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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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Critical Appraisal to Intraabdominal and Complicated Intraabdominal Guidelines to Develop Indonesian Specific Clinical Practice Guidelines Moenadjat, Yefta; Mulya, Dina D.; Lalisang, Toar JM.
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Introduction. There were many clinical practice guidelines (CPG) intraabdominal infection/complicated intraabdominal infections (cIAI) have been developed since 1992 and were periodically updated recently. But to date, the implementation in Indonesia encountering problems. One is Indonesian characteristics which is differed to the population of where the CPG developed. To adapt a CPG, the quality of CPG should be first critically appraised. The best will be used furthers as the subject to be adapted, with modification regarding Indonesian characteristics. Method. A literature search carried out on guidelines databases to find out CPG on cIAI (1992–2017). The assessment preceded using AGREE II tools (MyAGREE platform) focused on 23 assessments in 6 domains (scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, applicability, and editorial independence). Such an assessment placed a guideline in rating of 1 to 7. Updated guidelines were assessed using Checklist for the Reporting of Updated Guidelines (CheckUp). Appraised CPG were discussed. Results. There were 33 CPG in full text downloaded and subjected to selection criteria. Duplicates and those irrelevant were excluded. In the assessment there were 18 CPG included and 13 guidelines places the strong recommended category, two can be recommended and other 2 were not recommended. All updated CPG met the criteria of the best quality updates. Conclusion. Two cIAI–CPG were met the criteria of the quality guidelines to be adopted. These guidelines were developed in accordance with appropriateness in development a CPG and were updated.
Common Carotid–Esophageal Fistula following Migrated Fish Bone: A Rare Case report Suharto, Wuryantoro; Putra, Muhammad A.; Jamtani, Indah
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Correlation between Blood Types and Intraabdominal Infection: A Preliminary Study Robby, Rizky DK.; Moenadjat, Yefta
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Introduction. Intra-abdominal infection (IAI) remain a clinical problem with high mortality rate. Among factors contributed to this mortality, the important one is blood type that never be considered. It was thought to have correlation with a certain type. Thus, a retrospective study as a preliminary study run to find out the evidence. Method. A descriptive analytic with cross sectional design was run. Data of those diagnosed with intraabdominal infection due to abdominal trauma and gastrointestinal infections managed at dr Cipto Mangunkusumo General Hospital was taken from medical record. ABO blood types and microbial culture results in two groups were the focus of a study and were analyzed statistically. Results. In the study, out of 230 subjects, there were 22 subjects (9.6%) with postoperative intra-abdominal infection were observed during January 2014-March 2016. There was a significant correlation between blood transfusion (p <0.001, OR = 0.02) with intraabdominal infection. However, there was no significant correlations found in blood type to the occurrence of intra-abdominal infection. Conclusion. The study unable to show that blood type has a correlation to intra-abdominal infection in those diagnosed with abdominal trauma and gastrointestinal infections.
Characteristic of Mandibular Ameloblastoma and Postoperative Complication Influencing Factors in Cipto Mangunkusumo General Hospital during January 2008 – December 2012 Juliansyah, Amir; Briani, Farida
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Introduction. Ameloblastoma is a quite rare case but a common odontogenic tumor found, about 11% of all odontogenic tumors. The tumor is locally aggressive odontogenic one with a tendency to have recurrence and may cause severe facial deformity and dysfunction if not treated properly. The slow growing nature of this tumor usually lead to a delay in diagnostic. Recurrence rate of ameloblastoma reported as 15–25% after radical treatment and 75–90% after conservative treatment. This study aimed to find out the characteristics and influencing factors that contributed to postoperative complication. Method. Those diagnosed as ameloblastoma who underwent total mandibulectomy, hemi–mandibulectomy, segmental mandibulectomy, and subtotal mandibulectomy as the first surgery followed by reconstruction using with reconstruction plate or bone graft in dr. Cipto Mangunkusumo general hospital in during January 2008 – December 2012 were reviewed descriptively using cross sectional retrospective study. Results. Twenty–three subjects managed in the oncology surgery division, Department of Surgery, dr. Cipto Mangunkusumo general hospital during such a period. There were 7 males and 9 females aged in ranged of 20–55–year–old. The majority complained painless swelling (9 subjects, 39.1%) for less than 2 years (12 subjects, 52.2%). The most factor found to be related was tooth extraction (8 subjects, 34.8%), following removal of teeth cyst (6 subjects, 26.1%). The most x–ray finding of panoramic view was multilocular (19 subjects, 82.6%) and the most surgical procedure preceded was partial resection of hemi–mandibulectomy (17 subjects, 73.9%). The most histopathological finding was follicular type (8 subjects (34.8%). Morbidity rate was 21.7%, no mortality. The most complication found was plate exposed (3 subjects, 13.08%). Median length of stay was 9 days (ranged of 7–26 days). There was no recurrence found in this study for 1–year postoperative follow–up. No significance relation between characteristics and complication. Conclusion. The postoperative recurrence rate of mandibular ameloblastoma might be be minimized by a wide excision beyond safety margin.
Clinical Presentation of Abdominal Tuberculosis Putranto, Agi S.; Bakti, Purnama S.; Mazni, Yarman; Jeo, Wifanto S.; Lalisang, Toar JM.
The New Ropanasuri Journal of Surgery
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Introduction. Nowadays, tuberculosis remains an issue of global. It may have affected all gastrointestinal organs, including peritoneum. Thus, diagnostic approach of this abdominal tuberculosis remains challenging as it may present non–specific features and mimics other abdominal pathologies. A study focused on clinical and laboratory findings, imaging and evaluation of management of those diagnosed as abdominal tuberculosis was required. Method. A cross–sectional study proceeded retrospectively aimed for an evaluation. All abdominal tuberculosis managed in dr Cipto Mangunkusumo General Hospital, Jakarta and Fatmawati General Hospital, Jakarta during January 2011 to December 2013 were enrolled. Data collected from data registration, subject’s characteristic, clinical findings, laboratory findings, and imaging were variables subjected to analysis. Results. There were forty–eight subjects recorded. The most symptoms found were abdominal pain (81.25%), abdominal distention (72.9%), fever (68.75%) and weight loss (68.75%). While as most laboratory findings were leukocytosis (52%) and elevated erythrocyte sedimentation rate, ESR (72.9%). And up to 50% subject showed normal chest x–ray while as other showed non–specific features for pulmonary tuberculosis. Conclusion. Clinical presentations showed to be diverse. Laboratory finding, and imaging maybe valuable to diagnose abdominal tuberculosis, although chest x–ray represents non–specific features for pulmonary tuberculosis. Evaluation of these clinical findings and lead to accurate diagnostic approach; which was determine the characteristics associated with abdominal tuberculosis diagnostics value..
Hepatic Reperfusion Injury following Remote Ischemia: Experimental Study on Oryctolagus cuniculus Maulanisa, Sinta C.; Moenadjat, Yefta; Kekalih, Aria
The New Ropanasuri Journal of Surgery
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Introduction. Ischemia/reperfusion (I/RI) injury following limb ischemia is realized to be responsible for remote organs injury which is found in vary, commence with mild injury to a severe one. Nevertheless, liver is an organ susceptible to such an injury. There were studies on I/RI, where ischemia in those studies were induced by direct ligation of hepatic vessels. However, study of remote ischemia was infrequently found. Thus, we run a study aimed to find out hepatic injury following ischemia induced by ligation of an artery with a significant anatomical distance. Method. An experimental study was conducted on New Zealand white rabbit. Ischemia was induced by ligation of right common femoral artery under anesthesia. Ligation was maintained for four hours period. Afterwards, ligation was released, and rabbit was set free in the cage for eight hours period. Laparotomy was carried out to take liver specimens of three different area, namely central, midzonal, and peripheral. These specimens were subjected to study histopathology and biochemical examination for malondialdehyde as well as HIF–1α. In addition, liver function test was carried out for serum bilirubin and transaminases. Results. The study on histomorphologyshowed hepatic injury of central, midzonal and peripheral of the ischemic/reperfusion injury group, which was mostly sinusoidal dilatation. There was a significant statistical different of the three hepatics–zones (central, p = 0.028, midzonal, p = 0.012, and peripheral, p = 0.030). MDA levels showed a significant increase in the ischemic/reperfusion group (p = 0.012, sig α <0.05). Tissue HIF–1α level increased denoted tissue hypoxia in the treatment group. Liver function test showed no abnormality. Conclusion. Oxidative stress and sinusoidal changes were found in three zones, i.e. central, midzonal and peripheral following ischemic of a significant anatomical distance.
Triple Diagnostic Accuracy on Early Stage Breast Cancer at dr. Cipto Mangunkusumo and Persahabatan General Hospital Kartini, Diani; Megatia, Ika; Darmiati, Sawitri; Rustamadji, Primariadewi; Budiningsih, Setyawati
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Introduction. Breast cancer is the most common cancer in Indonesia with incidence rate 40.3 per 100.000 women and mortality rate 16.6 per 100.000women. On early stage, the decision for operative procedure (i.e. mastectomy) requires intraoperative frozen section to assess malignancy; which is mostly unavailable in secondary hospitals. The triple diagnostic (TD) test consists of physical examination, breast ultrasonography and fine needle aspiration biopsy is an accurate and simple preoperative diagnostic method that may solve the problem. The study aimed to find out conformance of the triple diagnostic to histopathology findings in those with breast lump where the malignancy was suspected. Method. A study of diagnostic accuracy conducted enrolling subjects with suspected malignant breast lump managed in dr Cipto Mangunkusumo General Hospital (RSCM) and Persahabatan Hospital (RSP) in period of February 2016 to August 2017 who met the criteria: those underwent preoperative triple diagnostic, intraoperative frozen section and histopathology examination. The conformance of TD and frozen section were compared to histopathology findings. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were the focuses of the study. Results. There were 33 subjects enrolled (prevalence of 4.3%), mean age of 49.6 years ± 10.9, were above 40 years (78.8%). Tumor size of 2–5 cm found in 63.6% subjects, and the most histopathology finding was invasive carcinoma (84.8%). Frozen section showed sensitivity of 96.8%, specificity of 100%, PPV of 100%, NPV of 66.7% and accuracy of 97.0%. TD showed sensitivity of 77.4%, specificity of 100%, PPV of 100%), NPV of 22.2% and accuracy of 78.8% (p = 0.016). Conclusion. Triple diagnostic reaches up to 78% accuracy on early stage breast cancer may be used secondary hospital in Indonesia whenever frozen section is unavailable.
CT Scan as A Diagnostic Modality of Gastrointestinal Stromal Tumor: A Systematic Review Mazni, Yarman; Robby, Rizky DK
The New Ropanasuri Journal of Surgery
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Introduction. Preoperative diagnosis of GIST is an important factor in the management. However, due to the rarity of the case, there is a controversy about the accuracy of CT scan as an accurate diagnostic tool. Therefore, a systematic review is required to find out the answer. Method. A review was conducted to find out evidence of the highest level regarding the accuracy of CT scan as a diagnostic modality of GIST. The study addressed to find out the sensitivity, specificity, positive and negative predictive values. A literature search carried out in database sites i.e. PubMed, ClinicalKey, ScienceDirect, and Cochrane using keywords “gastrointestinal stromal tumor” OR “GIST” AND “ultrasound” OR “CT scan” OR “MRI” AND “diagnostic” OR “imaging”. Systematic reviews, RCTs, cohort study, case report or series, studies in adults, published within the last ten years, and availability in full text were included. Correspondence, editorial, or commentary, and no histopathology data were excluded. The articles were critically appraised. The review proceeded in accordance with PRISMA. Results. Twelve studies were analyzed in the study. The sensitivity of CT scan was in range of 77.26–94.9%, specificity 77.2–100%, PPV 74.38– 100%, and NPV 68.32–81.2%. CT scan was found to be the modality of choice in establishing the diagnosis of GIST. Central necrosis, heterogenous enhancement, cavitation without lymphadenopathy were the features represented by CT scan. Conclusion. CT scan is the modality of choice in establishing diagnosis of uncomplicated GIST, with sensitivity and specificity of 94.9% and 100%, respectively. Other modalities were considered in advanced or GIST with metastasis.
Laparoscopic Approach in Correction of Adult Diaphragmatic Morgagni Hernia Mazni, Yarman; Prabowo, Andrio W
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Introduction. Adult diaphragmatic hernia of Morgagni is a very rare congenital anomaly. Therefore, to date there is no standard surgical techniques used in the management. Thus, a systematic review aimed to find the highest evidence in the management. Method. A systematic review conducted in accordance with PRISMA. Literature search proceeded on PubMed and ScienceDirect using keywords "diaphragmatic hernia of Morgagni in adult", and "treatment". These articles were reviewed and appraised for the study design used, enrolled samples, validation of results, etc. to find out the level of evidence. The analysis was focused on length of stay, the recurrence, and complications. Results. There were 15 articles reviewed. The transabdominal approach provides better exposure, short length of stays, and low complications. Laparoscopic has been used widely and replaces open surgery. The defect closure using mesh is indicated in large defect of ≥20 cm2 . The hernial sac is unnecessary to resect, with no complication such as seroma or recurrence. Conclusion. A laparoscopic approach referred to the method of choice in the management of adult diaphragmatic hernia of Morgagni. Unnecessary resection of hernial sac and tension free defect closure should be of one consideration.
Perianal Condyloma Acuminata: Factors that Contribute to the Recurrence Jeo, Wifanto S.; Sugiharto, Bobby; Kekalih, Aria
The New Ropanasuri Journal of Surgery
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Introduction. Condyloma Acuminata (CA) is the most common sexually transmitted disease caused by HPV with high recurrence rate up to 70%. Factors contribute to the recurrence such as age, site of predilection, previous treatment, HIV infection and sexual behavior were noted in perianal CA. To date the correlation of these factors to the recurrence remains unknown. Method. A cross sectional study was conducted. Patients with history of CA managed in clinic of surgery during period of January 2010 to June 2015 were reviewed. Subject characteristics, i.e. age, infected site, previous treatment, HIV infection and sexual behavior and recurrence were the variables of the study. Data collected from medical record were statistically analyzed. Significant correlation found if p value <0.05. Results. There were 48 subjects with the history of CA. On the analysis, age variable has a significant correlation with the recurrence p = 0.008 (OR = 5.83; 95% CI 1.66–20.56;). The recurrence was higher in productive age compared to non–productive age. Previous anal CA and high risk negative sexual behavior showed a higher recurrence risk than previous non–anal CA and positive sexual behavior (OR = 1.89 and 2.14, respectively). Conclusion. There was significant correlation between age and CA recurrence, anal CA and negative sexual behavior showing 1.89 and 2.14 times, respectively more likely to have recurrence (New Ropanasuri J Surg.2018;3(2):e218).

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