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Jurnal Ilmu Bedah Indonesia
Published by Ikatan Ahli Bedah Indonesia
ISSN : -     EISSN : 27237494     DOI : https://doi.org/10.46800/ilmbed
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology
The Indonesian Journal of Surgery (JIBI) is a peer-reviewed and open access journal focuses on publishing journals in the scope of surgery. JIBI accepts any kind of manuscript(s) related to surgery, i.e. original article, meta–analysis, systematic review, comprehensive review, case report, serial cases, and also idea and innovation (selected ideas and innovations) regarding surgical diseases and conditions, surgical procedure, and basic science. JIBI also accept letter to editor and comment / and or response to a published manuscript with an opinion included. JIBI accept subject in the following fields of surgery: Pediatric Vascular Digestive Orthopedic Urology Neurosurgery Plastic Surgery Oncology Cardiothoracic
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Articles 12 Documents
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Search results for , issue "Vol. 43 No. 1 (2014): September 2014" : 12 Documents clear
Management of Sigmoid Cancer In dr Cipto Mangunkusumo Hospital during 2008–2011 Wahyu Sriningsih; Ibrahim Basir; Benny Philippi
Jurnal llmu Bedah Indonesia Vol. 43 No. 1 (2014): September 2014
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v43i1.67

Abstract

A retrospective analysis was performed to sigmoid cancer cases in the digestive surgery division of Cipto Mangunkusumo Hospital during the period of 2008–2011. Fifty–two cases were analyzed for metastases, stages and histopathology; mortality and morbidity were calculated for anastomotic leakage, 3–year survival, and incidence of local recurrence. Three–year survival analysis was performed using Kaplan–Meier based on staging and histopathology. The overall operative mortality was 1.9%, and the anastomotic leakage incidence was 8.1%. The incidence of local recurrence was 9.1%. The 3–year survival rates based on Dukes Staging were as follows: 100% survival for Dukes A, 95.5% for Dukes B and 61.1% for Dukes C and 0% for Dukes C. The 3–year survival rates in sigmoid cancer according to histopathology were 73.5% for well differentiated, 63.6% for moderately differentiated and 100% for poorly differentiated (sample size was one patient, could not be assessed), with 50% survival for mucinous histopathology. The overall survival in this sigmoid cancer study was 69.2%.
Perbandingan Gambaran Histopatologi Mukosa Kolon Tikus Putih (Rattus Norvegicus) Galur Wistar setelah Dilakukan Washout antara yang Menggunakan Nacl 0,9% dan Larutan Garam Meja 1% Lindayanti Tanzil; Rizki Diposarosa; Anglita Yantisetiasti
Jurnal llmu Bedah Indonesia Vol. 43 No. 1 (2014): September 2014
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v43i1.68

Abstract

Pendahuluan. Irigasi usus melalui rektum atau washout merupakan suatu prosedur menggunakan sebuah pipa yang dimasukkan melalui anus dan sejumlah cairan dimasukkan melalui pipa tersebut dengan tujuan untuk membersikan usus. NaCl 0,9% sering digunakan pada pasien–pasien penderita penyakit Hirschsprung sebagai cairan washout. Ada berbagai jenis cairan washout yang digunakan, beberapa diantaranya berupa cairan siap pakai yang dapat dibeli di apotek atau toko obat, cairan lainnya dapat dibuat di rumah yaitu larutan garam. Larutan garam ini dianggap sama dengan NaCl 0,9%. Larutan ini selain mudah dibuat dengan biaya yang relatif lebih rendah, tentu saja diharapkan efektivitasnya sama dengan NaCl 0,9%. Namun, garam yang beredar di Indonesia sebagian besar telah mengalami fortifikasi iodium.Tujuan penelitian ini untuk melihat perubahan histopatologi setelah dilakukan washout menggunakan larutan garam meja 1% dibandingkan dengan NaCl 0,9%. Metode. Penelitian ini merupakan penelitian eksperimental menggunakan 12 tikus Wistar yang terbagi dalam 2 kelompok yaitu kelompok yang dilakukan washout menggunakan NaCl 0,9% dan kelompok yang dilakukan washout menggunakan larutan garam meja 1%. Setelah kedua kelompok dilakukan washout, sampel jaringan diambil dari kolon kemudian dilakukan pemeriksaan histopatologi untuk melihat gambaran kongesti, edema dan inflamasi pada mukosa kolon tikus. Analisis statistik menggunakan Mann whitney dan Independent–T test, signifikan jika p<0,05. Hasil. Variabel kongesti, edema dan inflamasi pada kelompok NaCl 0,9% mempunyai skor rata–rata yang lebih tinggi dibandingkan kelompok larutan garam meja 1%. Berdasarkan hasil uji statistik tidak terdapat perbedaan yang bermakna antara kedua kelompok (kongesti p=0,065, edema p=0,306, inflamasi p=0,296. Kesimpulan. Tidak terdapat perbedaan histopatologi yang bermakna antara penggunaan NaCl 0,9% dan larutan garam meja 1% sebagai cairan washout
Pengaruh Sinbiotik terhadap Penurunan Kadar C-Reactive Protein Serum Pasca operasi pada Anak Appendisitis Komplikata Vita Indriasari; Bustanul Arifin Nawas; Dikki Drajat Kusmayadi; Rizki Diposarosa
Jurnal llmu Bedah Indonesia Vol. 43 No. 1 (2014): September 2014
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v43i1.69

Abstract

Background. Appendicitis is the most common cause of acute abdomen in children. Complicated appendicitis due to perforation associated with high morbidity. Several perioperative conditions fascilitated systemic inflammation and postoperative infectious complication. Synbiotic has a potential effect on reducing inflammatory response which reflected with lower serum c-reactive protein (CRP) level, so that the infectious complication could be avoided. Aim.This study aimed to observe the effect of synbiotic on postoperative serum CRP level reduction in children with complicated appendicitis. Method. A randomized double blind study was done in 26 children with com- plicated appendicitis. The subjects were divided into synbiotic and placebo groups. Synbiotic was given 1 time preoperatively and continued 5 days afer surgery. Serum CRP level were examined preoperatively (CRP 0), postoperative day 1 (CRP 1), and 6 (CRP 6). Statistical analysis was done with Independent-t test (p<0,05 considered significan)t. Result. The mean age of the patients was 9,85 years. The onset of abdominal pain was 3,92 days. The mean reduction of CRP 0 –CRP 6 between synbiotic and placebo group was 65,21% ± 31,37 SD vs 78,29% ± 12,39 SD, p=0,073; and the mean reduction of CRP 1–CRP 6 was 73,54% ± 22,04 vs 74,56% ±17,58, p=0,897. Wound infection was lower in synbiotic group (7,69% vs 38,46%). Conclusion. There was no difference in postoperative serum CRP level reduction between synbiotic therapy and placebo in children with compli- cated appendicitis
Perubahan Volume Tumor, Jumlah Trombosit dan Kadar D–dimmer pada Karsinoma Payudara Lanjut Lokal Setelah Kemoterapi Neoadjuvan Fredy Rustomi Damanik; Maman Abdurahman; Kiki Akhmad Rizki
Jurnal llmu Bedah Indonesia Vol. 43 No. 1 (2014): September 2014
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v43i1.70

Abstract

Background. Locally advanced breast cancer places approximately 40–60% from all the new cases of breast cancer in developing countries. And this kind of breast cancer requires a combined therapy, i.e. chemotherapy, surgery and radiotherapy. Nowadays, the response of chemotherapy is evaluated from the reduction in tumor volume. There is also another parameter. Since half of patients with breast cancer show abnormalities of routine blood clotting factors, D–dimmer which is a fibrin degeneration product from vascular endothelial growth factor (VEGF) is used. There is an increase of plasma D–dimmer level among 86% of breast cancer patients. There is a strong relationship amongst serum VEGF and platelets count in breast cancer patient. Method. To analyze the correlation, we did an evaluation of the tumor volume, platelets count, and plasma D– dimmer among patients with locally advanced breast cancer, before and after cyclophospamide, doxorubicin, 5–fluorouracil (FAC) combined neoadjuvant chemotherapy. This was a prospective study enrolling 36 subjects. The data is obtained from the history, physical examination, laboratory and or radiological exams as it found in medical record. To have a normal distribution of the subjects, a Shapiro–Wilk test was done. Pearson correlation test was applied in evaluation of the relationship of tumor volume, platelet count and plasma D–dimmer level after chemotherapy. Data was analyzed using the SPSS program ver.19. Results. Tumor volume decreases till 153.811 cm3, the platelet level decreased till 4,958.333/mm3 and the plasma D–dimmer level also decreased up to101.389 ng/ml after FAC regimen. A significant relationship was found in platelet counts and tumor volume after chemotherapy with r of 0,391 (p=0,018). The relationship amongst the change in platelet level and plasma D–dimmer level showed a plateau which is quiet high with the value of r=0,473 (p=0,024). Conclusion. There is a positive correlation of the tumor volume, the platelet level, and plasma D–dimmer level after combined FAC neoadjuvant chemotherapy
Validitas Kombinasi Pemeriksaan Klinis dan Biopsi Aspirasi Jarum Halus Dalam Menegakkan Diagnosis Tumor Payudara Palpabel Yusuf Heriady; Dimyati Achmad; Henky Hartono
Jurnal llmu Bedah Indonesia Vol. 43 No. 1 (2014): September 2014
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v43i1.71

Abstract

Latar Belakang. Pasien dengan tumor payudara palpabel yang datang berobat memerlukan diagnosis cepat dan akurat untuk membedakan tumor tersebut ganas atau jinak serta lebih menguntungkan secara finansial dibandingkan biopsi terbuka melalui prosedur operatif. Prosedur triple test yang terdiri dari pemeriksaan klinis payudara, mammografi dan biopsi aspirasi jarum halus, memberikan hasil akurasi diagnosis yang baik. Namun pada kenyataannya tidak semua rumah sakit terutama rumah sakit di daerah memiliki fasilitas mammografi. Untuk menegakkan diagnosis tumor payudara palpabel di rumah sakit daerah dilakukan pemeriksaan klinis payudara dan biopsi aspirasi jarum halus. Penelitian ini dilakukan untuk menilai akurasi kombinasi dua pemeriksaan yaitu pemeriksaan klinis payudara dan biopsi aspirasi jarum halus dalam menegakkan diagnosis tumor payudara palpabel. Metode. Dilakukan penelitian prospektif pada 393 pasien tumor payudara palpabel, dengan melakukan pemeriksaan klinis payudara, biopsi aspirasi jarum halus dan biopsi terbuka dengan pemeriksaan histopa- tologi sebagai pemeriksaan baku emas di RSUD dr Soedarso Pontianak, Kalimantan Barat selama 7 tahun (2006–2013). Hasil. Pemeriksaan klinis payudara menunjukkan sensitivitas 90,8%, spesifisitas 92,8%, nilai duga positif 95,2% dan akurasi 91,6%. Pemeriksaan biopsi aspirasi jarum halus menunjukkan sensitivitas 97.5%, spesifisitas 99,4%, nilai duga positif 99,6%, dan akurasi 98,2%. Pada kombinasi dua pemeriksaan yang keduanya positif (konkordan), menunjukkan sensitivitas 97,7%; spesifisitas 99,3%; nilai duga positif 99,5%, dan akurasi 98,3%. Likelihood ratio atau rasio kemungkinan positif/ RK+ sebesar 139,5 dan RK negatif /RK– sebesar 0,02. Kesimpulan. Akurasi dua pemeriksaan bila ke dua pemeriksaan positif (konkordan) dalam mendiagnosis tumor payudara palpabel adalah 98,3%. RK+ sebesar 139,5 dan RK negatif /RK– sebesar 0,02. Berdasarkan hasil penelitian ini, kombinasi dua pemeriksaan dapat direkomendasukan sebagai alat diagnosis alternatif untuk mendiagnosis tumor payudara palpabel
Analisis Faktor Prediksi Keberhasilan Traksi Servikal Berdasarkan Tercapainya Realignment Tulang Servikal Pada Evaluasi Foto Polos Servikal Lateral Serial Pasien Dengan Cedera Tulang Servikal Subaksial Ahmad Faried; Muhammad Zafrullah Arifin; Rully Hanafi Dahlan; Firman Priguna Tjahjono; Agung Budi Sutiono
Jurnal llmu Bedah Indonesia Vol. 43 No. 1 (2014): September 2014
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v43i1.72

Abstract

Pendahuluan. Cedera tulang servikal merupakan cedera tulang belakang yang paling ditakuti, baik bagi dokter, pasien dan keluarganya. Semua pasien dengan cedera tulang servikal subaksial yang tidak stabil, harus segera dilakukan fiksasi menggunakan traksi servikal. Foto polos servikal lateral masih merupakan standar dalam menganalisis stabilitas stuktur tulang servikal dan masih memiliki nilai diagnostik tinggi dalam menge- valuasi keberhasilan traksi servikal pasien cedera tulang servikal. Keberhasilan traksi servikal dapat diprediksi dengan melihat tercapainya realignment tulang servikal berdasarkan evaluasi foto polos servikal lateral serial pada pasien cedera tulang servikal subaksial. Metode. Penelitian ini merupakan studi retrospektif yang dilakukan terhadap 30 pasien cedera tulang servikal subaksial yang masuk Unit Gawat Darurat (UGD) Rumah Sakit dr. Hasan Sadikin Bandung (RSHS) periode 2009–2013. Studi ini menggunakan metode statistik logistik regresi dengan kemaknaan berdasarkan nilai p < 0,05 dan confidence interval sebesar 95%. Hasil. Studi ini menunjukkan bahwa dari semua karakteristik pasien cedera servikal subaksial yang dilakukan traksi servikal (closed reduction), didapatkan interval kedatangan ke rumah sakit dan facet lock (FL) merupakan faktor utama suatu kegagalan traksi servikal. Interval kedatangan pasien ke RSHS pada keberhasilan traksi servikal bermakna signifikan secara statistik (p=0.015; 2–sided tail dengan Pearson's chi–square) dan distribusi FL pada keberhasilan traksi servikal bermakna signifikan secara statistik (p=0,001; 2 sided tail dengan fisher's exact test). Odds ratio untuk ada atau tidak adanya FL adalah 3,8 dengan 95% confidence interval 0.5–27.1; dengan p=0,001. Kesimpulan. Disimpulkan bahwa dalam penanganan dan terapi cedera servikal subaksial > 24 jam perlu di–informed concent–kan akan kegagalan upaya traksi, serta bilamana terdapat FL tidak perlu dilakukan suatu upaya traksi servikal (closed reduction) percobaan, melainkan harus langsung dilakukan terapi definitif (opened reduction) serta stabilisasi
Hubungan Gejala Klinis Dengan Tekanan Intraventrikuler Pada Hidrosefalus Akut Donny Argie; Muhammad Zafrullah Arifin; Achmad Adam; Akhmad Imron; Mirna Sobana; Agung Budi Sutiono
Jurnal llmu Bedah Indonesia Vol. 43 No. 1 (2014): September 2014
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v43i1.73

Abstract

Latar Belakang. Penelitian tentang gejala klinis atau tekanan intrakranial pasien pediatrik yang menderita hidrosefalus akut telah banyak dilakukan, tetapi penelitian yang menghubungkan antara gejala klinis dan tekanan intrakranial pasien pediatrik yang menderita hidrosefalus akut belum banyak dilakukan. Tujuan. Mengetahui hubungan antara gejala klinis dengan tekanan intraventrikuler pada pasien pediatrik penderita hidrosefalus akut. Metode. Penelitian prospektif analitik, dimana data diambil dari tanggal 1 Januari 2010 sampai dengan 17 Agustus 2013 di Departemen/ SMF Ilmu Bedah Saraf Fakultas Kedokteran Universitas Padjadjaran/ RSUP Dr. Hasan Sadikin Bandung. Hasil. Jumlah sampel pasien hidrosefalus akut, sebanyak 27 laki–laki (53%) dan 24 perempuan (47%). Penyebab hidrosefalus akut pada penelitian ini adalah neoplasma yaitu sebanyak 24 kasus (47%), dan infeksi 23 kasus (45%). Hasil uji secara statistik menunjukkan bahwa gejala klinis muntah dan penurunan kesadaran memiliki nilai yang bermakna dengan p<0.05 sedangkan nyeri kepala memiliki nilai yang tidak bermakna terhadap peningkatan tekanan intraventrikuler dengan nilai p >0.05. Kesimpulan. Gejala klinis muntah dan penurunan kesadaran mempunyai hubungan dengan tekanan tinggi intrakranial sehingga dapat digunakan sebagai deteksi dini pada pasien pediatrik penderita hidrosefalus akut yang dis- ebabkan oleh neoplasma maupun infeksi.
Efek Tindakan Bedah Terhadap Kadar Laktat Darah dan Glasgow Outcome Scale Penderita Hematoma Subdural Akut Traumatik Jefri Henky; Achmad Adam; Muhammad Zafrullah Arifin
Jurnal llmu Bedah Indonesia Vol. 43 No. 1 (2014): September 2014
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v43i1.74

Abstract

Pendahuluan. Hematoma subdural merupakan salah satu cedera otak lokal yang menyebabkan defisit neurologis, memiliki gejala sisa bahkan kematian. Hematoma subdural akut traumatik memicu iskemia serebri melalui peningkatan tekanan intrakranial akibat edema yang menyebabkan gangguan perfusi otak. Angka keberhasilan pengobatan dan perawatan hematoma subdural akut traumatik dinilai menggunakan Glasgow outcome scale yang sederhana, cepat dan mudah dilakukan. Metode. Studi akuasi eksperimental dengan one group pre–post test design dilakukan terhadap 40 penderita hematoma subdural akut traumatik yang masuk Unit Gawat Darurat RS Dr Hasan Sadikin Bandung periode Agustus–Oktober 2013. Penelitian ini menggunakan uji t–test berpasangan dan uji korelasi Spearman. Kemaknaan ditentukan berdasarkan nilai p<0,05 dan confidence interval sebesar 95%. Hasil. Hasil penelitian menunjukkan nilai rerata kadar laktat darah pra dan pasca bedah adalah 3,16+1,49 mmol/L dan 2,38+1,23 mmol/L, terdapat penurunan yang bermakna rerata kadar laktat pasca bedah (p<0,001). Uji korelasi Spearman didapatkan bahwa kadar laktat pra bedah memiliki korelasi negatif lemah dengan nilai glasgow outcome scale (r=–0,346; p = 0,026). Kesimpulan. Pemeriksaan kadar laktat darah pra dan pasca bedah dapat dipertimbangkan sebagai salah satu pemeriksaan rutin dalam menentukan kerusakan seluler dan nilai glasgow outcome scale akibat hematoma subdural akut traumatik
Laparoscopic Transperitoneal Approach for Vesicovaginal Repair : The First Experience in Hasan Sadikin Hospital Jumadi Santoso; Sawkar Vijay Pramod
Jurnal llmu Bedah Indonesia Vol. 43 No. 1 (2014): September 2014
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v43i1.75

Abstract

Background. Obstetric fistula is a severe and debilitating condition occurring throughout the developing world. Although there are no accurate data on the incidence and prevalence of the condition, the majority of vesicovaginal fistulas develop after obstetric procedure, with delayed labour accounting for 90% of cases. Several techniques are available for repairing the fistulas. Transperitoneal approaches give good results even for difficult posterior located fistulas, but are associated with increased morbidity compared with the transvaginal approach. We performed a laparoscopic repair and omentum interposition. The objective of this article is to report our first experience in transperitoneal laparoscopic repair of vesicovaginal fistula in Hasan Sadikin Hospital. Method. A 31–year–old female presented with vesicovaginal fistula after sectio caersaeran because of de- layed labour. After a failed trial of conservative treatment with catheter drainage, a transperitoneal laparoscopic repair was performed. Cystoscopy was performed initially to confirm the fistula location and for bilat- eral ureteric catheterization. A 4–port technique was performed with the patient in the position with her legs in lithotomy position. Without opening the bladder, the fistula tract was excised with separation of the bladder from the anterior vagina wall. Both the bladder and vagina walls were then closed separately using intracorporeal suturing with an interpositional omentum. Results. Total operative time was 270 min. Normal diet was resumed on day 1, drain was removed on post operative day 1 and patient was discharged on the second day with an indwelling catheter. Food cosmetic result on wound operation and no leakage under cystogram after 2 weeks. The catheter was removed after 2 weeks. Conclusion. Laparoscopic transperitoneal repair of vesicovaginal fistula with omentum inteposition is feasible in Hasan Sadikin Hospital with good outcomes, short hospital days, and good cosmetics result. Still need more same cases before a final conclusion
Transperitoneal Laparoscopic Ureterolithotomy for Large Distal Ureteric Stone: The first Experience in Hasan Sadikin Hospital, Bandung Bacilius Agung Priyosantoso; Sawkar Vijay Pramod
Jurnal llmu Bedah Indonesia Vol. 43 No. 1 (2014): September 2014
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v43i1.76

Abstract

Background. Laparoscopic ureterolithotomy has become an alternative to open surgery for removing large stones that is not amenable to endoscopic treatment. In most of the published literature, laparoscopic ap- proach for lower ureteric stone is described to be less successful than middle and upper ureter. Identifica- tion in anatomical landmarks and exposing the distal ureter has been the major boundaries in establishing laparoscopic distal ureteral stone. We hope to provide clarity and feasibility that may increase our knowledge in laparoscopic ureterolithotomy for large distal ureteral stone. Aim. The obbjective is to share our experience in laparoscopic ureterolithotomy for large distal ureteric stone with transperitoneal approach Methods. A 37 years old male has been diagnosed with a right hydronephrosis due to proximal ureterolithiasis and stone at left calyx inferior, first and stone migrated to right distal ureter on 12 hours prior surgery. He underwent laparoscopic ureterolithotomy with transperitoneal approach. Results. We successfully perform laparoscopic ureterolithotomy with transperitoneal approach on a 37 y.o male patient who diagnosed with a a right hydronephrosis due to distal ureterolithiasis and stone at left calyx inferior. Duration of operation was 45 minutes. Patient was discharged at 2nd postoperative day without any complications. Conclusion. A Transperitoneal laparoscopic ureterolithotomy for distal ureteric stone is a safe and feasible technique that should be an options on every patients who plan to undergo distal ureterolithotomy especially large stone

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