Medicine and Health Sciences Commons^™

Prognostic Factors Of Myasthenia Gravis Remission After Thymectomy At National Referral Hospital In Indonesia, Suprayitno Wardoyo, Winda J. Layardi

The New Ropanasuri Journal of Surgery

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 …

Quality Of Life And Its Associated Factors In Patients After Esophagectomy At A Single National Referral Center, Dogma H. Sirirui, Agi S. Putranto

The New Ropanasuri Journal of Surgery

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). …

Potential Of Tumor Cell Seeding And Clinical Impact On Percutaneous Breast Biopsy Tracks: A Literature Review, I G.N. Gunawan Wibisana, Muhammad Mirwan

The New Ropanasuri Journal of Surgery

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 …

Prognostic Factors For Mortality Of Pediatric Burn Injury In A National Tertiary Referral Center, Heru Angkoso, Aria Kekalih

The New Ropanasuri Journal of Surgery

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 …

Comparison Ultrasound-Guided Handheld Vacuum Assisted Breast Biopsy And Core Biopsy In Breast Cancer, Anak Agung Ngurah Bagus Satya Sueningrat, Mendy Mendy

The New Ropanasuri Journal of Surgery

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 …

Transplantation In Pediatrics Liver Failure Associated With Acute Hepatitis Of Unknown Etiology, Afid B. Putra, Agi S. Putranto, Muftah Risyaldi, Luthfian A. Nurachman

The New Ropanasuri Journal of Surgery

Introduction. On 5^th 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 …

The Correlation Between Premenopausal Estrogen And Estrogen Receptors In Breast Cancer, Ahmad Kurnia, Dedy Pratama, Muhammad Mirwan

The New Ropanasuri Journal of Surgery

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 …

The Potential Of Liquid For Breast Cancer: A Review, Sonar Soni Panigoro, Clarissa Kezia Yuella -

The New Ropanasuri Journal of Surgery

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 …

Surgical Intervention For Endobronchial Tuberculosis With Total Bronchial Occlusion: A Case Report, Muhammad A. Putra, Matthew Billy, Radhyaksa Ardaya, Rut Hp Ekasiwi, Sari Rahmawati, Karel Hs Sumarsudi

The New Ropanasuri Journal of Surgery

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 …

An Unusual Case Of Perforated Appendicitis In Situs Inversus Totalis In Indonesia, Valencia J. Martin, Imanuel T. Parinding

The New Ropanasuri Journal of Surgery

Situs inversus is a rare congenital anomaly where the internal organs are transposed in a mirror image. It is commonly unrecognized until a patient comes with a complaint, especially in developing countries where people do not have a routine medical checkup. We report a case of a young female with unusual left lower quadrant pain abdominal pain. Perforated appendicitis leading to peritonitis was confirmed using ultrasonography and successfully treated with laparotomy. Appendicitis should be considered a working diagnosis in lower left quadrant abdominal pain

Review: Conventional Thrombectomy With Intraoperative Fluoroscopy In Acute Limb Ischemia Rutherford Iib, Heru Angkoso, Dedy Pratama

The New Ropanasuri Journal of Surgery

Introduction. Acute limb ischemia (ALI) is a severe condition affecting the extremities and the patient’s survival that requires immediate treatment. It can be treated with either surgical or endovascular revascularization or both (hybrid procedure). It is crucial to evaluate the defect using intraoperative fluoroscopy or angiography in each case. The review aimed to find out the outcomes of the thrombectomy with intraoperative fluoroscopy for ALI Rutherford IIb.

Method. According to the PRISMA protocol, the literature search proceeded in online databases, i.e., Cochrane, Scopus, PubMed, and EBSCOhost, with no year limitation on the publication. All articles were screened and critically appraised. …

Effect Of Ischemia-Reperfusion Injury And Preconditioning On Lung Parenchyma After Acute Limb Ischemia, David Hutagaol, Dhama S. Susanti, Wuryantoro Soeharto, Muhammad A. Putra, Suprayitno Wardoyo, William Makdinata, Moira Setiawan

The New Ropanasuri Journal of Surgery

Introduction. Acute limb ischemia, a sudden decrease of perfusion to the extremities, can compromise the survival of the limbs. Medical intervention and surgery are often needed to return perfusion. However, reperfusion injury can trigger oxidative stress and inflammatory response, leading to local and remote tissue damage, such as the lungs, which increases morbidity and mortality. This research aims to study the effects of hypothermia and remote ischemic preconditioning (RIPC) on the lung parenchyma after being exposed to reperfusion after acute limb ischemia in rabbits.

Method. Eighteen New Zealand White rabbits were divided into three groups of 6. The …

Mini-Review: Omental Patch Repair Of Giant Perforated Peptic Ulcer, Ridho A. Syaiful, Muhammad F. Agustian

The New Ropanasuri Journal of Surgery

Introduction. A perforated giant peptic ulcer is an emergency that requires surgery. Closure of the perforation with an omental patch has been reported in several cases of perforated giant peptic ulcers. However, there is insufficient evidence regarding the option of preferred treatment. This review to discuss published reports of a perforated giant peptic ulcer closed with an omental patch that focused on the complications

Method. The literature search was conducted through the Cochrane, PubMed, Scopus, and EBSCO data sites. The articles obtained were screened for duplication, title, abstracts, and full-text based on inclusion and exclusion criteria.

Result: Two articles were …

Review: Partial Splenic Embolization Outcome On Liver Cirrhosis With Esophageal Varices, Raden Suhartono, Muhammad F. A Irsal

The New Ropanasuri Journal of Surgery

Introduction. Liver cirrhosis may be followed by complications such as esophageal varices for 30 days mortality rate up to 15-20%. Partial splenic embolism (PSE) or partial splenic embolization has been developed as a safe and effective alternative therapy for managing bleeding in esophageal varices. This study aims to determine the outcome of PSE in patients with liver cirrhosis with esophageal varices.

Method. In this review, the literature search proceeded on three online databases (Cochrane Library, MEDLINE (PubMed), and ScienceDirect) according to PRISMA protocol. Through selections, six articles were included, and all were the reports.

Results. Of six reports, three were …

Revascularization Techniques For Infra-Popliteal Peripheral Artery Disease In Diabetic Foot: A Literature Review, Raden Suhartono, Ghany H. Wijaya

The New Ropanasuri Journal of Surgery

Foot ulcers are one of the problems that are often encountered in uncontrolled diabetes mellitus. With diabetic peripheral neuropathy, the typical clinical symptoms of PAD (peripheral arterial disease) may be obscured, leading to critical limb ischemia (CLTI). Diabetes may accelerate atherosclerosis that diminishes blood flow in PAD—further, diabetic patients with PAD often enfaces infra-popliteal lesions and require revascularization. However, studies on revascularization techniques in infra-popliteal PAD remain minimal. We reviewed the literature on EBSCO, and PubMed focused on the revascularization techniques in PAD, namely: expanded polytetrafluoroethylene (ePTFE), saphenous vein graft (SVG), atherectomy, surgical revascularization first, revascularization with endovascular bypass, direct …

Graduated Compression Stockings For Deep Vein Thrombosis Prevention In Surgical Patients: A Systematic Review, Dedy Pratama, Satria M.H Simatupang

The New Ropanasuri Journal of Surgery

Introduction. Oral anticoagulant therapy is commonly used to prevent deep vein thrombosis (DVT). However, it might increase the risk of intraoperative and postoperative bleeding. Graduated compression stockings (GCS) reduced DVT risk, but there is a lack of supporting evidence. Thus, the study aimed to find the efficacy of GCS compared to the pharmacological method in high-risk surgical patients.

Method. Literature search proceeded in Cochrane, ClinicalKey, and PubMed. Using keywords graduated compression stockings" or "mechanic" or mechanical") and ("pharmacologic" or "oral anticoagulants" or "NOAC") and "comparison" and "prophylaxis" and ("DVT" or "deep vein thrombosis) and ("surgery" or "surgical").

Results …

Risk Of Upper Extremity Musculoskeletal Injury In Laparoscopy Training, Theddeus Oh Prasetyono, Christopher R. Andrian, Elisabet La Kinanthi

The New Ropanasuri Journal of Surgery

Introduction. The laparoscopy procedure still has an ergonomic burden that can increase the risk of musculoskeletal injury, especially in the upper extremity. Furthermore, the risk is compounded in laparoscopic training as the trainees have to repeat the same movements many times to achieve competencies. This study revealed the relation between the position and the risk of musculoskeletal injury in laparoscopy training.

Methods. A cross-sectional study on nine subjects was conducted during laparoscopy training. By fixing the table height at 77 cm, we measured the operator height and upper extremity positions to relate them to their VAS and DASH scores.

Results. …

Review: Management Of Complex Anal Fistula, Agi S. Putranto, Winda J. Layardi

The New Ropanasuri Journal of Surgery

Introduction. Complex anal fistula has a high postoperative recurrence rate and incontinence as well. There have been many emerging surgical techniques, but there are no new recommendations for managing complex anal fistula. One of the critical parameters in evaluating surgical technique outcomes is the recurrence rate and incontinence. This study describes postoperative results in recurrence rates and incontinence in various surgical techniques in managing complex anal fistula.

Method. This review commenced with literature searches on online databases, including Cochrane Library, MEDLINE (PubMed), ScienceDirect, and CINAHL (EBSCOhost).

Results. The study enrolled two RCTs, four systematic reviews, 14 retrospective and prospective studies, …

Serum Cea Level In Predicting Liver Metastases Of Colorectal Cancer Among Young Adult Patients, Ely S.P Sihotang, Agi S. Putranto

The New Ropanasuri Journal of Surgery

Introduction: Incidence and mortality of CRC are currently increasing in those under 50 years. The study aims to determine the predictive value of serum CEA levels as the liver metastases predictor of colorectal cancer (CRC) in young adults.

Methods: A cross-sectional study was conducted using secondary data (patient medical records) from 2015–to 2021. Patients aged <50 years who were diagnosed histopathologically with primary colorectal cancer at dr. Cipto Mangunkusumo General Hospital (CMGH) were recruited. We excluded patients with a history of other malignancies, who had undergone operative management for colorectal cancer, and preexisting liver disease. The outcome of this study is the cut-off of the CEA value obtained by the ROC curve and the sensitivity and specificity of the CEA value in predicting CR liver metastases.

Results: Out of 181 subjects enrolled, a total of 43.6% were female. Fifty-nine subjects (32.6%) had liver metastases. The CEA level of the metastases group was 208.1 (2.1–12503.2) ng/mL; this was much higher than the non-metastases group, which was 6.27 (0.8– 1099.4) …

False-Positive Serum Igm/Igg To Sars-Cov-2 In A Rare Pulmonary Neuroendocrine Carcinoma With Ocular Metastasis: A Case Report, Irandi P. Pratomo, Gatut Priyonugroho, Aris Ramdhani, Dian Zamroni, Thariqah Salamah, Yayi D.B Susanto, Ramdinal A. Zairinal, Annisa N. Witjaksono, Dita Aditianingsih, Jamal Zaini

The New Ropanasuri Journal of Surgery

The Coronavirus disease 2019 (COVID-19) pandemic impacts pulmonary cancer management since it shares similar clinical features and creates fear among patients to visit hospitals due to possible in-hospital disease transmission. We report a patient who presented with a rare case of a pulmonary neuroendocrine tumor with an ocular involvement, which, unfortunately, experienced a delay in diagnostics. The first hospitalization was due to superior vena cava syndrome, pleural and pericardial effusions, and swollen left eye. The patient was diagnosed with pulmonary cancer, released after the symptoms were relieved, and expected to visit a referral hospital for further diagnostics and treatments. The …