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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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Transplantation in Pediatrics Liver Failure Associated with Acute Hepatitis of Unknown Etiology Putra, Afid B; Putranto, Agi S; Risyaldi, Muftah; Nurachman, Luthfian A
The New Ropanasuri Journal of Surgery Vol. 7, No. 2
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Abstract

Introduction. On 5th April 2022, some cases of severe acute hepatitis of unknown etiology in children were reported in the United Kingdom. Since then, the number has increased rapidly, with 650 probable cases identified worldwide. This review focuses on available information about managing acute liver failure (ALF) in pediatrics with acute hepatitis of unknown etiology through the perspective of hepatobiliary surgery. Method. A literature review proceeded on some databases, namely PubMed and Google Scholar. Epidemiological data and technical policy were obtained from World Health Organization and some government institutions. Results. Severe acute hepatitis can progressively develop into acute liver failure, thus requiring a liver transplantation procedure immediately. There are about 30 patients have received a liver transplant. Fourteen patients reported had died. Liver transplantation is necessary to treat acute liver failure in children with acute hepatitis of unknown etiology. The need for a liver transplant can be avoided if ALF is prevented. Conclusion. The decision to perform or not to perform a liver transplant procedure may consider indications, contraindications, possible outcomes, patient status, availability of donors, and access to transplant centers' facilities and resources.
Quality of Life and Its Associated Factors in Patients After Esophagectomy at a Single National Referral Center Sirirui, Dogma H.; Putranto, Agi S
The New Ropanasuri Journal of Surgery Vol. 7, No. 2
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Abstract

Introduction. Esophagectomy is the standard surgical treatment for resectable esophageal cancer patients. However, the success rate for this procedure was about 25–35% and was associated with a severe risk of postoperative complications. In addition, patients after esophagectomy have decreased their quality of life (QOL), but no research has been done in Indonesia. Therefore, this study was conducted to determine the quality of life after esophagectomy in Indonesia based on the patient population at Dr. Cipto Mangunkusumo General Hospital (CMGH). Method. A retrospective study was conducted using quality–of–life instruments issued by the European Organization for Research and Treatment of Cancer (EORTC). It consists of the module for esophageal cancer EORTC–QLQ–OES18 and the core questionnaire C30. Subjects were patients after esophagectomy in 2015–2021 at CMGH. Results. About 35 subjects underwent esophagectomy and followed by reconstruction, which comprised 62.9% males and 37.1% females. The mean age was 43.8 + 13.1 years. All subjects' median global health was 83.3 (IQR: 25.0). The overall functional scale question item with the lowest score was cognitive functioning (CF) 66.7 (IQR: 50.0). Meanwhile, based on the question items on the overall symptom scale, the worst scores were nausea and vomiting (NV) 16.7 (IQR: 50.0), pain (PA) 16.7 (IQR: 33.3), dysphagia (OESDYS) 33.3 (IQR: 33.3), eating (OESEAT) 34.5 (IQR: 23.9), choking (OESCH) 33.3 (IQR: 33.3), and coughing (OESCO) 33.3 (IQR: 33.3). Conclusion. The overall QOL after esophagectomy at CMGH based on the EORTC–QLQ–C30 and OES18 questionnaires was good. However, prognostic factors associated with decreased quality of life should be better educated to patients and prepared well before the esophagectomy procedure, thus maximizing quality of life after esophagectomy.
Prognostic Factors of Myasthenia Gravis Remission After Thymectomy at National Referral Hospital in Indonesia Wardoyo, Suprayitno; Layardi, Winda J
The New Ropanasuri Journal of Surgery Vol. 7, No. 2
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Introduction. Thymectomy is a recommended treatment for myasthenia gravis, enfacing the problem of a low remission rate. However, Indonesian-specific characteristics of myasthenia gravis are somehow different from those of well-developed countries. Thus, identifying prognostic factors influencing remission is required for patient selection to provide optimal preoperative issues. Methods. A retrospective cohort proceeded in our tertiary hospital, enrolling those diagnosed with myasthenia gravis who underwent thymectomy for four years. Disease period modified Osserman classification, age, sex, preoperative plasmapheresis, preoperative steroid therapy, type of surgery, and thymic pathology were the variables of interest for three-year follow-up. In addition, these variables were subjected to statistical analysis for prognostic factors. Results. Twenty-six subjects completed the follow-up period with remission of 30.7% and associated with a period of suffering myasthenia gravis (p = 0.014) and the modified Osserman classification (p = 0.008). The disease period showed a specificity of 88.9% with a negative predictive value of 84.2% and a sensitivity of 62.5% with a positive predictive value of 71.4%. The modified Osserman classification showed a specificity of 83.2% with a negative predictive value of 88.2% and a sensitivity of 75% with a positive predictive value of 66.7%). Conclusions. In our tertiary hospital, the disease period and the modified Osserman classification are prognostic factors of remission following thymectomy for myasthenia gravis.
Prognostic Factors for Mortality of Pediatric Burn Injury in a National Tertiary Referral Center Angkoso, Heru; Kekalih, Aria
The New Ropanasuri Journal of Surgery Vol. 7, No. 2
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Introduction. In Indonesia, burn injuries cause about 195,000 deaths annually. Data from the Ministry of the Health Republic of Indonesia showed the incidence of burns predominated at 1-4 years old. The mortality of pediatric burn patients in a tertiary hospital was 37.26%. This study aimed to find an association between known and unknown prognostic factors of mortality in Indonesian-specific characteristics. Method. A retrospective analytical study included all pediatric burns admitted to Dr. Cipto Mangunkusumo General Hospital (CMGH) from 1998 to 2010. Variables within a period of the first 72 hours of admission were the focus of interest and were extracted from the medical record. Results. Of 609 pediatric burns, the mortality rate is 37.8%. Some contributing variables significantly associated with the mortality were TBSA, inhalation injury, length of hospitalization, hemoglobin 0-h level, hematocrit 24-h, and 48-h level, INR 0-h, and 48-h, fluid balance 24-h, base deficit, serum lactate, pulmonary edema, systemic inflammatory response syndrome (SIRS) + multiorgan failure (MOF), and acute coronary syndrome (ACS) (p <0.05). On multivariate analysis, the significant variable was length of hospitalization <14 days, SIRS+MOF, abnormal hematocrit 0-h level, and abnormal serum lactate level. Conclusion. The more identified prognostic factors a patient finds, the more the mortality risk. In addition, excessive fluid resuscitation leads to a high likelihood of pulmonary edema, SIRS+MOF, and ACS complications, followed by increased mortality risk
Comparison Ultrasound-Guided Handheld Vacuum Assisted Breast Biopsy and Core Biopsy in Breast Cancer Sueningrat, Anak Agung Ngurah Bagus Satya; Mendy, Mendy
The New Ropanasuri Journal of Surgery Vol. 7, No. 2
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Introduction. Needle biopsy, including core needle biopsy (CNB) and vacuum-assisted breast biopsy (VABB) with or without radiological support) is the initial investigative method of choice for the preoperative diagnosis of breast lesions. Ultrasound-guided VABB (US-VABB) has become widely accepted because of its high accuracy. In this review, the diagnostic performance indices of CNB were compared with US-VABBB techniques. Method. A literature search proceeded in online databases compiling studies from the last 20 years in the PubMed, EBSCOhost, ScienceDirect, and ProQuest databases. Eighteen eligible studies compared US-VABB and CNB for diagnostic accuracy. All studies were cohort retrospective. This literature search proceeded according to the PRISMA. Results. Eighteen retrospective studies in three categories: comparative studies of US-VABB and CNB and the diagnostic accuracy of US-VABB and CNB. The studies showed that US-VABB has higher sensitivity and specificity than CNB but lower inadequacy and underestimation rates in the comparative studies group. In addition, the diagnostic accuracy of US-VABB is higher than CNB when comparing the other two subgroups (sensitivity and specificity: 94.4%-100% vs. 82%-90% and 98%-100% vs. 96%-98%, respectively). Conclusion. US-VABB has higher overall diagnosis accuracy than CNB
The Correlation between Premenopausal Estrogen and Estrogen Receptors in Breast Cancer Kurnia, Ahmad; Pratama, Dedy; Mirwan, Muhammad
The New Ropanasuri Journal of Surgery Vol. 7, No. 2
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Introduction. The correlation between the premenopausal estrogen hormone and estrogen receptors is unknown. The hormone estrogen has a risk factor for causing breast cancer. Meanwhile, the estrogen receptor plays a role in determining further treatment plans in breast cancer patients. Patients with high estrogen receptors have a better prognosis. If the premenopausal estrogen hormone can affect the estrogen-receptor, then the estrogen hormone can be modified to have a better prognosis. Method. A cross-sectional study enrolled 32 subjects with complete data and was statistically analyzed to find the correlation between premenopausal estrogen hormone and estrogen-receptors. Results. The estradiol ranged from 15.3 − 89.8 pg/mL, and estrogen receptors showed a range of 10–90%. The Spearman correlation test between the estradiol and the estrogen receptor showed a p-value = 0.864 and a negative correlation coefficient of 0.032. Conclusion. Estrogen hormone is not statistically associated with estrogen receptors in premenopausal breast cancer patients, thus illustrating that the prognosis of breast cancer is not associated with the estrogen hormone
The Potential of Liquid for Breast Cancer: A Review Panigoro, Sonar Soni; Yuella, Clarissa Kezia, -
The New Ropanasuri Journal of Surgery Vol. 7, No. 2
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Introduction. Tissue biopsy is the current gold standard for cancer diagnosis, targeted treatment, and prognosis. However, biopsy is an invasive procedure that could result in postoperative bleeding, pain, and infection. Such limitations may now be resolved by the clinical technique known as liquid biopsy, which enables a better representation of disease status.Method. This literature review was conducted through online databases (PubMed, Ascopubs, EuroPMC) using the following keywords: "liquid biopsy", "ctDNA", "CTC", "breast cancer", "pathogenesis of breast cancer", "tumor microenvironment”, “ctdna detection technologies”, "early diagnosis", "targeted therapy" ,"monitoring disease progression”, and "prognosis”. The literature search was conducted using the PRISMA format (Figure 1). The appraised articles were further evaluated using the Joanna Briggs Institute (JBI).Discussion. Liquid biopsy, also known as blood-based analysis of circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA), has become more significant in breast cancer in recent years. There are several techniques for CTC and ctDNA detection that are continuously developing. PCR-based techniques are the initial approaches used to identify ctDNA, however targeted deep sequencing is now superior. Instead of tumor biopsy, liquid biopsy might be beneficial for breast cancer diagnosis, therapy, and prognosis based on the clinical trials. However, more clinical trial studies are still needed.Conclusion. The advancement of technology has made genetic alteration detection via liquid biopsy feasible to detect genetic alterations that are very important not only for early detection of breast cancer, but also targeted therapy and disease monitoring. Numerous studies have shown the potential of liquid biopsy as an alternative to tumor biopsy.
3rd Jakarta Annual Surgical Symposia: Comprehensive Surgical Update Proceeding Abstracts JASS, Scientific Committee
The New Ropanasuri Journal of Surgery Vol. 8, No. 1
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Introduction. The need for arteriovenous fistula (AVF) as access to hemodialysis is increasing, but the failure rate of AVF maturity is also relatively high. Umbilical cord mesenchymal stem cells (MSCs) have anti-inflammatory properties that can occur in homeostasis, repair, and regeneration in pathological responses caused by vascular injury. This study aims to determine how administering cord mesenchymal stem cells (MSC) affects vascular maturity based on Doppler ultrasound examination in AVF rabbit models. Method. An experimental study proceeded using a local male rabbit (Lepus Domestica). The administration of umbilical cord mesenchymal stem cells was applied in situ on AVF and intravenously. Vascular maturation assessed using ultrasound was the variable of interest. The data obtained in this study were analyzed by parametric test using the one-way analysis of variance (ANOVA) test. Results. Analysis of vascular maturation based on vascular diameter showed a p–value of Conclusion. The administration of stem cells in situ affects the diameter of blood vessels and intravenously affects blood flow. Administration of stem cells in situ and intravenously may suppress vascular hyperplasia.
Factors affecting the Survival of Soft Tissue Sarcoma Patients of the Extremities at Cipto Mangunkusumo Hospital, Indonesia Yulian, Erwin D; Sinaga, Kezia M.; Kartini, Diani; Kekalih, Aria
The New Ropanasuri Journal of Surgery Vol. 8, No. 2
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Introduction. The strategy for treating limb soft tissue sarcoma (STS) is challenging due to delayed diagnosis and the non-specific clinical picture, leading to the mortality of nearly 50% of newly diagnosed patients. Various therapeutic modalities have been applied to increase the survival of patients with extremity soft tissue sarcoma. However, clinicopathological factors can influence the survival rate and thus affect the effectiveness of therapy. This study aims to determine the numbers and factors influencing overall survival five years after treatment for patients with soft tissue sarcoma of the extremities at Dr. Cipto Mangunkusumo General Hospital (CMGH) in 2011-2015. Method. A prognostic study was run on patients with complete histopathology who underwent treatment during 2011-2015. Data analysis using the Kaplan-Meier method, cox regression test, and Cox regression with time-dependent variable. Results. A total of 42 were enrolled in the study. The median survival after therapy for patients was six years (3 months – 8.25 years), with a five-year survival of 52.4%. Factors affecting five-year survival were surgical procedures in limb-saving surgery (HR 0.852 95% CI 0.68 – 1.07, p = 0.163). Conclusion. The five-year survival rate of soft tissue sarcomas of the extremities was 52.4%. Overall survival is affected by higher-grade sarcoma, incomplete therapy, and worse clinical stage.
ABO Blood Group Type and the Risks of Peripheral Artery Disease in Type II Diabetes Mellitus Pratama, Dedy; Puruboyo, Adi N.D
The New Ropanasuri Journal of Surgery Vol. 8, No. 2
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Introduction. Peripheral artery disease (PAD) is a common complication of diabetes mellitus (DM), affecting up to 20% of people over 65. Blood type is hypothesized to influence PAD, although it has yet to be extensively studied. We aim to investigate the correlation between ABO blood group type and the severity of PAD in patients with type II DM. Methods. We conducted a cross-sectional study on DM type II patients with PAD at the Cipto Mangunkusumo National Hospital in Indonesia between January 2022 to June 2022. PAD was diagnosed based on the ankle-brachial index (ABI) measurement. The PAD severity was grouped into mild (ABI 0.7-0.9) and moderate-severe (ABI <0.7). Patients were categorized as O blood type and non-O (A, B, and AB). Results. Of 366 patients included, 194 with O type and 172 with non-O type. No significant difference in the occurrence. PAD was significantly more severe in non-O blood type patients (p = 0.041). Longer periods of diabetes (OR 10.325, CI95% 5.108-20.871, p <0.001) and hypertension (OR 4.531, CI95% 1.665-12.326, p <0.003) were risk factors for more severe PAD. Conclusion. ABO blood group type was not significantly associated with the occurrence of PAD in patients with type II DM. Non-O blood type was associated with more severe PAD, while more prolonged periods of diabetes and hypertension were found to be significant risk factors for more severe PAD.

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