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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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Inferior Vena Cava Filter in Managing Venous Thromboembolism Associated with Malignancy: A Systematic Review
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. The risk of venous thromboembolism (VTE) associated with malignancy is 4.1-fold greater than patients without malignancy. Malignancypatientst has a greater risk of bleeding with the commonly used anticoagulant therapy. Inferior Vena Cava Filter (Ihas have been recommended as a controversial alternative. This study aims to find the most robust evidence of the safety, advantage, and clinical outcome of the IVCF for managing VTE associated with malignancy. Method. Thus, we ran a systematic review found on Cochrane, PubMed, ScienceDirect, and ClinicalKey. Results. There were ten articles reviewed (1,191 participants). Safety and efficacy, advantage, and complications were discussed regarding the outcomes with a focus on the interest in managing the malignancy-associated VTE, especially in patients with contraindications to anticoagulants. Complication of IVCF found filter migration (0.9%), vena cava thrombosis (3.7%), recurrent PE (2.8%); filter fracture (0.9%); and IVCF penetration (0.9%). No mortality was found in patients due to complications due to filter insertion (LOE 2). IVCF insertion can reduce PE rates but with an increase in the number of DVT. (DVT: with filter vs without filters: 35.7% vs 27.5%; HR 1.52; CI95 % 1.02–2.27; p = 0.042; PE: 6.2% vs. 15.1%; HR 0.37; 95% CI 0.17–0.79; p = 0.008). Six studies found no statistically significant increase in PE-related mortality. Conclusion. IVCF is safe and beneficial for managing malignancy-associated VTE, especially in patients with contraindications to anticoagulants (LOE 2, 3, and 4).
Revascularization Techniques for Infra-popliteal Peripheral Artery Disease in Diabetic Foot: A Literature Review
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Foot ulcers are one of the problems that are often encountered in uncontrolled diabetes mellitus. With diabetic peripheral neuropathy, the typical clinical symptoms of PAD (peripheral arterial disease) may be obscured, leading to critical limb ischemia (CLTI). Diabetes may accelerate atherosclerosis that diminishes blood flow in PAD—further, diabetic patients with PAD often enfaces infra-popliteal lesions and require revascularization. However, studies on revascularization techniques in infra-popliteal PAD remain minimal. We reviewed the literature on EBSCO, and PubMed focused on the revascularization techniques in PAD, namely: expanded polytetrafluoroethylene (ePTFE), saphenous vein graft (SVG), atherectomy, surgical revascularization first, revascularization with endovascular bypass, direct and indirect angiosome revascularization, open surgery, direct bypass, indirect bypass, PTA, drug-eluting stent, pedal artery angioplasty, non-drug balloon angioplasty, DCB balloon angioplasty, infra-popliteal angioplasty, and cryoplasty. The methods of cryoplasty, atherectomy, direct bypass, balloon angioplasty, and eluting drug stent showed a better outcome in infra-popliteal CLTI.
Review: Conventional Thrombectomy with Intraoperative Fluoroscopy in Acute Limb Ischemia Rutherford IIb
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. Acute limb ischemia (ALI) is a severe condition affecting the extremities and the patient’s survival that requires immediate treatment. It can be treated with either surgical or endovascular revascularization or both (hybrid procedure). It is crucial to evaluate the defect using intraoperative fluoroscopy or angiography in each case. The review aimed to find out the outcomes of the thrombectomy with intraoperative fluoroscopy for ALI Rutherford IIb. Method. According to the PRISMA protocol, the literature search proceeded in online databases, i.e., Cochrane, Scopus, PubMed, and EBSCOhost, with no year limitation on the publication. All articles were screened and critically appraised. Five eligible articles enrolled in this study with 269 patients ALI Rutherford IIb. All selected articles are cohort studies, including prospective and retrospective. Results. The endovascular intervention (with intraoperative fluoroscopy assistance) showed lower mortality and morbidity than open thrombectomy – however, no difference between open and hybrid thrombectomy in mortality rate. In addition, morbidities such as amputation and limb salvage showed no difference significantly between these interventions. Open thrombectomy has a high risk of mortality and amputation. Meanwhile, the endovascular intervention likely showed a risk of reocclusion, thus, requiring a conversion to open thrombectomy. Conclusion. Intraoperative angiography during open thrombectomy may reduce complications of postintervention reocclusion.
Review: Management of Complex Anal Fistula
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. Complex anal fistula has a high postoperative recurrence rate and incontinence as well. There have been many emerging surgical techniques, but there are no new recommendations for managing complex anal fistula. One of the critical parameters in evaluating surgical technique outcomes is the recurrence rate and incontinence. This study describes postoperative results in recurrence rates and incontinence in various surgical techniques in managing complex anal fistula. Method. This review commenced with literature searches on online databases, including Cochrane Library, MEDLINE (PubMed), ScienceDirect, and CINAHL (EBSCOhost). Results. The study enrolled two RCTs, four systematic reviews, 14 retrospective and prospective studies, and a case series. The recurrence rate and incontinence of fistulotomy, seton drainage, advancement flap, were 4-19% and 0-4%, 3-47% and 0-7%, 20-27%, and 0-38%, respectively. The recurrence rate of LIFT, VAAFT, PERFACT, and TROPIS were 7-16.1%, 7.5-33%, 20-26.7%, and 14%, respectively; no change in pre– and postoperative continence scores. Conclusions. According to this study, the lowest recurrence rate was in the TROPIS procedure and the highest in fistulotomy. Meanwhile, the lowest incidence of incontinence was in LIFT, VAAFT, PERFACT, and TROPIS, and the highest was in the advancement flap procedure.
False-positive Serum IgM/IgG to SARS-CoV-2 in a Rare Pulmonary Neuroendocrine Carcinoma with Ocular Metastasis: A Case Report
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

The Coronavirus disease 2019 (COVID-19) pandemic impacts pulmonary cancer management since it shares similar clinical features and creates fear among patients to visit hospitals due to possible in-hospital disease transmission. We report a patient who presented with a rare case of a pulmonary neuroendocrine tumor with an ocular involvement, which, unfortunately, experienced a delay in diagnostics. The first hospitalization was due to superior vena cava syndrome, pleural and pericardial effusions, and swollen left eye. The patient was diagnosed with pulmonary cancer, released after the symptoms were relieved, and expected to visit a referral hospital for further diagnostics and treatments. The patient returned two weeks later with progressing disease, an ocular metastasis, and a reactive serum IgM/IgG to SARS-CoV-2; serial qPCR tests consistently returned negative. The patient was treated with the best supportive care before succumbing to death. Biopsy showed pulmonary tumor cells consistent with a neuroendocrine tumor. Fear of the pandemic makes patients reluctant to seek help from medical facilities. Pulmonary TBC has similar symptoms to pulmonary cancer, which can pose another challenge in diagnosing pulmonary cancer in TB-endemic countries. Thus, patients often present with advanced-stage pulmonary cancer with rare ocular metastasis, as in this report.
Review: Partial Splenic Embolization Outcome on Liver Cirrhosis with Esophageal Varices
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. Liver cirrhosis may be followed by complications such as esophageal varices for 30 days mortality rate up to 15-20%. Partial splenic embolism (PSE) or partial splenic embolization has been developed as a safe and effective alternative therapy for managing bleeding in esophageal varices. This study aims to determine the outcome of PSE in patients with liver cirrhosis with esophageal varices. Method. In this review, the literature search proceeded on three online databases (Cochrane Library, MEDLINE (PubMed), and ScienceDirect) according to PRISMA protocol. Through selections, six articles were included, and all were the reports. Results. Of six reports, three were focused on liver function tests, and the other three were focused on bleeding varices. All were comparing before and after embolization. Conclusion. There is a significant difference in serum cholinesterase and a decreasing incidence of varices bleeding before and after PSE treatment. However, there was no significant difference in serum albumin before and after PSE.
Mini-Review: Omental Patch Repair of Giant Perforated Peptic Ulcer
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. A perforated giant peptic ulcer is an emergency that requires surgery. Closure of the perforation with an omental patch has been reported in several cases of perforated giant peptic ulcers. However, there is insufficient evidence regarding the option of preferred treatment. This review to discuss published reports of a perforated giant peptic ulcer closed with an omental patch that focused on the complications Method. The literature search was conducted through the Cochrane, PubMed, Scopus, and EBSCO data sites. The articles obtained were screened for duplication, title, abstracts, and full-text based on inclusion and exclusion criteria. Result: Two articles were included in this study for critical review. From these two articles, no complications were reported regarding the closure of giant perforated gastric ulcers with an omental patch. Conclusion: In general, closure of perforated gastric has a minimal incidence of postoperative complications. An omental patch can be used to close gastric perforation in unusual cases, such as giant perforation and septic shock, as presented in this case.

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