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Department of Surgery, Faculty of Medicine, Universitas Indonesia RS dr. Cipto Mangunkusumo, Jakarta Jl. Diponegoro 71 Jakarta Pusat 10430, Indonesia
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The New Ropanasuri Journal of Surgery
Published by Universitas Indonesia
ISSN : 25033328     EISSN : 25497871     DOI : 10.7454
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology
The journal focused on general surgery with the scope of surgical research and surgery-related studies.
Arjuna Subject : Kedokteran - Pembedahan
Articles 7 Documents
 1 
Search results for , issue "vol. 2, no. 1" : 7 Documents clear
Qualitative Study on Endothelial Cell–to–cell–junction Disassembly in Severe Burn Injury Moenadjat, Yefta; Siregar, Nurjati C.; Wanandi, Septelia I.; Sadikin, Mohamad
The New Ropanasuri Journal of Surgery Vol. 2, No. 1
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Abstract

Introduction. Endothelial gap in severe burn injury remain a mystery. Capillary leaks possess its own characteristics, which is found in burned– and non–burned area. The gaps remain up to 10 post burned days or more. This is somehow representing the feature of systemic capillary leaks syndrome at the first date. VE–cadherin of adherens endothelial junction molecules known to be temporarily disassembled following thermal exposure, but there’s a question about reversibility. Question is also addressed to occludin of the tight junction molecules. We run a study to investigate these junction molecules. Method. We run an investigation to find out both molecules qualitatively descriptive on 30 burn patients enrolled, consist of 20 severe– and 10 of non–severe burn. Samples of moderate size vein taken from burned– and non–burned area were subjected to study of histomorphology and immunohistochemistry. Light microscopic study and polymerase chain reaction test were carried out to compare the features and its expression. Analysis is carried out to find the difference, specificity and sensitivity. Results. Samples took within the first 8 hours following ER presentation showed severely deteriorated endothelial lining and both ofVE–cadherin and occludin dissociation. This endothelial junction disassembly was found in both of burned– and non–burned area; both of severe– and non– severe burn as well. In burned area, mRNA expression of VE–cadherin found to be increased, as occludin decreased. In severe burned group, mRNA expression of VE–cadherin as well as occludin found to be increased. VE–cadherin synthesis was found to be earlier than occludin. Conclusion. Dissociation of both of endothelial cell–to–cell molecules junction show no differences between the two groups, and between burned– and non–burned areas.
Clinicopathological Predictors of Central Compartment Lymph Node Metastases in cN0 Papillary Thyroid Carcinoma Purnomo, Henricus SW.; Yulian, Erwin D.; Makes, Benyamin; Wangge, Grace
The New Ropanasuri Journal of Surgery Vol. 2, No. 1
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Abstract

Introduction. Prevalence of the lymph node metastases of central neck compartment in papillary thyroid carcinoma (PTC) and its correlation with regional metastatic remains high. There are pros and cons on central neck dissection which is thought to solve the problem. Selection of appropriate patient to undergo central neck dissection is then essential. Thus, predictive factors were very useful in such selection, and we run a study aimed to find out the clinicopathological predictive factors for metastases of central compartment in subjects treated in Cipto Mangunkusumo General Hospital. Method. Data of 62 cN0 papillary thyroid carcinoma (PTC) subjects who underwent central neck dissection were collected consecutively and retrospectively studied. The correlations between clinicopathological factors such as age. Gender, tumor size, extra thyroid extension. Distant metastasis, completeness of resection, histopathology variant, lymphovascular invasion and central compartment metastases were the variables analyzed. Chi square. Fischer exact and stratification test were used. Significance found if p value of <0.05 with 95% confidence interval. Results. In this study, the prevalencein our hospital is 20.9%. The clinicopathological factors that statistically showed significance were the positive lymphovascular invasion (OR=14.40; p<0.05), tall cell variant (OR= 14.00; p <0.05), positive extra thyroid extension (OR=10.44; p<0.05) and age ≥45 years (OR= 9.47; p <0.05). Lymphovascular invasion showed a higher OR (OR=14.40). Conclusion. The lymphovascular invasion, tall cell variant, extra thyroidal extension and age might be the predictors for central compartment lymph node metastases in cN0 PTC patients. However, lymphovascular invasion has the highest risk factor for central neck compartment metastases.
External Validation of Belgian Outcome of Burn Injury Score on Burned Patient In Burn Unit dr. Cipto Mangunkusumo General Hospital Karlie, John; Wardhana, Aditya
The New Ropanasuri Journal of Surgery Vol. 2, No. 1
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Abstract

Introduction. The scoring system in burns is a merit in predicting mortality. To date, there’s no scoring system used as a standard prognostic tool at Cipto Mangunkusumo General Hospital’s Burn Unit. Belgian Outcome of Burn Injury (BOBI) Score, one of the best scoring systems in accordance to systematic review in 2013 was validated externally in a study. Method. A retrospective cohort study was conducted enrolling all burn patients managed during period of 2012 to 2013 in burn unit of Cipto Mangunkusumo General Hospital. The prediction model of BOBI score (age, total burned surface area, and inhalation injury) were variables to be analyzed statistically. ROC and AUC was analyzed to find out its accurate level of prediction. The strong AUC is found with the value of >80– 90%. Results. Out of 304 subjects enrolled, the mean age was 28 years, mean TBSA was 29%, inhalation injury was 15.7%, and overall mortality was 17.7%. The model gave an accurate prediction of mortality. The receiver operating characteristic analysis demonstrated an area under the curve of 0.96 (95% CI 0.94–0.99). Conclusion. The mortality prediction model (BOBI score) demonstrated a good accuracy. This model provide a good prediction tool and could be implemented in our burn management.
Clinical Duration as a Predictor for Bowel Resection in Intussusception Juliansyah, Amir; Sastiono, Sastiono
The New Ropanasuri Journal of Surgery Vol. 2, No. 1
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Abstract

Introduction. Delayed hospital presentation is a characteristic we found in management of intussusception in our institution. However, with this delayed, surgical intervention is the only option in treatment. Thus, duration of onset is an answered problem. We run a study aimed to find out whether duration is a predictor of bowel resection in management of intussusception. Method.We run retrospective study on idiopathic intussusception managed in period of January 2008 to December 2015 in Cipto Mangunkusumo Hospital, Jakarta. Those other than idiopathic and insufficient data were excluded. Period of onset, signs and symptoms, ultrasound and surgical treatment as well as intraoperative findings were set as the variables and subjected to statistical analysis using χ2 or Fisher’s exact test and t–test; significance is met if p value of <0.05. Analysis to find out cut–off point using receiver operating characteristic curve were carried out. Results. There were seventy–three subjects diagnosed as intussusception enrolled in the study. Median age was 7 months (3-48 month). Median period of onset to definitive treatment was 81 hours (15-256 hours). Bloody stools found in 90.4% instead of classic triad (28.7%). All subjects underwent surgical procedure, and out of 73 subjects, 61.6% underwent resection. We found clinical duration was associated to bowel resection (p 0.004) and area under curve 73.7% (p 0.001). The cut–off point as prediction of bowel resection was 78.5 hours with sensitivity of 67.9% and specificity of 71.1%. Conclusion. Surgical intervention is recommended for management of intussusception in those with clinical duration of more than 78.5 hours, instead of non–surgical reduction.
Comparison of Wells Score, D–Dimer and Combination of Wells Score and D–Dimer with Venous Duplex Ultrasonography in Diagnosis of Acute Deep Vein Thrombosis in Lower Extremity Lesmana, Andy; Pratama, Dedy; Wangge, Grace
The New Ropanasuri Journal of Surgery Vol. 2, No. 1
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Abstract

Introduction. Diagnosis of acute deep vein thrombosis (DVT) of lower extremity using available diagnostic tools such as venous duplex ultrasonography (VDUS) encountered problems including cost, time consuming and the operator. A simple and practical tool is required. Thus, we run a study aimed to evaluate the efficacy of Wells score, D–Dimer, or combination of both, compared to VDUS in early detection of acute DVT of lower extremity. Method. A diagnostic study was run using cross–sectional design in Department of Surgery enrolling all adult subjects of which suspected to acute DVT of lower extremity managed in period of January 2014 –December 2015 who met the criteria. The diagnosis was confirmed by VDUS. Those data of medical record were analyzed statistically with diagnostic study to find out the sensitivity and specificity. Results. The study enrolled of 85 subjects. The prevalence of acute DVT of lower extremity was 65.88%. Sensitivity and the highest negative predictive value of 100.00% were found in score combination of II and IV. While as the highest specificity of 89.66% and the highest positive predictive value of 92.68% were found in score combination of III. The score with balanced diagnostic value (sensitivity of 87.50% and specificity of 72.41%) was found in Wells score 3 level I. Conclusion. Wells score and VDUS showed comparable efficacy in detection of acute DVT of lower extremity. Thus, a score could be used as a diagnostic tool.
Infection of Double Lumen Catheter as Hemodialysis Access Basri, Novrizal S.; Patrianef, Patrianef
The New Ropanasuri Journal of Surgery Vol. 2, No. 1
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Abstract

Introduction. One of the most common complications in vascular access was bacteremia or bloodstream infection. The purpose of this study was to know the infection rate in dialysis double lumen catheter (DLC) and it’s relating factors. Method. This was a cross–sectional analytical study that was carried out by enrolling all ≥18–year–old subjects who underwent surgical insertion of DLC for hemodialysis during 2015 in Cipto Mangunkusumo General Hospital, Jakarta. Variables of bloodstream infection, age, gender, diabetes mellitus, history of previous DLC infection, history of catheter related bacteremia, site of insertion and duration were subjected to statistical analysis. Significance achieved if p value <0.05. Results. Out of all subjects, there were 19 (17.6%) subjects with bacteremia. Whereas, 5 (9.4%) subjects were those with tunneled DLC, and the remaining 14 (26.4%) were those with non–tunneled DLC. Factors found to be related with infection were the use of non–tunneled DLC (p = 0.043) and no history of previous DLC insertion (p = 0.038). Conclusion. Tunneled DLC was found superior to non–tunneled one to prevent catheter related bacteremia. The use of non–tunneled DLC should be avoided as hemodialysis access.
Problem based management in delayed presented burned in dr. Cipto Mangunkusumo General Hospital, Jakarta Moenadjat, Yefta; Mulya, Dina
The New Ropanasuri Journal of Surgery Vol. 2, No. 1
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Abstract

Introduction. Burn injured victims managed in Burn Unit of dr. Cipto Mangunkusumo General Hospital, Jakarta (RSCM) is dominated by delayed presentation and categorized as the difficult cases. Though had been rescued before being referred to our unit, these cases were characterized by massive edema and minimal to nil responsiveness to standard burn fluid resuscitation and were followed by high mortality. Method. A retrospective study run on those resuscitated in period of 1998–2010 using different protocols aimed to find out the most suitable formula to treat these subjects. Pediatric–, chemical– and electrical burns was excluded. Hydration status, hemodynamic– and perfusion indices, complication(s), mortality as well as survival days were variables of interest subjected to statistical analysis. Significance met if p <0.05. Results. Out of 1768 subjects managed, 659 were enrolled in the study. Mortality in those treated in first period was 44.9% with survival 10.10 pbd ± 7.39, in the second period was 54.6% with survival 8.55 pbd ± 6.39, in the third period was 43.4% with survival 11.34 pbd ± 7.34, and the last period was 13.4% with survival 18.78 ± 6.32 pbd. Conclusion. In these characteristics, perfusion targeted resuscitation showed to be superior than volume oriented. Even though mortality remains the problem, survival days markedly increased.

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