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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. 8, no. 2" : 7 Documents clear
Factors affecting the Survival of Soft Tissue Sarcoma Patients of the Extremities at Cipto Mangunkusumo Hospital, Indonesia Yulian, Erwin D; Sinaga, Kezia M.; Kartini, Diani; Kekalih, Aria
The New Ropanasuri Journal of Surgery Vol. 8, No. 2
Publisher : UI Scholars Hub

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Abstract

Introduction. The strategy for treating limb soft tissue sarcoma (STS) is challenging due to delayed diagnosis and the non-specific clinical picture, leading to the mortality of nearly 50% of newly diagnosed patients. Various therapeutic modalities have been applied to increase the survival of patients with extremity soft tissue sarcoma. However, clinicopathological factors can influence the survival rate and thus affect the effectiveness of therapy. This study aims to determine the numbers and factors influencing overall survival five years after treatment for patients with soft tissue sarcoma of the extremities at Dr. Cipto Mangunkusumo General Hospital (CMGH) in 2011-2015. Method. A prognostic study was run on patients with complete histopathology who underwent treatment during 2011-2015. Data analysis using the Kaplan-Meier method, cox regression test, and Cox regression with time-dependent variable. Results. A total of 42 were enrolled in the study. The median survival after therapy for patients was six years (3 months – 8.25 years), with a five-year survival of 52.4%. Factors affecting five-year survival were surgical procedures in limb-saving surgery (HR 0.852 95% CI 0.68 – 1.07, p = 0.163). Conclusion. The five-year survival rate of soft tissue sarcomas of the extremities was 52.4%. Overall survival is affected by higher-grade sarcoma, incomplete therapy, and worse clinical stage.
ABO Blood Group Type and the Risks of Peripheral Artery Disease in Type II Diabetes Mellitus Pratama, Dedy; Puruboyo, Adi N.D
The New Ropanasuri Journal of Surgery Vol. 8, No. 2
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Abstract

Introduction. Peripheral artery disease (PAD) is a common complication of diabetes mellitus (DM), affecting up to 20% of people over 65. Blood type is hypothesized to influence PAD, although it has yet to be extensively studied. We aim to investigate the correlation between ABO blood group type and the severity of PAD in patients with type II DM. Methods. We conducted a cross-sectional study on DM type II patients with PAD at the Cipto Mangunkusumo National Hospital in Indonesia between January 2022 to June 2022. PAD was diagnosed based on the ankle-brachial index (ABI) measurement. The PAD severity was grouped into mild (ABI 0.7-0.9) and moderate-severe (ABI <0.7). Patients were categorized as O blood type and non-O (A, B, and AB). Results. Of 366 patients included, 194 with O type and 172 with non-O type. No significant difference in the occurrence. PAD was significantly more severe in non-O blood type patients (p = 0.041). Longer periods of diabetes (OR 10.325, CI95% 5.108-20.871, p <0.001) and hypertension (OR 4.531, CI95% 1.665-12.326, p <0.003) were risk factors for more severe PAD. Conclusion. ABO blood group type was not significantly associated with the occurrence of PAD in patients with type II DM. Non-O blood type was associated with more severe PAD, while more prolonged periods of diabetes and hypertension were found to be significant risk factors for more severe PAD.
Comparative Evaluation of Scar Tissue from Chest Tube Wound Closure Using Knotless and Conventional Methods Using the Patient and Observer Scar Assessment Scale Tangkilisan, Adrian N; Oley, Mendy H; Oley, Maximillian C; Loho, Claudia; Sukanto, Wega; Tamburian, Christha Zenithy; Langi, Fima L.F.G.
The New Ropanasuri Journal of Surgery Vol. 8, No. 2
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Introduction. Chest tube placement is widely practiced; most medical doctors can do this safely. However, releasing the chest tube can be a painful and challenging experience for the patient. A novel method has been developed with a new suture material that does not need to be knotted. The Patient and Observer Scar Assessment Scale (POSAS) provides objective and subjective scar assessment. This study aimed to compare the scars associated with chest tube release between the conventional and knotless methods. Methods. The study was a controlled trial in which patients were divided into two groups. The scar assessment was carried out by the researcher and the patient in the third month after the operation, using POSAS scores. Results. The Mann–Whitney test showed significant differences between the methods in both patient and researcher assessments (p Conclusion. According to POSAS scores, scar tissue formation from the knotless method was more acceptable to patients than the conventional method. Therefore, this can be an alternative method for chest tube wound management.
Impact of Advanced Trauma Life Support Training for Improving Mortality Outcome: A Systematic Review and Meta-analysis Putra, Afid B; Nurachman, Luthfian A; Suryawiditya, Bagus A; Risyaldi, Muftah; Sihardo, Lam
The New Ropanasuri Journal of Surgery Vol. 8, No. 2
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Introduction. The Global Burden of Disease Study has identified injuries as one of the top ten causes of death and disability worldwide. Injury is predicted to rise in the rankings by the year 2030. This study aimed to quantify the effectiveness of an Advanced Trauma Life Support (ATLS) training in improving mortality outcome after trauma injury. Method. This is a systematic review (of experimental and observational studies) and meta-analysis, reporting mortality outcome from trauma injury between ATLS-trained/certified physicians vs non-ATLS-certified. We performed literature searching through 3 electronic databases, including Cochrane (CENTRAL), MEDLINE (PubMed), and Scopus. Results. There are summarized results from 7 selected articles. The total patients included in this analysis were 11,595 patients in post-ATLS group and 21,603 patients in pre-ATLS group. There was high heterogeneity among studies (I2 = 95%) and therefore random effect model was used for analysis. Pooled analysis showed that ATLS had no significant effect in reducing the risk of mortality (OR: 0.68; 95% CI 0.39 – 1.20; p = 0.18). Although ATLS is not significantly associated with improved mortality outcomes, this meta-analysis has shown a tendency that health facilities and health workers implementing ATLS experienced lower mortality. Conclusion. ATLS is not the only aspect that contributes to patients’ survival. There are also roles in pre-emergency settings, resource availability, and experience. However, we believe that implementing the ATLS protocol in healthcare facilities will be the leading factor in improving trauma patients' management.
Seroma as a Biological Tissue Expander on Post-Mastectomy Reconstruction: A Case Report Kurnia, Ahmad; Muazdhani, Fatahillah
The New Ropanasuri Journal of Surgery Vol. 8, No. 2
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Introduction. Previous studies have reported that patient satisfaction with breast cancer management is related to the success of breast reconstruction. The tissue expander used in breast reconstruction today has several disadvantages: the high cost, the nature of the foreign body, and the risk of failure. Seroma has the potential as a natural tissue developer in post-mastectomy reconstruction. This case report aims to describe the technique, results, advantages, and limitations of post-mastectomy breast reconstruction using a seroma as a natural tissue expander that has never been done before. Case Presentation. A 37-year-old woman was diagnosed with stage IIIA non-special type (NST) invasive breast carcinoma stage III without lymphovascular invasion. The patient underwent a modified radical mastectomy (MRM) on the right side breast. Postoperatively, a drain was placed for observation. If no maceration of the skin was found, the drain was removed within the first 24 hours postoperatively to accumulate seroma in the dead space formed in the breast flap. Next, seroma molding is done with a special bra that fits the shape of the bust. Observations were made during the treatment, and the seroma molding process occurred. During the follow-up period, the patient complained of mild pain and did not experience tumor recurrence. Conclusion. This case report shows seroma as a biological tissue expander that can potentially be used as an alternative breast reconstruction method with body fluid accumulation.
Effect of Everolimus on the Liver Function of Children Receiving Liver Transplant with Chronic Rejection: An Evidence–Based Case Report Puruboyo, Adi ND; Rahayatri, Tri H; Stephanie, Marini
The New Ropanasuri Journal of Surgery Vol. 8, No. 2
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Abstract

Introduction. Chronic rejection, a complication after pediatric living donor liver transplantation (LDLT), is challenging to treat as management generally requires retransplantation. However, retransplantation is avoided because of rejection risks, longer operating time, higher mortality, and lower survival rates. Immunosuppressant therapy has potential as an option for nonsurgical treatment. Everolimus, a mammalian target of rapamycin inhibitors (mTOR inhibitors), is a well-known immunosuppressant in treating chronic rejection of LDLT. However, studies in the pediatric field remain minimum. Method. The discussion was based on evidence found from studies found through a systematic literature search. These three studies showed permanent liver function improvement after LDLT on immunosuppressant therapy without Everolimus. Liver function and fibrosis stability improved without mortalities. Differences in Everolimus’ efficacy in improving liver function due to the lack of facility to control Everolimus level in the blood resulted in overwhelming infection due to over-immunosuppression of this drug since Everolimus has a narrow therapeutic range. Conclusion. The administration of Everolimus pediatric after living donor liver transplantation reduces ALT and AST levels and improves fibrosis stability.
Secondary Spontaneous Tension Pneumothorax: A Case Report of an Uncommon Presentation of Post-Tuberculosis Sequelae Willim, Herick Alvenus
The New Ropanasuri Journal of Surgery Vol. 8, No. 2
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Introduction. Tuberculosis (TB) remains one of the top life-threatening infectious diseases worldwide. Even after completion of treatment, numerous patients had post-TB sequelae as a consequence of lung damage during TB infection. We reported an uncommon case of secondary spontaneous tension pneumothorax in a patient with post-TB sequelae. Case Presentation. A 68-year-old smoker man presented with sudden shortness of breath since 2 hours ago. He had a history of pulmonary TB 15 years ago which had completed antituberculosis treatment and had been experiencing symptoms associated with post-TB sequelae for the last 1 year. Physical examinations and chest X-ray showed tension pneumothorax. The recent GeneXpert sputum test showed a negative result for Mycobacterium tuberculosis. We performed urgent needle decompression, followed by chest tube insertion. He responded well to the treatment and was discharged after the seventh day with no residual pneumothorax. Conclusion. Spontaneous tension pneumothorax in patients with post-TB sequelae is rare and has a complex pathogenesis. It may include several factors including pulmonary fibrosis, pleural adhesion, ruptured open healed cavity or bullae, and lung damage from cigarette smoking. It should be managed by urgent needle decompression followed by chest tube thoracostomy.

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