Surgery Commons^™

The Survival Rate Of Colorectal Cancer In Dr. Cipto Mangunkusumo Hospital, Wifanto S. Jeo, Feyona H. Subrata

The New Ropanasuri Journal of Surgery

Introduction. Colorectal cancer (CC) is a malignancy with the third highest incidence and the second cause of death. 1.4 million new cases of colorectal cancer occurred in 2012, increasing to 1.8 million new cases in 2019, with almost 900,000 deaths caused by CC in the world. In Indonesia, there were 30,017 new cases of CC in 2019, with fatalities reaching nearly 16,000 cases. There are differences in the survival rates of the CC between developed countries and Indonesia. This study aims to determine the survival rate of CC patients in Indonesia.

Method. A retrospective cohort study design with …

The Efficiency Of Well-Written Manuals Aided-Hand Knotting Skills Acquisition For Undergraduates, Theddeus O.H Prasetyono, Putri Rezkini

The New Ropanasuri Journal of Surgery

Introduction. Standard procedural skills training methods include tutorial, workshop, and feedback. Written manuals might add value to those standard methods; nevertheless, depends on how well they are composed. This research is aimed to evaluate the efficiency of well-written manuals of hand knotting skills in order to improve students’ procedural skills learning and competency.

Methods. This research was conducted through preliminary study to identify the assessor reliability and main study to evaluate the students’ scores for reef and surgeon’s knots using an objective structured assessment of technical skills (OSATS). Subjects’ preparedness and perception of the quality of the manuals …

The Application Of Bromelain Enzyme On Pig Skin To Be Used As Surgery Training Model, Theddeus O.H Prasetyono, Christopher R. Andrian, Elisabet L.A Kinanthi, Siti R.K Putri

The New Ropanasuri Journal of Surgery

Introduction. Postmortem changes in pigskin made it difficult to be manipulated as a model for advanced technique in surgery training. The use of bromelain enzyme on these pigskins could be an alternative way to obtain the ideal surgery training model.

Method. Thirty-five pigskin-blocks (10×15cm) was divided evenly into seven groups consisted of six groups of different bromelain enzyme treatment (4g/20min, 4g/40min, 8g/20min, 8g/40min, 12g/20min, 12g/40min) and one group of control. Then five chief-plastic-surgery-residents blindly assessed and scored each pigskin and compared its likeliness to the back of human skin. The scores were then analyzed with an interrater reliability …

The Use Of Laparoscopy In Treatment Of Perforated Peptic Ulcer: A Literature Review, Alif R. Soeratman, Agi S. Putranto

The New Ropanasuri Journal of Surgery

No abstract provided.

Management Of Uncomplicated Stanford Type B Aortic Dissection : A Literature Review:, Zamzania A. Shalih, Akhmadu Muradi

The New Ropanasuri Journal of Surgery

No abstract provided.

Transanastomotic Feeding Tube In Surgical Management Of Congenital Duodenal Obstruction: Case Series, Hardian Gunardi, Asri D. Rachmawati, Nanok E. Susilo, Riana P. Tamba

The New Ropanasuri Journal of Surgery

Introduction. Prolonged fasting is a major concern in the postoperative management of congenital duodenal obstruction. Massive dilatation of the proximal segment would lead to diameter discrepancy and lack of propulsion, thus delaying enteral feeding. A transanastomotic feeding tube is an option to deliver early enteral feeding after surgical correction. The study evaluates the effectiveness and safety of a transanastomotic feeding tubes in the surgical management of congenital duodenal obstruction.

Method. The transanastomotic feeding tube's effectiveness in cases of congenital duodenal obstruction of the newborn underwent surgical correction was evaluated. Those managed from January 2016 to December 2018 at …

Final Outcome Of Hybrid Laparoscopic For Colorectal Cancer: A Literature Review, Dyan Novitalia, Yarman Mazni

The New Ropanasuri Journal of Surgery

No abstract provided.

Academic Atmosphere In Training Program Of Surgery, Yefta Moenadjat

The New Ropanasuri Journal of Surgery

No abstract provided.

Analysis Of Preoperative And Intraoperative Risk Factors Of Surgical Site Infection In Gastrointestinal Surgeries, Annisa Syafitri, Yarman Mazni, Setyawati Budiningsih

The New Ropanasuri Journal of Surgery

Introduction. Surgical site infection (SSI) after gastrointestinal surgery can affect the mortality and morbidity of the patients. Risk factors are needed to prevent and decrease the number of SSI. This study investigated the incidence of SSI, the preoperative and intraoperative risk factors of gastrointestinal surgeries..

Method. A retrospective audit analysis of age, nutritional status, preoperative length of stay, length of surgery, type of surgery, degree of contamination in adult gastrointestinal surgery patients at dr. Cipto Mangunkusumo General Hospital from 2012 to 2016. Outcomes consisted of incidence, and potential univariate risk factors were determined to investigate the independently associated …

External Validation Of 10 Points Intraoperative Gallbladder Scoring System (G10) In Laparoscopic Cholecystectomy At Rsupn Dr. Cipto Mangunkusumo, Yarman Mazni, Wifanto Saditya Jeo, Rony -

The New Ropanasuri Journal of Surgery

Introduction. Laparoscopic cholecystectomy has become a standard treatment for symptomatic cholecystolithiasis in dr. Cipto Mangunkusumo Hospital (RSCM). This study aims as a preliminary study to externally validate the 10-point intraoperative gallbladder scoring system (G10), an assessment system of laparoscopic cholecystectomy's difficulty.

Method. A cross-sectional study was carried out. Enrolling subjects who underwent laparoscopic cholecystectomy from January 2019 to December 2019. Data of the subjects were collected from medical records. We assessed each of the subjects' G10 scores and operation techniques based on the intraoperative images and surgical reports. The surgical technique divided into two groups, those are the …

Pulling Heart Strings: Quality Improvement Algorithm For Temporary Epicardial Pacing Wire Removal Post Cardiac Surgery, Jessica Norman

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The placement of temporary epicardial pacing wires (TEPW) is considered standard practice post cardiac surgery and is dependent on the patient’s cardiac function intra-operatively and their electrophysiologic profile after weaning from cardiopulmonary bypass (Reade, 2007; Elmistekawy et al, 2016). Complications associated with TEPW removal include myocardial damage, infection, perforation, tamponade, disruption of anastomoses, ventricular arrythmias, and death (Bojar, 2009; Carroll et al, 1998;Timothy & Rodeman, 2004). Currently there is no standard practice on the removal of TEPW and there is wide variation in removal practices involving patients who are routinely on medications such as dual antiplatelet therapies and systemic anticoagulation. …

Local Injections Of Β-Ngf Accelerates Endochondral Fracture Repair By Promoting Cartilage To Bone Conversion., Kevin O. Rivera, Fabrizio Russo, Ryan M. Boileau, Ryan E. Tomlinson, Theodore Miclau, Ralph S. Marcucio, Tejal A. Desai, Chelsea S. Bahney

Department of Orthopaedic Surgery Faculty Papers

There are currently no pharmacological approaches in fracture healing designed to therapeutically stimulate endochondral ossification. In this study, we test nerve growth factor (NGF) as an understudied therapeutic for fracture repair. We first characterized endogenous expression of Ngf and its receptor tropomyosin receptor kinase A (TrkA) during tibial fracture repair, finding that they peak during the cartilaginous phase. We then tested two injection regimens and found that local β-NGF injections during the endochondral/cartilaginous phase promoted osteogenic marker expression. Gene expression data from β-NGF stimulated cartilage callus explants show a promotion in markers associated with endochondral ossification such as Ihh, Alpl, …

Does Early Surgery Prevent Postoperative Icu Admission After Surgery For The Fracture Of The Hip. Nested Case Control Study Of 911 Patients, Obada Hasan, Laraib Mazhar, Umar Rabbani, Amna Rabbani, Fatima Mahmood, Shahryar Noordin

Department of Medicine

Introduction: Since most hip fractures are treated surgically, it is imperative to find an optimum fracture-to-surgery time to decrease the potential complications and enhance postoperative outcomes. In comparison to the vast plethora of literature available on surgical delay and its implications on mortality, very little, if any, research is available on the impact of delayed surgery on postoperative ICU admission. The primary objective of our study is to examine the factors influencing post-surgical ICU admission in order to work on preventive strategies to reduce the potential associated morbidity.
Material and methods: Investigators did a nested case control study in a …

A Case Of Carcinoid Heart Disease And Echocardiographic Findings, Brandon Alex, Jeffrey Songster, Helenmari L. Merritt, Rebecca A. Aron

Graduate Medical Education Research Journal

Abstract: Carcinoid heart disease occurs in approximately 50% of patients with carcinoid syndrome. Right heart involvement resulting in tricuspid regurgitation, tricuspid stenosis, pulmonic regurgitation and pulmonic stenosis is most common. We report a case of tricuspid heart disease resulting in tricuspid regurgitation, tricuspid stenosis, pulmonic regurgitation and pulmonic stenosis.

Does Breast Cancer Subtype Impact Margin Status In Patients Undergoing Partial Mastectomy?, Andrew Fenton, Elisabeth Dupont, Theodore Tsangaris, Carlos Garcia-Cantu, Marissa Howard-Mcnatt, Akiko Chiba, Adam Berger, Edward Levine, Jennifer Gass, Kristalyn Gallagher, Sharon Lum, Ricardo Martinez, Alliric Willis, Sonali Pandya, Eric A. Brown, Amanda Mendiola, Naveenraj Solomon, Maheswari Senthil, David Ollila, David Edmonson, Melissa Lazar, Jukes Namm, Fangyong Li, Meghan Butler, Noreen Mcgowan, Maria Herrera, Yoana Avitan, Brian Yoder, Laura L. Walters, Tara Mcpartland, Victor Haddad, Hongwei Ma, Ming Xie, Anees Chagpar

Conference Presentation Abstracts

BACKGROUND: Molecular subtype in invasive breast cancer guides systemic therapy. It is unknown whether molecular subtype should also be considered to tailor surgical therapy. The present investigation was designed to evaluate whether breast cancer subtype impacted surgical margins in patients with invasive breast cancer stage I through III undergoing breast-conserving therapy.

METHODS: Data from 2 randomized trials evaluating cavity shave margins (CSM) on margin status in patients undergoing partial mastectomy (PM) were used for this analysis. Patients were included if invasive carcinoma was present in the PM specimen and data for all 3 receptors (ER, PR, and HER2) were known. …

A Comparison Of 4-Year Total Medical Care Costs, Adverse Outcomes, And Opioid/Prescription Analgesic Use For 3 Knee Osteoarthritis Pain Treatments: Intra-Articular Hyaluronic Acid, Intra-Articular Corticosteroids, And Knee Arthroplasty., John Mackowiak, John T Jones, Vinod Dasa

School of Medicine Faculty Publications

To compare the medical costs associated with treatments for knee osteoarthritis (OA): intra-articular corticosteroids (ICS) and intra-articular hyaluronic acid (IHA) primarily, and ICS/IHA vs knee arthroplasty (TKA) secondarily. This was a retrospective analysis of an insurance claims database. Eligible members had diagnosed OA and no claims for ICS, IHA, or TKA during the 6–18-month look-back period. Cohorts of interest over the 4-year observation period were: patients who received ICS only, those who received IHA only, and those who received TKA only. Outcomes assessed included: (1) total allowed medical costs, (2) claims for pre-specified, treatment-related adverse outcomes and costs, and (3) …

International Evidence-Based Consensus Diagnostic And Treatment Guidelines For Unicentric Castleman Disease., Frits Van Rhee, Eric Oksenhendler, Gordan Srkalovic, Peter Voorhees, Megan Lim, Angela Dispenzieri, Makoto Ide, Sophia Parente, Stephen Schey, Matthew Streetly, Raymond Wong, David Wu, Ivan Maillard, Joshua Brandstadter, Nikhil Munshi, Wilbur Bowne, Kojo S Elenitoba-Johnson, Alexander Fössa, Mary Jo Lechowicz, Shanmuganathan Chandrakasan, Sheila K Pierson, Amy Greenway, Sunita Nasta, Kazuyuki Yoshizaki, Razelle Kurzrock, Thomas S Uldrick, Corey Casper, Amy Chadburn, David C Fajgenbaum

Department of Surgery Faculty Papers

Castleman disease (CD) includes a group of rare and heterogeneous disorders with characteristic lymph node histopathological abnormalities. CD can occur in a single lymph node station, which is referred to as unicentric CD (UCD). CD can also involve multicentric lymphadenopathy and inflammatory symptoms (multicentric CD [MCD]). MCD includes human herpesvirus-8 (HHV-8)-associated MCD, POEMS-associated MCD, and HHV-8-/idiopathic MCD (iMCD). The first-ever diagnostic and treatment guidelines were recently developed for iMCD by an international expert consortium convened by the Castleman Disease Collaborative Network (CDCN). The focus of this report is to establish similar guidelines for the management of UCD. To this purpose, …

Congenital Nasal Pyriform Aperture Stenosis Repair: A Case Series And Discussion Of Postoperative Care, Harper L. Wilson, Nicholas Van Maele, Kenneth C. Iverson

Otolaryngology--Head & Neck Surgery Faculty Publications

Congenital nasal pyriform aperture stenosis (CNPAS) is a rare condition related to holoprosencephaly in which bony overgrowth of the medial nasal process of the maxilla narrows the pyriform aperture. CNPAS presents in neonates with signs of upper airway obstruction ranging from mild to severe respiratory distress and failure to thrive. Surgical intervention is indicated after failed conservative measures and generally includes temporary stent placement. We report a series of 3 cases of CNPAS treated surgically, examine postoperative care recommendations in the literature, and present a comprehensive postoperative care regimen with a novel method to maintain stent patency.

Risk Of Mechanical Thrombectomy Recanalization Failure: Intraoperative Nuances And The Role Of Intracranial Atherosclerotic Disease, Joshua H. Weinberg, Ahmad Sweid, Ashlee Asada, Rawad Abbas, Keenan Piper, Daniel Joffe, Michael Reid Gooch, Stavropoula Tjoumakaris, Pascal Jabbour, Robert H. Rosenwasswer, Hekmat Zarzour

Department of Neurosurgery Faculty Papers

Objective: To present intraoperative observations that when recognized may facilitate the identification of patients at high risk of MT recanalization failure. We illustrate 4 cases of successful recanalization via rescue treatment with balloon angioplasty and/or stenting when such observations were noted. We also discuss the role of intracranial atherosclerotic disease in recanalization failure.

Patients and methods: We conducted a retrospective review of a prospectively maintained database for 450 stroke patients and identified 122 patients who underwent MT that failed to achieve recanalization. Operative notes were reviewed, and intraoperative nuances were discussed amongst neurointerventionalists.

Results: Intraoperative observations that may suggest a …

Increasing Nurse Knowledge Using A Formal Lung Transplant Education Program, Amy M. Stoddard, Donna Lynch-Smith, Kate Carlson Wrammert, Bobby Bellflower

Doctor of Nursing Practice Projects

This quality improvement project was completed to show that a formal lung transplant education course for nurses caring for lung transplant patients increased their knowledge. An eight-hour education course was developed by experts in the field of lung transplantation. A pretest was administered before the education course. A posttest was administered to determine if knowledge was improved. A three-month follow-up test was administered to determine knowledge retention. Based on the data analysis, nurse knowledge improved after formal education. Item analysis determined what areas of educational content need to be the focus of quarterly education. The education course was adopted as …