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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 152 Documents
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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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Abstract

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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Abstract

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.
Transformation of accreditation of higher education in health in Indonesia: qualitative assessment Moenadjat, Yefta; Tunru, Insan Sosiawan A.; Soemardjo, Sutrisno
The New Ropanasuri Journal of Surgery Vol. 9, No. 2
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Accreditation of higher education in health in Indonesia shifts to the qualitative assessment driven to ensure quality improvement. The method replaces the former quantitative assessment method that has been applied since 2012; it will be effective in January 2025. The driving factors and rationale of transformation are outlined in this article. The rationale of the qualitative assessment that applies principle–based accreditation and the quantitative assessment that applies rule–based accreditation is reviewed here. Information on the accreditation procedure and the goal is presented, aiming for institutions to prepare for this new version of accreditation.
Navigating Wound Closure Strategies: Primary Closure vs. Delayed Primary Closure in Digestive Surgery—A Systematic Review and Meta-Analysis on Surgical Site Infections Sihardo, Lam; Lalisang, Arnetta NL; Putra, Afid B; Suryawiditya, Bagus A
The New Ropanasuri Journal of Surgery Vol. 9, No. 2
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Introduction. Surgical site infection (SSI) is a significant concern following digestive surgery, with varying incidence rates based on wound contamination levels. The choice between Primary Closure (PC) and Delayed Primary Closure (DPC) impacts SSI occurrence, making it essential to evaluate their comparative effectiveness. DPC is hypothesized superior to PC to prevent SSI or wound infection after a contaminated abdominal surgery. Methods. This systematic review study was carried out through PubMed, Scopus, and Cochrane (CENTRAL). Quality was assessed using Risk of Bias (ROB-2) tool. All results were summarized, and quantitative analysis was performed using a random-effect model. This study is reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Eligibility criteria included adult patients undergoing abdominal gastrointestinal surgery, evaluating SSI and hospital stay, directly comparing PC and DPC, and randomized controlled trials (RCT) study. Results. Of 447 published studies, there were 10 eligible RCTs, consist of 672 subjects who received DPC and 668 subjects who received PC. We found no significant difference in SSI occurrence between PC and DPC (RR=0.62, 95%CI: 0.38–1.02; p=0.06) with high heterogeneity (I2=74%, p Conclusion. DPC tend to decrease SSI risk. Our findings revealed that PC is not inferior than DPC to prevent SSI and improve hospital stay in abdominal surgery. The choice between techniques should be individualized, considering patient characteristics and surgical context. Standardized criteria and further research are crucial for refining closure method selection, ultimately enhancing patient outcomes and reducing the burden of SSI.
The Role of Active Surveillance of Papillary Thyroid Microcarcinoma: A Literature Review Prasojo, Prasojo; Gunawan Wibisana, I Gusti Ngurah Gunawan
The New Ropanasuri Journal of Surgery Vol. 9, No. 2
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Introduction: Thyroid cancer is one of the most common cancers in the world, with incidence 144,7: 100.000 population. The incidence has risen up to 211% within the last 30 years, and one–third of thyroid cancer is papillary thyroid microcarcinoma. There are still controversies regarding whether immediate surgery or active surveillance is the better option for treating this condition. This review aims to evaluate the safety and efficacy of active papillary thyroid microcarcinoma surveillance. Methods: Cochrane, PubMed, EBSCOHost, and ProQuest were searched for relevant studies of active surveillance of papillary thyroid microcarcinoma. Results: Six publications were selected after a literature search and review Conclusion: Active surveillance could be implemented as a treatment of papillary thyroid microcarcinoma in selected cases. The overall survival rate of papillary thyroid microcarcinoma is up to 99%, with cancer growth >3mm at 4.4% to 8%. Lymph node metastases were 1.2% to 3.8%, and distant metastases were only found in 0.04% of cases
Surgical Treatment for Hepatocellular Carcinoma with Right Atrium Tumor Thrombus: A Literature Review Hazmi, Mohammad Z; Syaiful, Ridho A
The New Ropanasuri Journal of Surgery Vol. 9, No. 2
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Introduction. The prognosis of patients with hepatocellular carcinoma (HCC) with right atrial tumor thrombus (RATT) is poor, with a mortality rate of 60 to 90%. Along with the development of multimodality management and surgical techniques in cases of HCC, surgery is still an option for curative purposes. This study aims to review the indications, appropriate surgical techniques, and postoperative survival outcomes in HCC with RATT. Methods. This literature review conducted using online databases, including Cochrane Library, PubMed, ScienceDirect, EBSCOhost, and ProQuest. Results. Six case reports and four retrospective studies were reviewed. Surgery for HCC with RATT has one, three, and five–year survival rates of 34% to 53%, 14% to 26%, and 13%, with a median survival of 8 months to 26 months. Surgery with adjuvants has a five–year survival rate of up to 41% up to 12 years. However, one study stated that ionizing particle radiation had a one and three–year higher survival rate than surgery (47% and 16% compared to 34% and 14%). Conclusion. In cases of HCC with RATT, It can undergo thrombectomy through the total hepatic vascular exclusion (THVE) technique in cardiopulmonary bypass (CPB) control to prevent the release of tumor thrombus and proceed with hepatectomy. This procedure is safe and has a survival rate of 8 to 26 months
C-Reactive Protein as an Early Predictor of Anastomosis Leakage after Colorectal Surgery: A Literature Review Permana, Lucky; Syaiful, Ridho A
The New Ropanasuri Journal of Surgery Vol. 9, No. 2
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Introduction. Anastomosis leakage is a defect in the intestinal wall at the anastomosis site after surgery. This condition is a serious complication causing increased morbidity and mortality. CRP is commonly used as an acute postoperative indicator after abdominal surgery. The use of CRP as an early predictor of anastomosis leakage after colorectal surgery is supported by several studies showing its good diagnostic value. However, using CRP as a biomarker is not standard at Cipto Mangunkusumo National Hospital. Therefore, this literature review aims to support the evidence for CRP in the early detection of anastomosis leakage after colorectal surgery. Method. This study is a literature review conducted by searching online databases, including PubMed, ScienceDirect, and ClinicalKey. Several key terms, such as "anastomosis leak," "C–Reactive Protein," "colorectal," "predictor," and "open surgery," were used. Results. Database searches yielded 445 articles, of which six studies met the inclusion criteria and were included in this review. These include one systematic review, two meta–analyses, and three prospective studies. Conclusion. CRP is a good early predictor for anastomosis leakage, with sensitivity ranging from 68% to 86%. The highest diagnostic value of CRP was observed between postoperative days 3 and 5.

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