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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 152 Documents
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Bacillus Calmette-Guerin (BCG) as an Intralesional Therapy for Cutaneous Metastatic Malignant Melanoma: A Literature Review Dina, Farisa B; Kurnia, Ahmad
The New Ropanasuri Journal of Surgery Vol. 9, No. 2
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Introduction. Malignant melanoma is the most lethal form of skin cancer and is the third most common cause of death of all malignancies in the world. Cutaneous metastatic lesions are the earliest and the most frequently encountered metastatic lesions in malignant melanoma. The use of Bacillus Calmette-Guerin (BCG) as an intradermal therapy agent has been long debated due to its effectiveness and adverse effects. This literature review aims to provide a comprehensive explanation regarding the use of intralesional BCG in establishing local control and preventing recurrence in cutaneous metastatic malignant melanoma. Method. A literature search was conducted on various online databases. The articles that were obtained were selected according to the 2020 PRISMA flow diagram. Among 79 articles obtained, six selected articles were included in this study. Results. Five included studies stated that intralesional BCG effectively induces complete regression of cutaneous metastatic lesions of malignant melanoma. Variable results have been obtained regarding the effectiveness of intralesional BCG in preventing the recurrence of malignant melanoma. In three studies, significant differences were found in disease-free and median survival, but no studies included incidence of recurrence data in their results. Conclusion. BCG can be considered as an intralesional therapy agent of choice to induce local control in cutaneous metastatic malignant melanoma. However, its use has proven ineffective in preventing cutaneous metastatic malignant melanoma recurrence.
Infrarenal Abdominal Aortic Pseudoaneurysm with Suspected Behcet Disease: A Unique Case Report Gunardi, Harsya D; Pratama, Danny; Prabowo, Andrio W; Hidayat, Nanang W; Putera, M Aprizal; Krisandi, Grady
The New Ropanasuri Journal of Surgery Vol. 9, No. 2
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Introduction. Abdominal aortic pseudoaneurysm caused by autoimmune vasculitis is a rare complication. Clinical presentation of patients is often late with life–threatening complications. Case Illustration: A 62–year–old male patient with infrarenal abdominal aortic pseudoaneurysm presenting with a 2–week worsening severe abdominal and lumbar pain with a history of uncontrolled hypertension and a history of oral ulcer. He was successfully treated with tube grafting through open surgical repair. Conclusion: The pseudoaneurysm was successfully removed and replaced with a polyester tube graft with no perioperative complications and was discharged 5 days later
A Glimpse of Liver Resection Profile in An Indonesian Tertiary Hospital: A Retrospective Descriptive Study Vaniara, Florencia V; Lalisang, Arnetta NL; Lalisang, Toar JM; Mazni, Yarman; Putranto, Agi S; Jeo, Wifanto S; Ibrahim, Febiansyah; Syaiful, Ridho A; Sihardo, Lam; Marbun, Vania MG
The New Ropanasuri Journal of Surgery Vol. 10, No. 1
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Introduction. In-depth liver resection profile is needed for evaluation to improve the procedure’s outcome. This study aims to describe the clinical characteristics and outcomes of liver resection in HCC patients in Cipto Mangunkusumo Tertiary Hospital. Methods. This study retrospectively analyzed the clinical data of 19 HCC patients who underwent liver resection in Cipto Mangunkusumo Tertiary Hospital from 2021 to 2024. Demographic, clinical, laboratory, operative, and pathological data were collected. Postoperative complications were assessed using the Clavien-Dindo classification system within 30- and 90-day postoperative periods. Result. Nineteen patients were included, comprising 12 (63.2%) males and 7 (36.8%) females. Sixteen patients (84.2%) had Child-Pugh (CP) class A liver function with 10 (62.5%) CP A(5) patients and 6 (37.5%) CP A(6) patients; 3 (15.8%) patients had CP class B(7). There were 6 (31.6%) patients with thrombocytopenia and 4 (21.1%) patients with portal hypertension. Liver resection was done laparoscopically in 4 (21.1%) patients and with an open approach in 15 (78.9%) patients. Left hepatectomy was done in 3 patients (15.78%), right hepatectomy in 2 (10.5%), right anterior sectionectomy in 4 (21%), left lateral sectionectomy in 1 (5.26%), bisegmentectomy in 1 (5.26%), segmentectomy in 6 (31.58%), and non-anatomical resection in 2 (10.52%). Based on histopathologic examination, HCC was found in 13 (68.41%) patients. Among 19 patients, 12 (63.2%), 5 (26.3%), and 2 (10.5%) patients had 1 tumor, 2 tumors, and 3 tumors respectively (total tumors resected: n=28). About 16 (84.21%) patients had elevated alpha fetoprotein (AFP) (> 10 ng/mL). The mean intraoperative blood loss was 884 mL. No postoperative complications classified as Clavien-Dindo grade I-IV were observed. Two patients (10.5%) experienced postoperative mortality within 90 days (Clavien-Dindo grade V), both due to circulatory failure. Conclusion. This study presents a descriptive overview of liver resection in an Indonesian tertiary hospital. Comparative conclusions should be interpreted with caution due to the limited sample size.
Whipple Procedure for High-Grade Pediatric Pancreatic Injury After Blunt Trauma: A Case Report El Gah, David C; Rahayatri, Tri H; Rachmawati, Asri D; Nugroho, Adianto
The New Ropanasuri Journal of Surgery Vol. 10, No. 1
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Introduction: Pediatric pancreatic injury isuncommon but carries significant morbidity. While non-operative management is standard for low-grade injuries, the optimal approach for high-grade trauma (AAST grade III–V) remains debated. Pancreaticoduodenectomy (Whipple procedure) is rarely performed due to high procedural risks and is typically reserved for severe pancreatic head injury with concomitant duodenal damage. Case presentations: A 13-year-old boy presented three days after blunt abdominal trauma with epigastric pain and bilious vomiting. CT imaging revealed free fluid, a large retroperitoneal hematoma, and suspected pancreatic head injury. Despite initial stability and conservative management in the High Care Unit, worsening abdominal distension prompted an exploratory laparotomy. Discussion: Surgery revealed pancreatic head laceration and duodenal tears. Consequently, a pancreaticoduodenectomy with pancreaticojejunostomy, choledochojejunostomy, and gastrojejunostomy wasperformed. The patient recovered steadily, resumed oral intake at two weeks, and was discharged in good condition. At the one-year follow-up, he remained asymptomatic and had resumed normal activities. Conclusion. This case demonstrates that pancreaticoduodenectomy is a definitive option for stable pediatric patients with high-grade pancreatic head and duodenal injuries when local reconstruction is unfeasible. However, due to its complexity, it should remain a last-resort strategy reserved for specialized hepatopancreatobiliary centers.
Locoregional Management in Breast Cancer with BRCA1/2 Mutation: Evidence Based Case Report Karisyah, Adlina; Panigoro, Sonar S
The New Ropanasuri Journal of Surgery Vol. 10, No. 1
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Introduction. Breast cancer is still one of the top health issues worldwide. Hereditary predisposition is linked with morbidity and mortality of breast cancer patients. BRCA 1/2 genetic mutation, one of mutations in breast cancer that has been extensively observed, has tremendous effects on the carrier. Studies showed that patients with BRCA1/2 mutation are often associated with poor pathological characteristics. Further research isyet to identify the effect of the mutation with prognosis including locoregional recurrences. This study aims to understand the risk of locoregional recurrences on the patients with breast cancer and BRCA 1/2 genetic mutation who had BCT or mastectomy. Method. Comprehensive literature search conducted based on clinical-questions-related keywords from various sites i.e., Cochrane, PubMed, EBSCOhost, ProQuest, and ScienceDirect. Three articles were selected considering the exclusions and inclusions criteria. Later the articles were critically appraised based on validity, importance, and applicability. Results. Two of the three articles showed no statistical difference on the locoregional recurrence on the patients with the breast cancer and the BRCA1/2 genetic mutation who had BCT and mastectomy. The locoregional recurrence was 0 – 8.1% in patients underwent BCT. Whilst the patient underwent mastectomy had 3.5 – 22.2% locoregional recurrence with p value < 0.05. Conclusion. BCT can be considered as a locoregional treatment in breast cancer with BRCA 1/2 genetic mutation as it is equally effective as mastectomy because both had negligible differences in locoregional recurrences.
The Outcome of Snare Loop Catheter for Foreign Body Removal in Superior Vena Cava: An Evidence-Based Case Report Noorsukma, Hutomo Rezky; Darwis, Patrianef
The New Ropanasuri Journal of Surgery Vol. 10, No. 1
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Introduction. In recent years, the utilization of central venous catheters (CVC) in medical practice has become increasingly common. One of the complications associated with central venous catheterization is embolization of catheter fragments, which arefound in 1% of cases. Currently, endovascular techniques, such as snare loop catheter, have been developed for the extraction of intravascular foreign bodies. However, there is no strong evidence regarding this method. Thisliterature review aims toevaluate the efficacy and safety of snare loop catheters for foreign body removal within the superior vena cava (SVC). Method. We searched four databases, that is Cochrane, PubMed, EBSCO, and ProQuest. We only included studies relevant to our clinical question about the efficacy and safety of snare loop catheter for foreign body removal in SVC. Results. We found 24 case reports and 10 case series from our search with a total of 224 cases. The effectiveness of the snare loop in extracting intravascular foreign bodies from the 34 articles was 97.77%, and the snare loop was successful in removing foreign bodies in 218 cases. We only found 7 cases of complications after the procedure, which are supraventricular tachyarrhythmia (3 cases), hematoma (3 cases), and tricuspid regurgitation (1 case). Conclusion. The removal of foreign bodies in the superior vena cava using a snare-loop catheter is effective and relatively safe. However, further studies with a higher level of evidence are still needed
Management of Gastrointestinal Tract Arteriovenous Malformations in Adults: A Literature Review Ibrahim, Febiansyah; Beatrice, Angie
The New Ropanasuri Journal of Surgery Vol. 10, No. 1
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Introduction. Arteriovenous malformations (AVMs) of the gastrointestinal (GI) tract are rare vascular lesions that can cause significant GI bleeding, posing a diagnostic challenge in clinical practice. This literature review examines the management strategies for AVMs in adults, focusing on identifying optimal treatment approaches and minimizing recurrence, particularly in Indonesia where no standardized treatment guidelines are available. Method. A literature search was conducted from August 24, 2022, to September 11, 2023, using PUBMED®, Cochrane®, Proquest®, and Scopus® databases. The inclusion criteria were studies published in English or Indonesian within the last 25 years, including case series, cohort studies, or systematic reviews involving patients with GI AVMs. The Joanna Briggs Institute Critical Appraisal Checklist was used for evaluating study quality. After screening for relevance and duplicates, 5 studies met the inclusion criteria. Result. Database search using specific keywords obtained in total of 1012 titles. Screening of titles and abstracts then 5 studies met the criteria. AVMs were reported in various anatomical locations of gastrointestinal tract. Including ileum, colon, and duodenum. Treatment strategis tailored into three major approaches: operative, non-operative (minimally invasive including interventional radiology), and medical. Transarterial embolization (TAE) which emerged as the most frequent employed and effective modality in both emergent and elective settings. Recurrence rates following TAE varied but were generally lower than those observed with conservative or incomplete interventions. Endovascular embolization also served as a valuable alternative in patients who declined surgical intervention or when lesions were inaccessible surgically. Conclusion. Advancement in endovascular interventional radiology and super-selective embolization have led to effective management of non-variceal gastrointestinal bleeding, including AVMs with minimal recurrence, though organ ischemia remains a risk. Surgical intervention is crucial when embolization fails or complications arise. Innovations in intraoperative AVM localization have improved surgical accuracy and reduced recurrrence.
Roux-en-Y Duodenojejunostomy as Surgical Treatment for Congenital Duodenal Obstruction: A Case Report Yani, Ahmad; Ruhimat, Albireza
The New Ropanasuri Journal of Surgery Vol. 10, No. 1
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Introduction. Congenital duodenal obstruction is an anatomical abnormality in newborns. Various intrinsic and extrinsic etiologies can cause duodenal obstruction. The surgical treatment that is commonly performed on duodenal obstruction in neonates is duodenoduodenostomy. However, several etiological conditions, such as preduodenal portal vein (PDPV) and pancreatic annulare cause duodenoduodenostomy nearly impossible to perform, so an alternative surgery procedure with a good outcome is necessary. Case Illustration. A female neonate had been suspected congenital duodenal obstruction since pregnancy due to polyhydramnios. An OGT was inserted with greenish yellow residue after the baby was born. Based on abdominal x-ray examination, a double bubble appearance was seen. The patient then underwent surgery at 5 days old. Intraoperatively, there was a PDPV and annular pancreas covering the 2nd and 3rd part of the duodenum, so it was decided to perform Roux-en-Y duodenojejunostomy. Conclusion. In patients with congenital duodenal obstruction with special etiology and anatomy, such as PDPV and pancreatic annulare, it is possible to perform a Roux-en-Y duodenojejunostomy. Even though this operation is rarely performed on neonates and is more common in adult patients, it can be an alternative in cases of congenital duodenal obstruction.
Potential of Tumor Cell Seeding and Clinical Impact on Percutaneous Breast Biopsy Tracks: A Literature Review Gunawan Wibisana, I G.N.; Mirwan, Muhammad
The New Ropanasuri Journal of Surgery Vol. 7, No. 2
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Introduction. Based on its effectiveness, a percutaneous breast biopsy was chosen because it has minimum side effects and fewer complications, does not distort the breast tissue architecture, and can be performed on an outpatient basis. However, the biopsy can damage the integrity of tumor cells, creating seeding at the site of the track made. Therefore, core biopsy is the method of choice for breast lesion sampling using a 14G needle that provides greater sensitivity. This study aims to explain whether the percutaneous biopsy track has the potential for the formation of tumor cell seeding and its clinical impact. Methods. Literature searches were conducted in online databases, including Cochrane Library, MEDLINE (PubMed), ScienceDirect, CINAHL (EBSCOhost), and Google Scholar. Results. Eight articles were selected after a literature search and review. Conclusion. The potential of tumor seeding formation in the percutaneous breast biopsy tracks varies statistically in number. Overall, the potential of tumor seeding in the percutaneous breast biopsy tracks varies, and the clinical impact is insignificant. Variations in the prevalence of tumor seeding still inconclusive the potential for tumor seeding formation in the percutaneous breast biopsy pathway, particularly core biopsy. Tumor seeding is only found microscopically and does not have a significant clinical impact.
Surgical Intervention for Endobronchial Tuberculosis with Total Bronchial Occlusion: A Case Report Putra, Muhammad A; Billy, Matthew; Ardaya, Radhyaksa; Ekasiwi, Rut HP; Rahmawati, Sari; Sumarsudi, Karel HS
The New Ropanasuri Journal of Surgery Vol. 7, No. 2
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Introduction. Endobronchial Tuberculosis (EBTB) is a specific TB form affecting the tracheobronchial tree with microbial and histopathological evidence. Early diagnosis is essential to provide timely treatment and prevent complications but also proves difficult due to the low positive rate of acid–fast bacilli (AFB) staining of sputum smears and non–specific clinical and radiological findings. Case Illustration. We reported a 19–year–old man with a productive cough suspected of pulmonary tuberculosis, with a positive GeneXpert test and negative AFB smear. He received anti–tuberculosis drugs for six months. Although the symptoms initially seemed to improve, the patient complained of dyspnea during moderate activities in the sixth month. Chest x–ray showed complete atelectasis of the left lung. Further investigation with thorax computed tomography and confirmation with bronchoscopy revealed total occlusion of the left main bronchus. Left pneumonectomy was successfully conducted. Conclusion. Endobronchial tuberculosis may progress to an advanced stage despite adequate anti–tuberculosis drugs. Therefore, early diagnostic strategies are required to prevent the progression of the disease, particularly due to the insidious nature of its pathophysiological process

Page 13 of 16 | Total Record : 152

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