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All Journal Open Access Indonesian Journal of Medical Reviews Plexus Medical Journal
Syaeful Agung Wibowo
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Health Professions Medicine & Pharmacology Public Health

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Reconstruction of Multiple Renal Arteries in Live Donor Kidney Transplantation: Moewardi Hospital Experience Muhammad Hilmy Labibi; Syaeful Agung Wibowo; Husein, Ali; Wibisono; Bimanggono Hernowo Murti; Suharto Wijanarko; Tusarawardaya , Setya Anton; Rodjani, Arry; Rasyid, Nur; Susanto , Agung; Putro , Prasetyo Sarwono
Plexus Medical Journal Vol. 4 No. 4 (2025): Agustus
Publisher : Fakultas Kedokteran, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/plexus.v4i4.2292

Abstract

Background: Kidney transplant is the procedure for end stage renal disease (ESRD). This treatment has longer survival advantage than dialysis. Anatomical variations in the renal vasculature like multiple renal arteries, may increase surgical difficulties and influence postoperative outcomes. Case Presentation: We report a 46-year-old female living donor with two renal arteries on the left side of kidney. The recipient was her 25-year-old daughter with end stage renal disease due to systemic lupus erythematosus. A left open donor nephrectomy was completed without complications. The two renal graft arteries were side-to-side anastomosed each other, then an end-to-side anastomosis to the external iliac artery. The kidney achieved rapid reperfusion and returned to function immediately. Doppler ultrasound examination showed the normal perfusion. The creatinine level was 1.2 mg/dL on second day postoperative and stable at 0.8 mg/dL during a three-month follow-up. Conclusion: This case highlights the feasibility of transplanting a kidney from a donor with multiple renal arteries, emphasizing the critical role of comprehensive preoperative evaluation and meticulous surgical planning in achieving optimal outcomes.
Penile Preservation in a Young Adult with Aggressive Spindle Cell Carcinoma: A Case of Wide Local Excision and Glanular Reconstruction in a Resource-Limited Setting Dony Marthen Bani; Syaeful Agung Wibowo
Open Access Indonesian Journal of Medical Reviews Vol. 6 No. 1 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v6i1.836

Abstract

Penile sarcomatoid squamous cell carcinoma, also known as spindle cell carcinoma, is a rare and aggressive malignancy characterized by biphasic histology. Its management in young adults under 40 years of age is challenging, particularly in resource-limited settings where advanced diagnostic adjuncts like immunohistochemistry are often unavailable, necessitating reliance on morphological diagnosis and clinical acumen. We report the case of a 36-year-old uncircumcised male presenting with a rapidly growing, 2.5 cm exophytic glanular mass (cT2N0M0). Diagnostic workup relied on clinical assessment and morphological evaluation to rule out differentials, as immunohistochemical markers were unavailable. The patient underwent penile-sparing wide local excision (WLE) with intraoperative frozen section control (5 mm margins) and primary glanular reconstruction. Due to the high-grade histology and resource constraints preventing dynamic sentinel node biopsy, the patient was managed with a strict active surveillance protocol for the inguinal basin. Histopathology using Hematoxylin and Eosin (H&E) staining confirmed a high-grade malignancy with a predominant population of atypical spindle cells arranged in fascicles, consistent with Spindle Cell Carcinoma. Deep and lateral margins were negative. At 12-month follow-up, the patient remains disease-free with no evidence of local recurrence or inguinal lymphadenopathy. The International Index of Erectile Function (IIEF-5) score remained stable (23/25), indicating excellent functional preservation. In conclusion, penile preservation via WLE is a viable option for selected cases of Spindle Cell Carcinoma. In resource-limited settings where immunohistochemistry is inaccessible, accurate diagnosis relies on identifying characteristic morphological features on H&E staining combined with clinical history. Strict surveillance is mandatory to monitor for nodal progression in the absence of invasive staging.
Co-Authors Arry Rodjani Bimanggono Hernowo Murti Dony Marthen Bani Husein, Ali Muhammad Hilmy Labibi Nur Rasyid Putro , Prasetyo Sarwono Suharto Wijanarko Susanto , Agung Tusarawardaya , Setya Anton Wibisono