adeodatus handaya - Academia.edu (original) (raw)
Papers by adeodatus handaya
Annals of medicine and surgery, May 12, 2023
Introduction: Rectovaginal fistula (RVF) repair after failed primary repair is uncommon. Patients... more Introduction: Rectovaginal fistula (RVF) repair after failed primary repair is uncommon. Patients with RVF experience physiological and sexual dysfunction with a significantly high risk of intravaginal infection and sepsis. There are many surgical procedures available for RVF repair. We performed an improvised transvaginal repair technique. Methods: We report two cases of recurring RVF after failed primary repair. Patient 1 developed RVF because of a failed vaginoplasty due to cosmetic reasons, while patient 2 developed RVF because of a fourth-degree perineal rupture repair post-delivery. We used a combination of horizontal mattress and running suture with the addition of diverting colostomy. Both surgeries went successfully and there were no complications. Outcomes: RVF repair using a combination of horizontal mattress and running suture went successfully and there were no complications. Both patients were able to be discharged after a short stay. Long-term evaluation was done by physical and supporting examinations for 2–3 months. Both patients showed excellent wound healing and physiological function. Conclusions: The combination of a transvaginal horizontal mattress and running suture in the posterior to anterior fashion with diverting colostomy is a safe and effective procedure for recurring RVF repair.
Latar Belakang: Pasien pascaoperasi laparatomi dengan General Anestesi (GA) akan mengalami ganggu... more Latar Belakang: Pasien pascaoperasi laparatomi dengan General Anestesi (GA) akan mengalami gangguan sistem fisiologis pada system saraf pusat, sirkulasi dan respiratori akibat penggunaan agen anestesi. Hal ini dapat menimbulkan efek samping motilitas gastrointestinal dan muntah dan apabila berlangsung lebih dari 24 jam dan menyebabkan Ileus Post Operasi (IPO) jika terjadi lebih dari 4 hari disebut Prolonged (PIPO). PIPO yang tidak segera teratasi dapat menyebabkan nyeri, mual ,intoleran diet dan perpanjangan hari rawat sehingga meningkatan biaya Rumah sakit. Tujuan penelitian ini adalah untuk mengetahui pengaruh mengunyah permen karet terhadap perubahan frekuensi peristaltik usus pada pasien pascaoperasi laparotomi. Metode: Desain penelitian ini adalah quasi-experimental, pre and post test with control group. Penelitian ini dilakukan di RSUD. Banyumas Jawa Tengah , Indonesia dengan melibatkan 62 pasien pascaoperasi laparotomi. 31responden kelompok intervensi dengan mengunyah permen karet dan 31 responden kelompok kontrol dengan mobilisasi miring kanan dan kiri. Frekuensi peristaltik diukur menggunakan stetoskop dan Fetal doppler digital. Pengukuran outcome dilakukan 3 kali yakni setelah operasi selesai diruang pulih sadar, sebelum intervensi dan sesudah intervensi, intervensi dilakukan 3 kali yakni setelah pasien sadar penuh, 2 jam setelah sadar penuh dan diulang lagi 2 jam kemudian. Analisis data menggunakan uji wilcoxon dan Mann-Whithney. Hasil : Hasil uji wlcoxon menunjukkan terdapat perbedaan yang signifikan rerata frekuensi peristaltik masing-masing kelompok setelah intervensi dengan nilai p=0.000. Rerata peningkatan frekuensi peristaltik pada kelompok yang mengunyh permen karet lebih tinggi dibandingkan kelompok kontrol setelah intervensi (p<0.05). Terdapat perbedaan yang signifikan selisih frekuensi peristaltik setelah 3 kali intervensi antara kedua kelompok dengan penurunan lebih tinggi pada kelompok intervensi intervensi I (p=0,0040, intervensi II (p=0,002) dan intervensi III (p=0,001) Kesimpulan : Mengunyah permen karet efektif meningkatkan frekuensi pristaltik usus pada pasien pascaoperasi laparotomi. Background: Postoperative laparotomy patients with General Anesthesia (GA) will experience physiological system disorders in the central nervous system, circulation and respiration due to the use of anesthetic agents. Its can cause side effect on gastrointestinal motility and vomiting can last more than 24 hours and cause the Post Operative Ileus (IPO) if it occurs more than 4 days it called Prolonged (PIPO). PIPO which is not immediately resolved can cause pain, nausea, dietary intolerance and proonged treatment that increase the hospital costs. The study aims to determine the effect of chewing gum on the changes in the intestinal peristaltic frequency in postoperative laparotomy patients. Methods: The design of this study was quasi-experimental, pre and post test with control group. This study was conducted in RSUD. Banyumas, Central Java, Indonesia, involving 62 postoperative laparotomy patients. 31 interventiongroup with gum chewing, and 31 in control group with early mobilization. Peristaltic frequency was measured by a stethoscope and digital Fetal doppler. Outcome measurement was carried out 3 times, after the surgery was finished in the recovery room, before the intervention and after the intervention, the intervention was carried out 3 times after the patient was fully conscious, 2 hours after being fully conscious and repeated again 2 hours later. Data analysis using Wilcoxon and Mann-Whithney tests. Results: The results of the Wilcoxon test showed a significant difference in the mean peristaltic frequency of each group after the intervention (p=0.000). The mean increase in peristaltic frequency in intervention group was higher than the control group after the intervention (p<0.05). There were significant differences on the peristaltic frequency after 3 interventions between the two groups with higher decreases in the intervention group of intervention I (p=0.0040, intervention II (p=0.002) and intervention III (p=0.001) Conclusion: Chewing gum significantly increases the frequency of intestinal peristaltic in postoperative laparotomy patients
Clinical Nutrition, Sep 1, 2018
Medeniyet medical journal, Mar 27, 2023
Objective: To compare the Simple Nutrition Screening Tool (SNST) with other nutritional screening... more Objective: To compare the Simple Nutrition Screening Tool (SNST) with other nutritional screening tools [Nutrition Risk Screening 2002 (NRS-2002), Nutrition Risk index (NRI)], nutritional assessment parameters, and the Subjective Global Assessment (SGA) in surgical patients. Methods: A comparative observational study with a total of 122 surgical patients. Patients were assessed during the first 24 h of admission in the ward from January to July 2022 using the NRI, NRS-2002, SNST, body mass index (BMI), mid-upper arm circumferences (MUAC), albumin serum, hemoglobin level, total lymphocyte count (TLC), and SGA. Sensitivity, specificity and predictive values were calculated to evaluate NRI, NRS-2002, SNST, BMI, MUAC, albumin, hemoglobin, TLC compared to SGA. Results: The screening tools identified a high nutritional risk in surgical patients from 58.2%-72.1%. Meanwhile, about 29.5% to 71.3% was affected by malnutrition based on nutritional assessment tools. There were significant associations between the type of disease, the screening tools, the anthropometric parameters, albumin, TLC as well and SGA (p<0.05). The SNST has a good category among the nutritional screening tools with sensitivity and specificity >80%, as well as area under the curve >0.8. Conclusions: There were significant associations for screening (NRS-2002, SNST) and nutritional assessment tools (BMI, MUAC, albumin) compared with SGA. Both these tools can be used to determine the risk of malnutrition in surgical patients.
International Journal of Case Reports and Images, 2022
Jurnal Promkes
Background: The incidence of colorectal cancer (CRC) in Asia has kept increasing in the last deca... more Background: The incidence of colorectal cancer (CRC) in Asia has kept increasing in the last decade. The morbidity and mortality for CRC can be reduced with early detection; however, mass CRC screening with imaging modalities such as colonoscopy, CT scan, or MRI is unfeasible in developing countries such as Indonesia. Asia Pacific Colorectal Screening (APCS) is utilized to stratify individual CRC risk. Online screening via mobile application is an alternative method to ensure the continuity of community screening without risking COVID-19 transmission. Objective: We conducted a descriptive study to evaluate CRC risk using APCS in two different villages. Methods: This is a cross-sectional study involving 925 and 207 subjects in 2019 and 2020, respectively. The APCS survey in 2019 was done before the COVID-19 pandemic with paper-based questionnaires and direct assessment by door-to-door approach. Meanwhile, the APCS survey in 2020 was done during the COVID-19 pandemic using websites an...
Mutiara Medika: Jurnal Kedokteran dan Kesehatan, 2005
Asian Journal of Endoscopic Surgery, 2021
IntroductionDuring the coronavirus disease 2019 (COVID‐19) pandemic, digestive surgery potentiall... more IntroductionDuring the coronavirus disease 2019 (COVID‐19) pandemic, digestive surgery potentially exposes both health‐care professionals and vulnerable patients to COVID‐19. A survey was conducted with aim to determine the digestive surgery services provided during the COVID‐19 pandemic, optimize safety for patients and clinicians, and safeguard health‐care services.MethodsAn online survey was conceived and circulated to members of the Indonesian Society of Digestive Surgeons. The survey was conducted in two phases, in April 2020 and July 2020, to evaluate changes in response to the COVID‐19 pandemic.ResultsEarly in the pandemic (April 2020), the median number of major digestive surgeries performed monthly declined from 20 cases (range. 3‐100 cases) to 1 case (range. 0‐10 cases) (P < .001; Wilcoxon signed‐rank test). Most of the cases in April 2020 addressed emergency problems, but more definitive surgeries were performed during the later period of the survey. The importance of ...
Journal Of The Indonesian Medical Association, 2020
Digestive surgery service including surgical management of gastrointestinal disease and digestive... more Digestive surgery service including surgical management of gastrointestinal disease and digestive cancers are experiencing the impact of COVID-19 pandemic. Therefore it is necessary to formulate recommendation for digestives surgery service, as guidelines to engage in case-by-case assessment of particular patients with digestive diseases. We are aware that the knowledge and science of COVID-19 are still evolving, with new progression every day. This recommendation reflect actual condition and are subject for future adjustment in the future.
Annals of Coloproctology, 2017
Constipation is a digestive disorder that often occurs in the elderly; its main cause is bowel mo... more Constipation is a digestive disorder that often occurs in the elderly; its main cause is bowel motility disorder. Treatments for patients with chronic constipation include pharmacotherapy, diet changes, and surgery if other therapies do not offer satisfactory results. We describe 4 patients, 2 men (70 and 65 years old) and 2 women (75 and 66 years old), who were diagnosed with chronic constipation (slow transit constipation) and treated with conventional therapy, but did not improve. For that reason, side-to-side ileosigmoidostomy shunting surgery was performed. After the surgery, the average time until normal defecation was 16 days, and the defecation frequency was 3 to 4 times a day with no need for a laxative. No patient had a recurrence of constipation. Based on these results, side-to-side ileosigmoidostomy shunting surgery is expected to restore digestive function and can be considered as an alternative therapy for elderly patients with chronic constipation.
Annals of Coloproctology, 2018
Management of large-size retrorectal gastrointestinal stromal tumors (GISTs) is complex and chall... more Management of large-size retrorectal gastrointestinal stromal tumors (GISTs) is complex and challenging from diagnosis to treatment. This may create technical difficulties in surgical access and complete resection of the tumor. The abdominosacral resection has the benefit of improved visualization via the anterior incision, with enhanced exposure of the midrectal area, which makes resecting the tumor completely via the posterior approach easier. We report 2 cases of patients with a retrorectal GIST and neurofibromatosis type 1, one in a 27-year-old woman with a defecation complaint and the other in a 58-year-old woman with a defecation and urination complaint. Based on the anatomical pathology, both patients were diagnosed with a GIST. The tumors were excised via an abdominosacral resection. Retrorectal GISTs are rare, and abdominosacral resection allows complete resection of a large-size retrorectal GIST with low morbidity and an absence of functional impairment. The abdominosacral resection should be considered in certain situations.
Annals of Coloproctology, 2017
Because most surgeons perform an esophagectomy and colonic transposition as the main reconstructi... more Because most surgeons perform an esophagectomy and colonic transposition as the main reconstruction method for patients with esophageal stenosis caused by swallowing corrosive materials, we report 2 cases in which ileocolonic transposition was used to treat such patients. Both patients displayed stenosis in the middle third of the esophagus. Their chief complaint was dysphagia. Ileocolonic transposition using vascularization of the Drummond and ileal arteries was followed by a prepared ileocolic graft by ligating ileocolic vessels. We performed an ileocolonic transposition esophagogastric bypass without an esophagectomy. All surgeries resulted in minimal intraoperative bleeding. Patients experienced no leakage, postoperative fistulas, dysphagia, or postoperative reflux. Three weeks after surgery, 1 patient experienced reversible hoarseness caused by extensive laryngeal-nerve manipulation. Cumulatively, ileocolonic transposition with cervical anastomosis for the treatment of patients with esophageal stenosis caused by corrosive esophageal injury can be considered to be an antireflux treatment because the ileocaecal sphincter is maintained.
BMC Surgery
Background Mini laparotomy cholecystectomy (MLC) is an alternative surgical procedure in conditio... more Background Mini laparotomy cholecystectomy (MLC) is an alternative surgical procedure in conditions where laparoscopic cholecystectomy (LC) is not feasible. MLC is a simpler and easier technique compared to LC. MLC involves smaller skin incision, low morbidity rate, and early return to oral diet. MLC has the potential to be the preferred surgical technique in developing countries due to its low cost and availability. Method A cohort retrospective study was performed on 44 patients who underwent mini laparotomy cholecystectomy due to ineligibility for LC. Patients were documented for successful mini laparotomy or conversion to laparotomy cholecystectomy. There are pre-operative aspects recorded and analyzed to formulate predictor factors for conversion surgery, as well as intra-operative and post-operative aspects. Patients also filled evaluation questionnaire based on Likert Scale about their satisfaction towards result of MLC. Result MLC is performed in 31 (70.5%) patients while 13...
Annals of Medicine & Surgery
Medeniyet Medical Journal
Annals of Coloproctology, 2019
Anal stenosis is a late hemorrhoidectomy complication. Sphincterotomy and various anoplasty techn... more Anal stenosis is a late hemorrhoidectomy complication. Sphincterotomy and various anoplasty techniques are used for treatment severe anal stenosis, such as the C flap, House flap, U flap, and rotational S flap, but no procedure is ideal for every patient. We review 2 cases of severe circular anal stenosis. Their complaints included narrow caliber of the stool and feeling unsatisfied defecation. Excision of scar tissue using the circular technique was followed by reconstruction using the bilateral rotational S flap procedure. At the 1-year follow-up, the patient had complaints about neither defecation nor pain, and no longer needed laxative agents. In conclusion, the bilateral rotational S flap technique should be considered as a viable treatment because it can also prevent the occurrence of restenosis, especially given the consideration of adequate blood supply.
Open Journal of Gastroenterology, 2016
Introduction: Colorectal gastrointestinal stromal tumors (GISTs) mesenchymal tumor is very uncomm... more Introduction: Colorectal gastrointestinal stromal tumors (GISTs) mesenchymal tumor is very uncommon. GISTs effect mostly on the stomach and small intestine and rarely occur in the colon, rectum and esophagus, that originating from precursors of the interstitial cells that originate of Cajal. The symptoms of gastrointestinal stromal tumor depend on the site and size of the tumor, and may include abdominal pain, gastrointestinal bleeding or signs of obstruction; small tumors may, however, be asymptomatic. Some of the patients with gastrointestinal stromal tumor have bloody stools, obstruction and abdominal pain as the commonest manifestation. Immunocytochemical staining for CD117 is helpful in confirming the diagnosis. Case presentation: We report 3 new cases of GISTs: two occurred at the rectal and the other at descending Colon. Two cases are over 50 years of age and, and all cases the chief complain of bowel obstruction, abdominal pain in two cases, and one case with anemia and urine retention. All the patients were operated and were permormed pathology examinatiom. All case ware positive result for immunocytochemical staining CD117. All cases we had presented had size more than 5 cm are considered as unfavorable prognostic factors to Fletcher criteria, all patients scheduled for chemotherapy with Glivec but just one patient continued to used Glivec. Post surgery follows up one patient post milles with urinary incontinence complaints found and that patients are trained to CIC (intermittent catheterization). Conclusion: Colorectal gastrointestinal stromal tumors are very rare and can present as mass abdomen. Resection and chemotherapy are the treatment of choice.
Annals of medicine and surgery, May 12, 2023
Introduction: Rectovaginal fistula (RVF) repair after failed primary repair is uncommon. Patients... more Introduction: Rectovaginal fistula (RVF) repair after failed primary repair is uncommon. Patients with RVF experience physiological and sexual dysfunction with a significantly high risk of intravaginal infection and sepsis. There are many surgical procedures available for RVF repair. We performed an improvised transvaginal repair technique. Methods: We report two cases of recurring RVF after failed primary repair. Patient 1 developed RVF because of a failed vaginoplasty due to cosmetic reasons, while patient 2 developed RVF because of a fourth-degree perineal rupture repair post-delivery. We used a combination of horizontal mattress and running suture with the addition of diverting colostomy. Both surgeries went successfully and there were no complications. Outcomes: RVF repair using a combination of horizontal mattress and running suture went successfully and there were no complications. Both patients were able to be discharged after a short stay. Long-term evaluation was done by physical and supporting examinations for 2–3 months. Both patients showed excellent wound healing and physiological function. Conclusions: The combination of a transvaginal horizontal mattress and running suture in the posterior to anterior fashion with diverting colostomy is a safe and effective procedure for recurring RVF repair.
Latar Belakang: Pasien pascaoperasi laparatomi dengan General Anestesi (GA) akan mengalami ganggu... more Latar Belakang: Pasien pascaoperasi laparatomi dengan General Anestesi (GA) akan mengalami gangguan sistem fisiologis pada system saraf pusat, sirkulasi dan respiratori akibat penggunaan agen anestesi. Hal ini dapat menimbulkan efek samping motilitas gastrointestinal dan muntah dan apabila berlangsung lebih dari 24 jam dan menyebabkan Ileus Post Operasi (IPO) jika terjadi lebih dari 4 hari disebut Prolonged (PIPO). PIPO yang tidak segera teratasi dapat menyebabkan nyeri, mual ,intoleran diet dan perpanjangan hari rawat sehingga meningkatan biaya Rumah sakit. Tujuan penelitian ini adalah untuk mengetahui pengaruh mengunyah permen karet terhadap perubahan frekuensi peristaltik usus pada pasien pascaoperasi laparotomi. Metode: Desain penelitian ini adalah quasi-experimental, pre and post test with control group. Penelitian ini dilakukan di RSUD. Banyumas Jawa Tengah , Indonesia dengan melibatkan 62 pasien pascaoperasi laparotomi. 31responden kelompok intervensi dengan mengunyah permen karet dan 31 responden kelompok kontrol dengan mobilisasi miring kanan dan kiri. Frekuensi peristaltik diukur menggunakan stetoskop dan Fetal doppler digital. Pengukuran outcome dilakukan 3 kali yakni setelah operasi selesai diruang pulih sadar, sebelum intervensi dan sesudah intervensi, intervensi dilakukan 3 kali yakni setelah pasien sadar penuh, 2 jam setelah sadar penuh dan diulang lagi 2 jam kemudian. Analisis data menggunakan uji wilcoxon dan Mann-Whithney. Hasil : Hasil uji wlcoxon menunjukkan terdapat perbedaan yang signifikan rerata frekuensi peristaltik masing-masing kelompok setelah intervensi dengan nilai p=0.000. Rerata peningkatan frekuensi peristaltik pada kelompok yang mengunyh permen karet lebih tinggi dibandingkan kelompok kontrol setelah intervensi (p<0.05). Terdapat perbedaan yang signifikan selisih frekuensi peristaltik setelah 3 kali intervensi antara kedua kelompok dengan penurunan lebih tinggi pada kelompok intervensi intervensi I (p=0,0040, intervensi II (p=0,002) dan intervensi III (p=0,001) Kesimpulan : Mengunyah permen karet efektif meningkatkan frekuensi pristaltik usus pada pasien pascaoperasi laparotomi. Background: Postoperative laparotomy patients with General Anesthesia (GA) will experience physiological system disorders in the central nervous system, circulation and respiration due to the use of anesthetic agents. Its can cause side effect on gastrointestinal motility and vomiting can last more than 24 hours and cause the Post Operative Ileus (IPO) if it occurs more than 4 days it called Prolonged (PIPO). PIPO which is not immediately resolved can cause pain, nausea, dietary intolerance and proonged treatment that increase the hospital costs. The study aims to determine the effect of chewing gum on the changes in the intestinal peristaltic frequency in postoperative laparotomy patients. Methods: The design of this study was quasi-experimental, pre and post test with control group. This study was conducted in RSUD. Banyumas, Central Java, Indonesia, involving 62 postoperative laparotomy patients. 31 interventiongroup with gum chewing, and 31 in control group with early mobilization. Peristaltic frequency was measured by a stethoscope and digital Fetal doppler. Outcome measurement was carried out 3 times, after the surgery was finished in the recovery room, before the intervention and after the intervention, the intervention was carried out 3 times after the patient was fully conscious, 2 hours after being fully conscious and repeated again 2 hours later. Data analysis using Wilcoxon and Mann-Whithney tests. Results: The results of the Wilcoxon test showed a significant difference in the mean peristaltic frequency of each group after the intervention (p=0.000). The mean increase in peristaltic frequency in intervention group was higher than the control group after the intervention (p<0.05). There were significant differences on the peristaltic frequency after 3 interventions between the two groups with higher decreases in the intervention group of intervention I (p=0.0040, intervention II (p=0.002) and intervention III (p=0.001) Conclusion: Chewing gum significantly increases the frequency of intestinal peristaltic in postoperative laparotomy patients
Clinical Nutrition, Sep 1, 2018
Medeniyet medical journal, Mar 27, 2023
Objective: To compare the Simple Nutrition Screening Tool (SNST) with other nutritional screening... more Objective: To compare the Simple Nutrition Screening Tool (SNST) with other nutritional screening tools [Nutrition Risk Screening 2002 (NRS-2002), Nutrition Risk index (NRI)], nutritional assessment parameters, and the Subjective Global Assessment (SGA) in surgical patients. Methods: A comparative observational study with a total of 122 surgical patients. Patients were assessed during the first 24 h of admission in the ward from January to July 2022 using the NRI, NRS-2002, SNST, body mass index (BMI), mid-upper arm circumferences (MUAC), albumin serum, hemoglobin level, total lymphocyte count (TLC), and SGA. Sensitivity, specificity and predictive values were calculated to evaluate NRI, NRS-2002, SNST, BMI, MUAC, albumin, hemoglobin, TLC compared to SGA. Results: The screening tools identified a high nutritional risk in surgical patients from 58.2%-72.1%. Meanwhile, about 29.5% to 71.3% was affected by malnutrition based on nutritional assessment tools. There were significant associations between the type of disease, the screening tools, the anthropometric parameters, albumin, TLC as well and SGA (p<0.05). The SNST has a good category among the nutritional screening tools with sensitivity and specificity >80%, as well as area under the curve >0.8. Conclusions: There were significant associations for screening (NRS-2002, SNST) and nutritional assessment tools (BMI, MUAC, albumin) compared with SGA. Both these tools can be used to determine the risk of malnutrition in surgical patients.
International Journal of Case Reports and Images, 2022
Jurnal Promkes
Background: The incidence of colorectal cancer (CRC) in Asia has kept increasing in the last deca... more Background: The incidence of colorectal cancer (CRC) in Asia has kept increasing in the last decade. The morbidity and mortality for CRC can be reduced with early detection; however, mass CRC screening with imaging modalities such as colonoscopy, CT scan, or MRI is unfeasible in developing countries such as Indonesia. Asia Pacific Colorectal Screening (APCS) is utilized to stratify individual CRC risk. Online screening via mobile application is an alternative method to ensure the continuity of community screening without risking COVID-19 transmission. Objective: We conducted a descriptive study to evaluate CRC risk using APCS in two different villages. Methods: This is a cross-sectional study involving 925 and 207 subjects in 2019 and 2020, respectively. The APCS survey in 2019 was done before the COVID-19 pandemic with paper-based questionnaires and direct assessment by door-to-door approach. Meanwhile, the APCS survey in 2020 was done during the COVID-19 pandemic using websites an...
Mutiara Medika: Jurnal Kedokteran dan Kesehatan, 2005
Asian Journal of Endoscopic Surgery, 2021
IntroductionDuring the coronavirus disease 2019 (COVID‐19) pandemic, digestive surgery potentiall... more IntroductionDuring the coronavirus disease 2019 (COVID‐19) pandemic, digestive surgery potentially exposes both health‐care professionals and vulnerable patients to COVID‐19. A survey was conducted with aim to determine the digestive surgery services provided during the COVID‐19 pandemic, optimize safety for patients and clinicians, and safeguard health‐care services.MethodsAn online survey was conceived and circulated to members of the Indonesian Society of Digestive Surgeons. The survey was conducted in two phases, in April 2020 and July 2020, to evaluate changes in response to the COVID‐19 pandemic.ResultsEarly in the pandemic (April 2020), the median number of major digestive surgeries performed monthly declined from 20 cases (range. 3‐100 cases) to 1 case (range. 0‐10 cases) (P < .001; Wilcoxon signed‐rank test). Most of the cases in April 2020 addressed emergency problems, but more definitive surgeries were performed during the later period of the survey. The importance of ...
Journal Of The Indonesian Medical Association, 2020
Digestive surgery service including surgical management of gastrointestinal disease and digestive... more Digestive surgery service including surgical management of gastrointestinal disease and digestive cancers are experiencing the impact of COVID-19 pandemic. Therefore it is necessary to formulate recommendation for digestives surgery service, as guidelines to engage in case-by-case assessment of particular patients with digestive diseases. We are aware that the knowledge and science of COVID-19 are still evolving, with new progression every day. This recommendation reflect actual condition and are subject for future adjustment in the future.
Annals of Coloproctology, 2017
Constipation is a digestive disorder that often occurs in the elderly; its main cause is bowel mo... more Constipation is a digestive disorder that often occurs in the elderly; its main cause is bowel motility disorder. Treatments for patients with chronic constipation include pharmacotherapy, diet changes, and surgery if other therapies do not offer satisfactory results. We describe 4 patients, 2 men (70 and 65 years old) and 2 women (75 and 66 years old), who were diagnosed with chronic constipation (slow transit constipation) and treated with conventional therapy, but did not improve. For that reason, side-to-side ileosigmoidostomy shunting surgery was performed. After the surgery, the average time until normal defecation was 16 days, and the defecation frequency was 3 to 4 times a day with no need for a laxative. No patient had a recurrence of constipation. Based on these results, side-to-side ileosigmoidostomy shunting surgery is expected to restore digestive function and can be considered as an alternative therapy for elderly patients with chronic constipation.
Annals of Coloproctology, 2018
Management of large-size retrorectal gastrointestinal stromal tumors (GISTs) is complex and chall... more Management of large-size retrorectal gastrointestinal stromal tumors (GISTs) is complex and challenging from diagnosis to treatment. This may create technical difficulties in surgical access and complete resection of the tumor. The abdominosacral resection has the benefit of improved visualization via the anterior incision, with enhanced exposure of the midrectal area, which makes resecting the tumor completely via the posterior approach easier. We report 2 cases of patients with a retrorectal GIST and neurofibromatosis type 1, one in a 27-year-old woman with a defecation complaint and the other in a 58-year-old woman with a defecation and urination complaint. Based on the anatomical pathology, both patients were diagnosed with a GIST. The tumors were excised via an abdominosacral resection. Retrorectal GISTs are rare, and abdominosacral resection allows complete resection of a large-size retrorectal GIST with low morbidity and an absence of functional impairment. The abdominosacral resection should be considered in certain situations.
Annals of Coloproctology, 2017
Because most surgeons perform an esophagectomy and colonic transposition as the main reconstructi... more Because most surgeons perform an esophagectomy and colonic transposition as the main reconstruction method for patients with esophageal stenosis caused by swallowing corrosive materials, we report 2 cases in which ileocolonic transposition was used to treat such patients. Both patients displayed stenosis in the middle third of the esophagus. Their chief complaint was dysphagia. Ileocolonic transposition using vascularization of the Drummond and ileal arteries was followed by a prepared ileocolic graft by ligating ileocolic vessels. We performed an ileocolonic transposition esophagogastric bypass without an esophagectomy. All surgeries resulted in minimal intraoperative bleeding. Patients experienced no leakage, postoperative fistulas, dysphagia, or postoperative reflux. Three weeks after surgery, 1 patient experienced reversible hoarseness caused by extensive laryngeal-nerve manipulation. Cumulatively, ileocolonic transposition with cervical anastomosis for the treatment of patients with esophageal stenosis caused by corrosive esophageal injury can be considered to be an antireflux treatment because the ileocaecal sphincter is maintained.
BMC Surgery
Background Mini laparotomy cholecystectomy (MLC) is an alternative surgical procedure in conditio... more Background Mini laparotomy cholecystectomy (MLC) is an alternative surgical procedure in conditions where laparoscopic cholecystectomy (LC) is not feasible. MLC is a simpler and easier technique compared to LC. MLC involves smaller skin incision, low morbidity rate, and early return to oral diet. MLC has the potential to be the preferred surgical technique in developing countries due to its low cost and availability. Method A cohort retrospective study was performed on 44 patients who underwent mini laparotomy cholecystectomy due to ineligibility for LC. Patients were documented for successful mini laparotomy or conversion to laparotomy cholecystectomy. There are pre-operative aspects recorded and analyzed to formulate predictor factors for conversion surgery, as well as intra-operative and post-operative aspects. Patients also filled evaluation questionnaire based on Likert Scale about their satisfaction towards result of MLC. Result MLC is performed in 31 (70.5%) patients while 13...
Annals of Medicine & Surgery
Medeniyet Medical Journal
Annals of Coloproctology, 2019
Anal stenosis is a late hemorrhoidectomy complication. Sphincterotomy and various anoplasty techn... more Anal stenosis is a late hemorrhoidectomy complication. Sphincterotomy and various anoplasty techniques are used for treatment severe anal stenosis, such as the C flap, House flap, U flap, and rotational S flap, but no procedure is ideal for every patient. We review 2 cases of severe circular anal stenosis. Their complaints included narrow caliber of the stool and feeling unsatisfied defecation. Excision of scar tissue using the circular technique was followed by reconstruction using the bilateral rotational S flap procedure. At the 1-year follow-up, the patient had complaints about neither defecation nor pain, and no longer needed laxative agents. In conclusion, the bilateral rotational S flap technique should be considered as a viable treatment because it can also prevent the occurrence of restenosis, especially given the consideration of adequate blood supply.
Open Journal of Gastroenterology, 2016
Introduction: Colorectal gastrointestinal stromal tumors (GISTs) mesenchymal tumor is very uncomm... more Introduction: Colorectal gastrointestinal stromal tumors (GISTs) mesenchymal tumor is very uncommon. GISTs effect mostly on the stomach and small intestine and rarely occur in the colon, rectum and esophagus, that originating from precursors of the interstitial cells that originate of Cajal. The symptoms of gastrointestinal stromal tumor depend on the site and size of the tumor, and may include abdominal pain, gastrointestinal bleeding or signs of obstruction; small tumors may, however, be asymptomatic. Some of the patients with gastrointestinal stromal tumor have bloody stools, obstruction and abdominal pain as the commonest manifestation. Immunocytochemical staining for CD117 is helpful in confirming the diagnosis. Case presentation: We report 3 new cases of GISTs: two occurred at the rectal and the other at descending Colon. Two cases are over 50 years of age and, and all cases the chief complain of bowel obstruction, abdominal pain in two cases, and one case with anemia and urine retention. All the patients were operated and were permormed pathology examinatiom. All case ware positive result for immunocytochemical staining CD117. All cases we had presented had size more than 5 cm are considered as unfavorable prognostic factors to Fletcher criteria, all patients scheduled for chemotherapy with Glivec but just one patient continued to used Glivec. Post surgery follows up one patient post milles with urinary incontinence complaints found and that patients are trained to CIC (intermittent catheterization). Conclusion: Colorectal gastrointestinal stromal tumors are very rare and can present as mass abdomen. Resection and chemotherapy are the treatment of choice.