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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 8 Documents
 1 
Search results for , issue "vol. 9, no. 1" : 8 Documents clear
Methylene Blue as an Adjuvant Analgesic Postoperative Anal Fistula: A Randomized Clinical Trial Jeo, Wifanto S.; Irsal, Muhammad FA; Tamba, Riana P; Moenadjat, Yefta; Friska, Dewi
The New Ropanasuri Journal of Surgery Vol. 9, No. 1
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Abstract

Introduction. Anal fistula is a pathological condition that connects the anorectal mucosa to the perianal skin, requiring various types of surgical procedures. However, surgery often causes postoperative pain. The use of methylene blue is being studied as a potential analgetic adjuvant in anal fistula surgery. Previous studies have shown that methylene blue can effectively reduce postoperative pain in various types of anorectal surgery. This study aims to determine methylene blue's clinical efficacy as an analgetic adjuvant. Methods. A double-blind, randomized controlled trial was conducted. Subjects consisting of subjects with simple anal fistula to undergo fistulectomy were randomly allocated into two groups. The first group received adjuvant analgesics in the form of methylene blue and NSAIDs, while the second group only received NSAIDs. Methylene blue 4 mL 1% was administered subcutaneously to the edge of the wound, sprayed on the surgery site, and intravenously administered ketorolac 3 x 30 mg. Randomization was done using the double-blind method. Pain levels were evaluated on the first, second, third, and seventh postoperative days using a visual analog scale (VAS). Results. Thirty-four subjects were enrolled (17 subjects in each group). Significant differences in pain levels (VAS values) were recorded between the group receiving the combination of methylene blue and NSAIDs compared to the group receiving only NSAIDs on days 1 to 3 after surgery (p <0.05). This difference was no longer significant between the two groups on the seventh postoperative day (p >0.05). Conclusion. The use of methylene blue in subjects undergoing anal fistula surgery as an adjuvant analgesic along with NSAIDs may reduce the intensity of pain better than NSAIDs alone.
Safety and Efficacy of Rivaroxaban-Aspirin Combination Compared to Aspirin Monotherapy on Lower Peripheral Artery Disease after Revascularization: Systematic Review and Meta-analyses Thio, Robby E; Pratama, Dedy
The New Ropanasuri Journal of Surgery Vol. 9, No. 1
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Introduction. Currently, single antiplatelet treatments using aspirin or clopidogrel are recommended for post-revascularization peripheral artery disease (PAD) patients. However, a recent study suggested that a combination of rivaroxaban and aspirin was more favorable to use. We conducted a systematic review to determine the efficacy and safety of rivaroxaban and aspirin combination compared to aspirin alone. Method. A systematic review conducted based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol. Search using keywords was conducted on Cochrane, PubMed, Scopus, EBSCOHost, and Google Scholar. Inclusion and exclusion criteria were applied. Selected studies were appraised using the Cochrane risk of bias tool v.2 for inclusion. The studies included were extracted for characteristics and outcomes. Outcomes were analyzed qualitatively and quantitatively. We used a fixed- or random-effect model to determine the pooled ratio per appropriate. A 95% confidence interval and p-value of 0.05 and below were used as indicators of statistical significance. Results. Two multicentered, randomized controlled studies were included after searching. They were appraised with a low risk of bias. Both studies showed greater primary effectivity outcomes in the combination group and improvements in major bleeding risk. The quantitative analysis found lower PAD complications rate (OR = 0.79; 95% CI = 0.66–0.95), which included myocardial infarction, stroke, cardiovascular death, and acute limb ischemia. The combination group provided lesser primary (OR = 1.32; 95% CI = 1.06–1.67) and secondary (OR = 1.47; 95% CI = 1.19–1.84) safety outcomes. Conclusion. A combination of rivaroxaban and aspirin provided better clinical outcomes in post-revascularization PAD patients. However, this combination should be used carefully as this yields a more significant risk of bleeding in the population.
Efficacy of Full Dose and Sandwich Neoadjuvant Chemotherapy in Breast Cancer: A Literature Review Wibisana, I Gusti NG; Putra, Shandy V
The New Ropanasuri Journal of Surgery Vol. 9, No. 1
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Introduction. Breast cancer is the leading cause of death in productive-age women, and that needs to be addressed with systemic medication. There has been a big-scale success using adjuvant chemotherapy; however, the optimal method of chemotherapy administration has yet to be determined. Two methods have been introduced today: full dose and sandwich methods. In full dose, we administer chemotherapy before surgical intervention, whereas in the sandwich method, we administer chemotherapy before and after surgical intervention. In this literature review, we aim to observe the effectiveness of chemotherapy administration through both full-dose and sandwich methods. Method. In the initial phase, 51 articles were enrolled. We excluded duplicate studies, studies that did not meet the inclusion/exclusion criteria, and studies with different outcome measures, resulting in two articles. The effectiveness of each method is based on three main outcome measures: pathological complete response (pCR), overall survival (OS), and disease-free survival (DFS). Results. The pCR of the full dose method was higher (17.7%) when compared to the sandwich method (8.6%), p = 0.012. Overall survival in the full dose method is better, as observed from the hazard ratio (HR); the HR of the full dose method is 1.37, while the sandwich method is only 1.08. Regarding DFS, there is no significant effect difference between the two methods, p = 0.237. Conclusion. Neoadjuvant administration with the full-dose method shows higher overall survival, whereas the sandwich method exhibits comparable disease-free survival.
Correlation Between Age, Initial Body Mass Index (BMI) with Excessive Weight Loss in Very Early Postoperative Period Indarto, Fanny; -, Jeffrey; Limas, Peter I
The New Ropanasuri Journal of Surgery Vol. 9, No. 1
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Introduction. As a major outcome of bariatric surgery, weight loss can be affected by many factors, such as sociodemographic, behavioral problems, genetics, patient status, and the surgical technique. However, limited data were available. This research aimed to seek a correlation between age and BMI with excessive weight loss after bariatric surgery. Method. Cross–sectional study design from 2 bariatric centers in Jakarta, using data from 2018–2022. Percentage Excessive Weight Loss (%EWL) 3 months was an outcome measurement tool. Results. Of 87 subjects enrolled with male to female ratio was 1:4. Age ranged from 14–62 years (median 39 years). Type 1 obesity, type 2 obesity, and type 3 were 37.9%, 20.6%, and 28.7%, respectively. Bariatric surgeries include gastric balloon (10.3%), endoscopic sleeve gastrectomy (ELSG) (8%), laparoscopic sleeve gastrectomy (LLSG) (41.3%), sleeve gastrectomy with duodenojejunal bypass (1.1%), Roux en Y gastric bypass (RYGB) (31%), single anastomosis duodeno–ileal bypass (SADI) (8%). In the 3rd month postoperative, it was found 29.8% of participants with %EWL ≥50%: mean %EWL LLSG 46.7% (41.6–51.9%), mean %EWL RYGB 45.5% (40.5–50.7%). Correlation analysis showed a reverse correlation between BMI with %EWL (r = –0.294, p 0.006) and age showed a weak correlation to %EWL (r = 0.063, p 0.565) Conclusion. In the 3rd month, the higher the BMI, the lower %EWL found. Age barely correlates with weight loss.
Recurrence Analysis of Pediatric Thyroid Carcinoma in Dr. Cipto Mangunkusumo General Hospital and its associated factors Yulian, Erwin D; Prawirodihardjo, Marlin MP
The New Ropanasuri Journal of Surgery Vol. 9, No. 1
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Introduction. Thyroid cancer is the most common endocrine malignancy in children aged 0-14 years, frequently occurring in adolescents and young adults. The global incidence rate stands at 0.54 cases per 100,000 individuals. Pediatric patients exhibit higher recurrence rates compared to adults, although their mortality rates are low. Research exclusively for the pediatric population is still sparse in Indonesia. Thus, This study aimed to provide essential data on recurrence and mortality rates of pediatric thyroid cancer, along with an analysis of contributing factors. Method. This study is a retrospective cohort focusing on survival analysis. The research sample was drawn from the medical records registry of Cipto Mangunkusumo General Hospital (CMGH) from 2014 to 2020. Inclusion criteria encompassed all pediatric patients (0-18 years) diagnosed with thyroid cancer since January 1, 2014, and with confirmed thyroid cancer pathology results. Bivariate and multivariate analyses and recurrence event analyses proceeded. Results were considered significant at p <0.05. Results. Out of 35 pediatric subjects with thyroid cancer, complete data for analysis were available for 29 patients. The overall median age was 16 (5-18) years. No reported mortality was observed among the subjects. The median overall survival was 60.0 months (32.5-60.0). The overall recurrence rate was 25.0%. None of the factors studied age, sex, histopathology, therapy, and types of surgery affect recurrency (p >0.05). Conclusion. The recurrence rate among pediatric patients with thyroid cancer at CMGH is 25.0%, with a median disease-free survival of 96.0 months. No significant factors contributing to the increased risk of recurrence
Evaluation of antimicrobial stewardship implementation in elective surgery in dr Cipto Mangunkusumo General Hospital using Gyssens Method Ulima, Rhea P; Moenadjat, Yefta
The New Ropanasuri Journal of Surgery Vol. 9, No. 1
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Introduction. Nowadays, surgical site infections (SSI) remain the most common complication of surgical procedures. In prevention, prophylactic antibiotics are the first option, which leads to the high use of antibiotics. However, antibiotic administration should be based on strategies such as stewardship. Thus, the study aimed to assess the situation using Gyssens' method. Method. A retrospective cohort study analyzed the antibiotic administration of most major elective surgeries, including thyroidectomy, mastectomy, and cholecystectomy, proceeded in Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia, from January to July 2023. Indication, type, dosage, timing, interval, duration, and route of administration were the variables of interest. Results. Of 191 subjects who underwent the most common elective surgery procedures, 30 used combination antibiotics. Gyssens category 0 consists of 165 subjects (86.5%), and 11 subjects (5.8%) were classified as category IIA, indicating inappropriate dose (inadequate, insufficient). Inaccuracies were identified as mistimed administration (5.8%), less effective antibiotic selection (3.1%), incorrect dosage (2.6%), and inappropriate timing (2.1%). The association of Gyssens categories with SSIs showed a p-value of > 0.05 with an odds ratio of 1, indicating that both appropriate and inappropriate antibiotics of the Gyssens category showed no impact on SSIs or non–SSIs. Conclusion. The adherence to antimicrobial stewardship in the most common elective surgery in the Department of Surgery, dr. Cipto Mangunkusumo General Hospital was 86.4 and subjected to improvement.
Long-Term Patency of Stent Angioplasty for Aortoiliac Occlusive Disease: A Literature Review Siagian, Ira H; Utama, Alexander J
The New Ropanasuri Journal of Surgery Vol. 9, No. 1
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Introduction. Surgical revascularization remains a definitive therapy for aortoiliac occlusive disease. Revascularization could be achieved via endovascular treatment using angioplasty or open surgery. A limited number of studies currently assess the long-term patency of stent angioplasty of aortiliac occlusive disease. This study aims to evaluate or find recent evidence regarding the evaluation of the long-term patency of stent angioplasty for the treatment of aortoiliac occlusive disease. Method. Literature searching was conducted through several online databases, including Cochrane, PubMed, and EBSCOHost. Several cohort and randomized controlled studies assessing long-term patency of stent angioplasty ranging from bare metal stent to balloon angioplasty published from 2010 to 2022 were included. Critical appraisal was conducted using the Oxford Centre of Evidence-Based Medicine checklist. Results. Initial database searching yielded 26 published titles, of which 21 were excluded based on our inclusion-exclusion criteria and being a duplicate. Five studies, consisting of five cohort studies and one systematic review, were included. Long-term primary, assisted-primary, and secondary patency data were acquired in each study. Conclusion. We found heterogeneous data regarding long-term patency in each study. We found that 60-month primary patency ranges from 74.7% - 83.9%, assisted primary patency ranges from 83.7% - 95.8%, and secondary patency ranges from 92.8% - 99%. Overall, endovascular therapy by angioplasty has proven satisfactory long-term patency over five years.
Outcome Of Benign Breast Tumor Excision Using Ultrasound-Guided Vacuum Assisted Breast Biopsy: A Literature Review Wibisana, I Gusti N.G; Kinanthi, Elisabet L.A
The New Ropanasuri Journal of Surgery Vol. 9, No. 1
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Introduction. Benign breast tumors have a significant incidence among breast diseases that cause anxiety for patients. Surgical management is one of the managements. Vacuum-assisted breast biopsy (VABB) could be applied to tumors with a size of less than 3 cm or multiple lesions. One of its techniques is guided by ultrasonography (USG). In Indonesia, the ultrasound-guided (USG-guided) VABB has already been applied in several healthcare instances. Nevertheless, there are still opinions about tumor recurrence after the procedure. This study’s purpose is to observe the tumor recurrence and patients' satisfaction with benign breast tumor excision with USG-guided VABB. Method. Literature was reviewed through the Cochrane Database of Systematic Reviews, PubMed, Scopus, and ProQuest from December 2021 to March 2022. All papers identified were screened and identified. The study's level of evidence and quality were assessed using the Centre for Evidence-Based Medicine, University of Oxford criteria 2011. Results. In total, 1677 studies were found, and after evaluation, 29 studies were relevant—the recurrence rates of benign breast tumors after USG-guided VABB were varied. The lowest being 0% and the highest being 32.6%. Higher recurrence occurs in larger lesion sizes. Moreover, several factors that could be related were lesion size, multiple size, and hematoma in the procedure. Patients' satisfaction was high, including the postoperative scar that is not visible or minimal (5-6 mm). Conclusion. Benign breast tumor management with USG-guided VABB is a good alternative, with a recurrence rate similar to open excision and high patient satisfaction.

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