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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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INDONESIA
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 107 Documents
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Prognostic and Predictive Factors of Mortality in Burn Patients at dr. Cipto Mangunkusumo General Hospital, Indonesia Hasibuan, Muhamad Irfan A; Moenadjat, Yefta
The New Ropanasuri Journal of Surgery
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Abstract

Introduction. Some prognostic– and predictive factors in burn have never been investigated in Indonesian specific characteristics, which is delayed treatment. A study was conducted to determine prognostic and predictive factors in this specific characteristic. Method. A retrospective cohort focused on burn mortality in extensive burns managed in CMGH from 1998–2010. Some known prognostic– and predictive factors and unknown ones were the variables of interest. Bivariate and multivariate using logistic regression analysis proceeded to find out these factors. Results. Out of all factors investigated, the variables that showed a significant correlation were: TBSA, inhalation injury, Baux score, revised Baux score, serum albumin, blood urea, serum creatinine, haemoconcentration, base excess, serum lactate, international normalized ratio, and random blood glucose. Conclusion. In the study, Baux score, revised Baux score, serum creatinine, haemoconcentration, base excess, and INR as predictive factors for mortality in the extensive burn.
Cutaneous Horn on the Right Supraclavicular Region in an Adolescent Female, a Rare Case Report Gupta, Rohit; Kumar, Manoj; Sinha, Ruchi; Sahu, Reva Shankar
The New Ropanasuri Journal of Surgery
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Cutaneous horn (CH) is an outgrowth from the skin surface, composed of keratin, and associated with benign to malignant skin lesions. We report a case of CH in a 15-year-old female associated with Keratoacanthoma. It is uncommon in young people and is associated with a good prognosis because of its benign nature. This case needs to be reported as it highlights the rare occurrence of this condition in the younger age group and its good prognosis. Surgical excision is the treatment of choice, with histopathologic diagnosis playing a critical role in determining the nature and further treatment of this condition if required.
Consequential Surgeries Limit Recurrence of Skin Malignancies in Xeroderma Pigmentosum: A Case Report Kurnia, Ahmad; Kartini, Diani; Herwirastri, Novinda; Adyasa, Zoya M
The New Ropanasuri Journal of Surgery
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Xeroderma Pigmentosum (XP) is a rare inherited skin malignancy with no causative treatment options. Reporting a 23-year-old woman with xeroderma pigmentosum who underwent several surgical tumor removals followed by further five procedures to apply tissue expander, facial resurfacing using full-thickness skin grafts with a donor from abdominal. The next series was tumor resection in the chin, forehead, nasal reconstruction, tumor removal on bilateral third digits, and defect closure. No recurrence after nine years of postoperative monitoring with an aesthetically acceptable result.
Different Approaches of Suspected Unilateral and Bilateral Maxillary Sinus Myxoma, Two Rare Cases Report Adham, Marlinda; Moulanda, Ferucha
The New Ropanasuri Journal of Surgery
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Maxillary sinus myxoma is a rare benign tumor with locally aggressive behavior and can infiltrate surrounding structures. Surgical intervention is considered the primary procedure with several approaches for wider tumor exposure, complete tumor removal, and better wound healing. In this article, two cases of suspected unilateral and bilateral maxillary sinus myxoma were presented with different approaches applied for both cases. We managed two patients, a 37-year-old male with mass at right maxilla and a 60-year-old male with mass at both maxillae. Physical examination, radiology imaging, and pre-operative histopathology examination showed maxillary sinus myxoma. The total maxillectomy procedure with Weber Ferguson incision was performed for the 1st patient; meanwhile, the combined sub-labial degloving and left Weber Ferguson incision was performed for the 2nd patient. Result: Clear and wide surgical fields were obtained in both cases with the approaches applied. Complete resection was performed, and follow-up showed no residue with an excellent clinical appearance. Conclusion: Different approaches were planned based on the extent of the tumor, considering important structures nearby. Complete removal is the treatment of choice for proper healing, reconstruction procedures afterward, and prevention of recurrences.
Survival Rate of Critically Ill Coronavirus Disease 2019 Patients on Tracheostomy in Indonesia Ramdhani, Aris; Aditianingsih, Dita; Zahra, Raihanita; Putra, Muhammad A; Soeharto, Wuryantoro; Kwa, Melvin D.B.
The New Ropanasuri Journal of Surgery
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Introduction. During COVID-19 global pandemic, tracheostomy is often performed on critically ill COVID-19 patients. There is no available data on the survival rate of critically ill COVID-19 patients on tracheostomy in Indonesia. This study aimed to find the survival rate of critically ill COVID-19 patients on tracheostomy in Indonesia. Methods. A descriptive survival analysis study enrolled critically ill COVID-19 patients in RSUI who underwent a tracheostomy procedure. Baseline data, including clinical characteristics and laboratory findings before tracheostomy, were recorded. Survival analysis was conducted using the Kaplan-Meier plot. Results. Forty-two subjects were enrolled in the study: 25 males (59.5%) and 17 females (40.5%). The median age was 57 (26 – 72) years. Subjects with diabetes mellitus or hypertension were 78.6% and 78.6% with BMI >25 kg/m2. The mean duration of intubation was 16.24 ±7.62 days, the median duration of tracheostomy before the outcome was 8 (0 – 53) days. There were 9.5% of subjects survived and were discharged. The median survival time was 8 (0 – 53). In the first 15 days after tracheostomy procedures, those who were deceased were 75% of the subjects. Conclusion. In this study, the survival rate of critically ill COVID-19 patients on tracheostomy remains low. Another study to evaluate the cause of the low survival rate of critically ill patients with COVID-19 on tracheostomy is required.
Serum CEA Level in Predicting Liver Metastases of Colorectal Cancer Among Young Adult Patients
The New Ropanasuri Journal of Surgery
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Introduction: Incidence and mortality of CRC are currently increasing in those under 50 years. The study aims to determine the predictive value of serum CEA levels as the liver metastases predictor of colorectal cancer (CRC) in young adults. Methods: A cross-sectional study was conducted using secondary data (patient medical records) from 2015–to 2021. Patients aged <50 years who were diagnosed histopathologically with primary colorectal cancer at dr. Cipto Mangunkusumo General Hospital (CMGH) were recruited. We excluded patients with a history of other malignancies, who had undergone operative management for colorectal cancer, and preexisting liver disease. The outcome of this study is the cut-off of the CEA value obtained by the ROC curve and the sensitivity and specificity of the CEA value in predicting CR liver metastases. Results: Out of 181 subjects enrolled, a total of 43.6% were female. Fifty-nine subjects (32.6%) had liver metastases. The CEA level of the metastases group was 208.1 (2.1–12503.2) ng/mL; this was much higher than the non-metastases group, which was 6.27 (0.8– 1099.4) ng/mL (p <0.001). The AUC value was at 0.904, and the CEA level cut-off was 38.765 ng/mL (Youden's Index = 1.718). The sensitivity and specificity were 91.53% (91.5 CI, 81.32%– 97.19%) and 80.3% (72.16%– 86.97%), respectively. The odds ratio of young colorectal cancer patients having liver metastases was 44.10 (95% CI, 15.92–122.20). Conclusion: CEA level ≥38.765 ng/mL has good sensitivity and specificity in predicting liver metastases among young adults with CRC.
Effect of Ischemia-Reperfusion injury and Preconditioning on Lung Parenchyma after Acute Limb Ischemia
The New Ropanasuri Journal of Surgery
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Abstract

Introduction. Acute limb ischemia, a sudden decrease of perfusion to the extremities, can compromise the survival of the limbs. Medical intervention and surgery are often needed to return perfusion. However, reperfusion injury can trigger oxidative stress and inflammatory response, leading to local and remote tissue damage, such as the lungs, which increases morbidity and mortality. This research aims to study the effects of hypothermia and remote ischemic preconditioning (RIPC) on the lung parenchyma after being exposed to reperfusion after acute limb ischemia in rabbits. Method. Eighteen New Zealand White rabbits were divided into three groups of 6. The femoral artery was ligated to induce ischemia. The hypothermia group was given cooling pads to maintain a temperature of 28°C for 4 hours, and the RIPC group was assigned RIPC before ligation for 5 minutes in three cycles. Both groups underwent reperfusion for eight hours. Evaluation of histologic characteristics was performed independently by a pathologist. Results. The mean scores for the control group, hypothermia group, and RIPC group were 12.03 + 1.43 (severe injury), 8.03 + 3.03 (moderate injury), and 4.80 + 2.61 (mild injury), respectively. In addition, there was a significant difference between lung parenchymal damage in the control group and hypothermia group (p = 0.015) and between the control group and RIPC group (p = 0.000). Conclusion. Both hypothermia and RIPC have a protective effect on lung parenchyma exposed to remote reperfusion injury after lower limb ischemia, where RIPC protects the lungs to a higher degree.
Risk of Upper Extremity Musculoskeletal Injury in Laparoscopy Training
The New Ropanasuri Journal of Surgery
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Introduction. The laparoscopy procedure still has an ergonomic burden that can increase the risk of musculoskeletal injury, especially in the upper extremity. Furthermore, the risk is compounded in laparoscopic training as the trainees have to repeat the same movements many times to achieve competencies. This study revealed the relation between the position and the risk of musculoskeletal injury in laparoscopy training. Methods. A cross-sectional study on nine subjects was conducted during laparoscopy training. By fixing the table height at 77 cm, we measured the operator height and upper extremity positions to relate them to their VAS and DASH scores. Results. The overall ratio of table height to subject height was Conclusions. There is a risk of upper extremity musculoskeletal injury without disabilities. The pain produced by laparoscopy activity has shown to be mild and needs no medication. The wrist position is considered the highest risk of initiating the upper extremity injury.
An Unusual Case of Perforated Appendicitis in Situs Inversus Totalis in Indonesia
The New Ropanasuri Journal of Surgery
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Situs inversus is a rare congenital anomaly where the internal organs are transposed in a mirror image. It is commonly unrecognized until a patient comes with a complaint, especially in developing countries where people do not have a routine medical checkup. We report a case of a young female with unusual left lower quadrant pain abdominal pain. Perforated appendicitis leading to peritonitis was confirmed using ultrasonography and successfully treated with laparotomy. Appendicitis should be considered a working diagnosis in lower left quadrant abdominal pain
Graduated Compression Stockings for Deep Vein Thrombosis prevention in Surgical Patients: A Systematic Review
The New Ropanasuri Journal of Surgery
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Introduction. Oral anticoagulant therapy is commonly used to prevent deep vein thrombosis (DVT). However, it might increase the risk of intraoperative and postoperative bleeding. Graduated compression stockings (GCS) reduced DVT risk, but there is a lack of supporting evidence. Thus, the study aimed to find the efficacy of GCS compared to the pharmacological method in high-risk surgical patients. Method. Literature search proceeded in Cochrane, ClinicalKey, and PubMed. Using keywords graduated compression stockings" or "mechanic" or mechanical") and ("pharmacologic" or "oral anticoagulants" or "NOAC") and "comparison" and "prophylaxis" and ("DVT" or "deep vein thrombosis) and ("surgery" or "surgical"). Results. There were six articles reviewed (27,966 participants). The analysis focused on follow-up, diagnostic method, GCS application days, thromboprophylaxis baseline used, and outcomes, i.e., DVT and pulmonary embolism. No statistically significant clinical advantage was found in surgical patients using the mechanical method of GCS for DVT prophylaxis over the pharmacological method. Conclusion. No significant clinical advantage of using the GCS for DVT prophylaxis over the pharmacological method but preventing intraoperative and postoperative bleeding. However, the efficacy of GCS remains an issue to be evaluated, as recently supported by insufficient data. However, GCS implementation as a prophylactic method in surgical patients with a high risk of DVT contraindications for pharmacological prophylaxis is safe.

Page 10 of 11 | Total Record : 107

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