations related to the selection of diagnostic modalities and 10 recommendations related to management options. Recommendations regarding diagnosis include the use of ultrasonography, abdominal CT-scan, and magnetic resonance cholangiopancreatography (MRCP). In addition to standard therapeutic procedures, this consensus also provides recommendations regarding contemporary procedures such as endoscopic retrograde cholangiopancreatography (ERCP), laparoscopic common bile duct exploration (LCBDE), and open common bile duct exploration (OCBDE).Conclusion: These recommendations are aimed to assist digestive surgery experts in providing the best management for CBD stone cases.
Ileocolonic transposition in an HIV patient with an esophageal stricture: A case study Handaya, Adeodatus Yuda; Andrew, Joshua; Susilo, Naufal Caesario Jouhari; Subroto, Polycarpus David; Azriel Farrel Kresna Aditya; Prakosa, Yovan Indra Bayu; Arianda, Daldy; Tyanti, Belvia Adelaida Maiya
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 16, No 1, (2025)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol16.Iss1.art14

Abstract

Introduction: Esophageal strictures in patients with HIV (Human immunodeficiency virus) are poorly understood in terms of pathogenesis, prevalence, incidence, and surgical management. Case Presentation: This case study is a 50-year-old man who has had trouble swallowing for ten months, which has left him unable to swallow for the past nine months. Clinical examination revealed thoracic esophageal constriction ranging from Vertebra thoracal (VTh) 4-5. Endoscopic findings revealed a convoluted, constricted lumen that impeded scope passage. A contrast-enhanced computed tomography (CT) scan on eight months ago revealed esophageal constriction, with suspicions of tuberculoma and fibrosis in the right upper lung. Reactive HIV results prompted anti-HIV therapy, supported by fine needle aspiration biopsy (FNAB) results, which demonstrated no evidence of malignancy but indicated granulomatous inflammation. Preoperative evaluations, including negative interferon-gamma release assay (IGRA) and sputum Acid-Fast Bacilli (AFB) tests, cleared the way for a three-hour ileocolonic transposition procedure. The procedure involved median and substernal incisions, dissection of the terminal ileum and the right colon as a graft, retrosternal tunnelling, and anastomosis with cervical oesophagus, which resulted in positive outcomes. A week later, the patient reported increased comfort, recovered eating and drinking abilities, and successful surgical incision healing. Conclusion: The ileocolonic transposition appears to be a potential therapeutic option. This safe and effective alternative not only addresses dysphagia but also improves the overall quality of life.
HALP and PNI Score as Predictors of Nutritional Status in the Incidence of Incisional Hernia after Laparotomy in Colorectal Cancer Patients: A Case-Control Study Nurasti, Wawan Suci; Handaya, Adeodatus Yuda; Barmawi, Agus; Anwar, Sumadi Lukman
Indonesian Journal of Cancer Vol 18, No 3 (2024): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i3.1215

Abstract

Background: Colorectal cancer ranks as the third most common cancer in the world. If patients can still be resected, surgical therapy is carried out. An incisional hernia is one of the complications after laparotomy surgery. Nutritional status can influence the incidence of incisional hernias after laparotomy. Colorectal cancer patients must have their nutritional status assessed using a simple scoring. This research aims to evaluate Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) and Prognostic Nutritional Index (PNI) scores as a predictor of incisional hernia after laparotomy surgery in colorectal cancer patients at Dr. Sardjito General Hospital, Yogyakarta. Methods: This study uses a case-control study design which consisted of two groups, a case group of colorectal cancer patients with incisional hernias after laparotomy surgery and a control group of colorectal cancer patients without incisional hernias. The independent variable was nutritional status which was assessed by HALP and PNI score, and the dependent variable was incisional hernia. This research by taking data from laboratory patients at Dr. Sardjito General Hospital, Yogyakarta. For multivariate analysis, a logistic regression test was used with a significance value of p 0.05. Results: There is a relationship between the stage of cancer and the comorbid diabetes mellitus with the incidence of incisional hernias after laparotomy, this can be seen in the results of the chi-square test. Advanced stage has an OR of 13 (P=.001; OR=13; 95% CI 3.551-47.597), while comorbid diabetes mellitus has an OR of 6.571 (P=.002; OR=6.571; 95% CI 2.109-20.479). However, there is no correlation between the HALP and PNI score with the incidence of incisional hernia after laparotomy. The multivariate analysis results in HALP score have a significant correlation between the nutritional status and the incidence of incisional hernia with OR=17.981 (p= 0.037 OR=17; 95% CI 1.198-269.803). Conclusions: The HALP score can be used as a screening predictor in the incidence of incisional hernia after laparotomy for colorectal cancer patients.
Panduan Pelayanan Bedah Digestif Selama Masa Pandemi COVID-19: Perhimpunan Dokter Spesialis Bedah Digestif Indonesia (IKABDI) Nugroho, Adianto; Arifin, Fransicus; Widianto, Perwira; Wibowo, Agung Ari; Handaya, A. Yuda; Kristian, Iwan; Rivai, M Iqbal; Mulyawan, Made; Niam, Mohammad; Budiono, Parish; Putro, Mamiek Dwi; Warsinggih, Warsinggih
Majalah Kedokteran Indonesia Vol 70 No 6 (2020): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.70.6-2020-239

Abstract

Digestive surgery service including surgical management of gastrointestinal disease and digestive cancers are experiencing the impact of COVID-19 pandemic. Therefore it is necessary to formulate recommendation for digestives surgery service, as guidelines to engage in case-by-case assessment of particular patients with digestive diseases. We are aware that the knowledge and science of COVID-19 are still evolving, with new progression every day. This recommendation reflect actual condition and are subject for future adjustment in the future.