Wifanto Jeo | University of Indonesia (original) (raw)

Papers by Wifanto Jeo

Research paper thumbnail of A curious case of isolated pancreatic head tuberculosis treated with Whipple’s procedure

Annals of Hepato-Biliary-Pancreatic Surgery

Background: Isolated pancreatic Tuberculosis (TB) is a rare extrapulmonary TB, even in endemic re... more Background: Isolated pancreatic Tuberculosis (TB) is a rare extrapulmonary TB, even in endemic regions such as Indonesia, especially in an immunocompetent patient. Pancreatic head TB may present as an obstructive jaundice case with a pancreatic head mass suspected of malignancy. Methods: We report a curious case of pancreatic head TB in a 19-year-old male patient. Results: A 19-year-old male patient was referred to us with obstructive jaundice due to a pancreatic head mass that was suspected to be malignant. The patient underwent endoscopic retrograde cholangiopancreatography (ERCP) by internal medicine for biopsy and stent placement. The biopsy results showed atypical cells. The team proceeded with classic Whipple's procedure because malignancy cannot be ruled out. The final pathology result of the mass showed TB of the pancreatic head tissue. The patient did not have a history of TB before, and a complete TB workup by the pulmonary team did not suggest TB in any other organ. He was immediately started on anti-tuberculosis medicine after surgery with a good response. Conclusions: Isolated pancreatic head TB is rare and can be misdiagnosed as malignancy. A multidisciplinary approach is essential in diagnosing and managing such a curious case. In addition, as we are a high-volume center, the indications of Whipple's procedure have been extended to cases with unclear biopsy results or even benign diseases with good results.

Research paper thumbnail of Hepatic vascular anatomy and intrahepatic bile duct variation: Donor’s characteristic of liver transplantation in Indonesia

Annals of Hepato-Biliary-Pancreatic Surgery

Research paper thumbnail of Successful hiatal hernia repair with Nissen fundoplication by laparoscopic approach: a case report

Intisari Sains Medis, Dec 1, 2020

Background: Hiatus hernias represent a herniation of viscera, most commonly the stomach, into the... more Background: Hiatus hernias represent a herniation of viscera, most commonly the stomach, into the mediastinum through the esophageal hiatus of the diaphragm. There are two main classifications, sliding hernias and paraesophageal hernias. This case study aims to evaluate the successful hiatal hernia repair with Nissen fundoplication by a laparoscopic approach. Case Presentation: We present a case of a 60-year-old male who presented with recurrent abdominal discomfort 6 months prior to the consultation. This was accompanied by loose stools, bloating, nausea, and vomiting. An initial diagnosis of Gastroesophageal Reflux Disease (GERD) was made. Conservative treatment was initiated with limited success. Endoscopy was then performed, revealing a hiatal hernia. Surgical intervention was then chosen as a therapeutic option via a laparoscopic approach and additional Nissen fundoplication with favorable outcomes. Conclusion: Symptomatic paraesophageal hernias are indicated for surgical repair. Paraesophageal hernias can be repaired transthoracically and transabdominal. Repairs via the transabdominal route can be performed with an open approach or laparoscopically, with the laparoscopic approach suggesting lower mortality and morbidity. Nissen fundoplication has been proven as an effective measure in GERD's control and in maintaining an intraabdominal location of the gastroesophageal junction (GEJ).

Research paper thumbnail of Analysing 11 years of incidence trends, clinicopathological characteristics, and forecasts of colorectal cancer in young and old patients: a retrospective cross-sectional study in an Indonesian national referral hospital

BMJ Open

ObjectiveTo obtain annual incidence trends, understand clinicopathological characteristics, and f... more ObjectiveTo obtain annual incidence trends, understand clinicopathological characteristics, and forecast the future burden of colorectal cancer (CRC) in Indonesia.Design11-year retrospective cross-sectional study.SettingA national referral hospital in Jakarta, Indonesia.ParticipantsData from 1584 eligible cases were recorded for trends and forecasting analyses; 433 samples were analysed to determine clinicopathological differences between young (<50 years) and old (≥50 years) patients.MethodsTrend analyses were done using Joinpoint software, expressed in annual percentage change (APC), and a regression analysis was executed to generate a forecasting model. Patients’ characteristics were compared using χ2or non-parametric tests.Main outcomesAnalysis of trends, forecasting model, and clinicopathological features between the age groups.ResultsA significant increase in APC was observed among old patients (+2.38%) for CRC cases. Colon cancer increased remarkably (+9.24%) among young p...

Research paper thumbnail of Pedunculated hepatocellular carcinoma masquerading as a giant GIST: A case report

International Journal of Surgery Case Reports

Research paper thumbnail of Efficacy and Safety of Near-Infrared Florescence Cholangiography Using Indocyanine Green in Laparoscopic Cholecystectomy: A Systematic Review and Meta-Analysis

Journal of Laparoendoscopic & Advanced Surgical Techniques

Research paper thumbnail of Correlation between microsatellite instability and metachronous disease recurrence after endoscopic mucosal resection in patients with early stage gastric carcinoma

Cancer, 2001

Correlation between RAS gene mutation and microsatellite instabi lity (MSI) status in cancer tiss... more Correlation between RAS gene mutation and microsatellite instabi lity (MSI) status in cancer tissues and clinicopathological parameters of patients with stage Ⅲ colorectal cancer (CRC) were investigated. Tissues were collected from 180 patients diagnosed with stage Ⅲ CRC in the Department of Gastrointestinal Surgery of the Fourth Hospital of Hebei Medical University from 2012 to 2016. RAS gene mutations in paraffin sections were detected by PCR and Sanger sequencing. Expression of mismatch repair proteins MLH1, MSH2, MSH6 and PMS2 was detected by immunohistochemistry, and MSI status was determined based on the positive and negative expression combinations of the above proteins, and the correlation with clinicopathological parameters of CRC was analyzed. Mutation rates of KRAS and NRAS were 48.33% (87/180) and 2.78% (5/180), respectively. Mutation rate of p.G12D in codon 12 of exon 2 in KRAS gene was the highest (31/87, 35.63%). Mutation rate of p.G12D in codon 12 of exon 2 in NRAS gene was the highest (2/5, 40%). Mutation rate of KRAS gene in right colon was higher than that in left colon and rectum (p<0.05), and mutation rate in N2b phase was higher than that in N2a and N1 phases (p<0.01). In low degree of microsatellite instability (MSI-L) and high degree of microsatellite instability (MSI-H) status, negative MKH1 protein expression was dominant (18/32, 56.25%). MSI-H in CRC patients aged ≥50 years was higher than that of CRC patients <50 years. Rates of MSI-H in N1, N2a, and N2b were 1.75, 12.82, and 1.11% (p<0.05). Mutation rate of KRAS gene in MSI-H status of stage Ⅲ CRC patients was significantly higher than that in MSI-L/microsatellite stability (MSS) (p<0.05). Mutation of RAS gene and the status of MSI are involved in the occurrence and development of stage Ⅲ CRC. Detection of RAS gene has important significance for the individual treatment of CRC in clinic.

Research paper thumbnail of Perioperative evaluation of liver donor – An initial experience of the living donor liver transplant (LDLT) program in Indonesia

HPB, 2018

Overall survival curve of the study groups Introduction: Portal vein thrombosis (PVT) is a common... more Overall survival curve of the study groups Introduction: Portal vein thrombosis (PVT) is a common complication for patients with end-stage liver disease. The presence of PVT used to be a contraindication to LDLT. This is related to technical difficulties of PV reconstruction, increased blood loss, and the risk for postoperative PV complications. Methods: We reviewed the data of LDLT patients at Liver Transplantation Unit, Mansoura University, Egypt during the period between May 2004 till March 2017. Patients were divided into three groups. Group I: patients without PVT, Group II: attenuated PV patients (PV diameter <8 mm), and Group III PVT patients. Results: During the study period, 500 cases underwent LDLT. Group I included 446 patients (89.2%), Group II included 26 patients (5.2%), and Group III included 28 patients (5.6%). Higher incidence of hematemesis and encephalopathy was detected in Group III. Longer anhepatic phase duration was found in Group III. There were no significant differences regarding operation time, blood loss, and transfusion requirements. Higher incidence of postoperative vascular complications was found in Group III. The median OS was 33 months (4-169). The 1-, 3-, and 5years OS survival rates of Group I were 80.5%, 77.7%, and 75%, while for Group II were 84.6%, 79.6%, and 73.5%, and for Group III were 88.3%, 64.4%, and 64.4% respectively. There was no significant difference between the groups regarding OS rates (Log-Rank: 0.793). Conclusion: Preoperative PVT increases the complexity of LDLT operation and the operative trauma to the patient, but it does not reduce the OS rates.

Research paper thumbnail of Correlation Between Serum Level of Alpha-Fetoprotein and Histological Differentiation Grade of Hepatocellular Carcinoma

Journal of Physics: Conference Series, 2018

Research paper thumbnail of Utility of botulinum toxin injection for post-operative pain management after conventional hemorrhoidectomy: a systematic review and meta-analysis of clinical trials

Scandinavian Journal of Gastroenterology, Sep 1, 2022

Research paper thumbnail of Global economic burden of unmet surgical need for appendicitis

British Journal of Surgery

Background There is a substantial gap in provision of adequate surgical care in many low- and mid... more Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality wa...

Research paper thumbnail of Laser hemorrhoidoplasty for hemorrhoidal disease: a systematic review and meta-analysis

Lasers in Medical Science

Research paper thumbnail of Decentralisation of mobile single-team approach for superior outcomes on pancreaticoduodenal resection in Indonesia

Research paper thumbnail of Infected hemorrhagic pancreatic pseudocyst: A rare complication of acute pancreatitis

Introduction: Pancreatitis is an uncommon disease defined as an inflammatory disorder of the panc... more Introduction: Pancreatitis is an uncommon disease defined as an inflammatory disorder of the pancreas that can be acute or chronic. After four weeks, unresolved acute pancreatitis can result in pancreatic pseudocyst. Usually pancreatic pseudocyst formed in the absence of pancreatic necrosis, although rare but exception has been reported and it affects the treatment of choice. Pseudocyst must be managed correctly due to its high mortality complication, such as bleeding pseudoaneurysm. Case Report: A 51-year-old man presented to the emergency room with his third episode of abdominal pain. In one month prior, the patient had already been hospitalized twice with acute pancreatitis. He came with severe abdominal pain three hours prior to admission. Patient had a history of alcohol abuse. Physical examination revealed tachycardia, afebrile, distended, and rigid abdomen with no bowel sound. Laboratory examination revealed high leucocyte (35,200/ uL), high amylase (1063 U/L), and high lipase (540 U/L). Abdominal computed tomography (CT) scan revealed enlargement of pancreas body and tail with heterogenous density (necrotic), with around 11 cm mass containing fluid mean 70 HU (blood) in pancreas body. Dian Daniella1, Candra Wiguna2, WIfanto Saditya Jeo3 Affiliations: 1General Practitioner, Department of Internal Medicine, Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia; 2Internist, Department of Internal Medicine, Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia; 3Digestive Surgeon, Department of Surgery, Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia. Corresponding Author: Dian Daniella, Jalan Bisma 6 blok B 12 nomor 17, Jakarta Utara, DKI Jakarta, Indonesia; Email: dian.daniella@gmail.com Received: 06 October 2019 Accepted: 04 December 2019 Published: 31 December 2019 One week before the abdominal CT scan showed acute pancreatitis with no cyst. The patient was kept fasting with parenteral nutrition, antibiotic, octreotide subcutaneously, opioid, and laparoscopic drainage and debridement was scheduled. During surgery, mass containing approximately 1000 mL of fluid and blood clot was seen and drained. The patient did well after the surgery. Conclusion: Diagnosis and prompt treatment of pseudocyst is important. In a patient with pseudocyst and necrotizing pancreatitis, surgical drainage is the treatment of choice.

Research paper thumbnail of Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

The Lancet. Infectious diseases, Jan 13, 2018

Surgical site infection (SSI) is one of the most common infections associated with health care, b... more Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with e...

Research paper thumbnail of IDDF2022-ABS-0196 The role of circulating tumor cells in peripheral blood as an adjunctive non-invasive diagnostic methods for colorectal cancer

Clinical Gastroenterology

Research paper thumbnail of Model Prediksi Kejadian Pneumonia 30 Hari Pasca Bedah Abdomen pada Pasien Usia Lanjut

Jurnal Penyakit Dalam Indonesia, Apr 2, 2022

Pendahuluan. Perubahan fisiologis sistem pernapasan pada usia lanjut meningkatkan risiko kejadian... more Pendahuluan. Perubahan fisiologis sistem pernapasan pada usia lanjut meningkatkan risiko kejadian pneumonia pasca bedah. Pneumonia pasca bedah non-toraks ditemukan paling tinggi pada bedah abdomen. Tujuan penelitian ini adalah mendapatkan model prediksi pneumonia 30 hari pasca bedah abdomen pada pasien usia lanjut. Metode. Penelitian dengan desain kohort retrospektif dilakukan dengan menggunakan rekam medis pasien usia lanjut yang menjalani bedah abdomen di Rumah Sakit Cipto Mangunkusumo. Analisis multivariat dengan regresi logistik digunakan untuk mendapatkan nilai odds ratio (OR). Performa kalibrasi dinilai dengan uji Hosmer-Lemeshow. Performa diskriminasi dinilai dengan menghitung area under the curve (AUC).

Research paper thumbnail of Cancer-associated fibroblast (CAF) secretomes-induced epithelial-mesenchymal transition on HT-29 colorectal carcinoma cells associated with hepatocyte growth factor (HGF) signalling

JPMA. The Journal of the Pakistan Medical Association, 2021

OBJECTIVE The aim of this study was to investigate the effect of cancer-associated fibroblasts (C... more OBJECTIVE The aim of this study was to investigate the effect of cancer-associated fibroblasts (CAF) secretomes on the epithelial-mesenchymal transition (EMT) of colorectal carcinoma (CRC) cells and its association with hepatocyte growth factor (HGF) signalling focussing on the HGF receptor, c-Mesenchymal epithelial transition (c-Met), and the EMT markers, vimentin and e-cadherin, in CRC cells. Methods Conditioned mediums (CM) containing secretomes from colorectal CAFs and their counterpart normal fibroblasts (NFs) of three CRC patients were collected and supplemented to the HT-29 CRC cells. The mRNA levels of a-smooth muscle actin (a-SMA) and HGF in both fibroblasts, as well as c-Met, vimentin, and e-cadherin in HT-29 cells after supplemented with CAF- and NF-CM were determined using quantitative reverse transcription-polymerase chain reaction (qRT-PCR). HGF protein level in the CM of CAFs and NFs was measured using enzyme-linked immunosorbent assay (ELISA). Vimentin and e-cadherin...

Research paper thumbnail of Five-Year Cancer Epidemiology at the National Referral Hospital: Hospital-Based Cancer Registry Data in Indonesia

JCO Global Oncology, 2021

PURPOSE In 2016, there were 1,308,061 cases of cancer being treated in Indonesia, with 2.2 trilli... more PURPOSE In 2016, there were 1,308,061 cases of cancer being treated in Indonesia, with 2.2 trillion rupiahs spent, amounting to $486,960,633 in US dollars (purchasing power parity 2016). The high burden of cancers in Indonesia requires a valid data collection to inform future cancer-related policies. The purpose of this study is to report cancer epidemiological data from 2008 to 2012 based on Hospital-Based Cancer Registry (HBCR) data from Cipto Mangunkusumo Hospital, Indonesia. METHODS This was a descriptive study with cross-sectional design. Data were collected from Cipto Mangunkusumo Hospital HBCR 2008-2012. Demographical, diagnostic, stages of cancer, and histopathological types of cancer data were extracted. RESULTS After screening, 18,216 cases were included. A total of 12,438 patients were older than 39 years of age (68.3%), with a female-to-male ratio of 9:5. Most patients have cancers at advanced stages (stages III and IV, 10.2%). The most common sites of cancer were cervix...

Research paper thumbnail of Global variation in anastomosis and end colostomy formation following left‐sided colorectal resection

BJS Open, 2019

Background: End colostomy rates following colorectal resection vary across institutions in high-i... more Background: End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods: This study comprised an analysis of GlobalSurg-1 and-2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle-and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results: In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6⋅9 per cent) from low-HDI, 254 (15⋅5 per cent) from middle-HDI and 1268 (77⋅6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57⋅5, 40⋅9 and 35⋅4 per cent; P < 0⋅001) and subsequent use of end colostomy (52⋅2, 24⋅8 and 18⋅9 per cent; P < 0⋅001) in low-compared with middle-and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3⋅20, 95 per cent c.i. 1⋅35 to 7⋅57; P = 0⋅008) after risk adjustment for malignant disease (OR 2⋅34, 1⋅65 to 3⋅32; P < 0⋅001), emergency surgery (OR 4⋅08, 2⋅73 to 6⋅10; P < 0⋅001), time to operation at least 48 h (OR 1⋅99, 1⋅28 to 3⋅09; P = 0⋅002) and disease perforation (OR 4⋅00, 2⋅81 to 5⋅69; P < 0⋅001). Conclusion: Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone.

Research paper thumbnail of A curious case of isolated pancreatic head tuberculosis treated with Whipple’s procedure

Annals of Hepato-Biliary-Pancreatic Surgery

Background: Isolated pancreatic Tuberculosis (TB) is a rare extrapulmonary TB, even in endemic re... more Background: Isolated pancreatic Tuberculosis (TB) is a rare extrapulmonary TB, even in endemic regions such as Indonesia, especially in an immunocompetent patient. Pancreatic head TB may present as an obstructive jaundice case with a pancreatic head mass suspected of malignancy. Methods: We report a curious case of pancreatic head TB in a 19-year-old male patient. Results: A 19-year-old male patient was referred to us with obstructive jaundice due to a pancreatic head mass that was suspected to be malignant. The patient underwent endoscopic retrograde cholangiopancreatography (ERCP) by internal medicine for biopsy and stent placement. The biopsy results showed atypical cells. The team proceeded with classic Whipple's procedure because malignancy cannot be ruled out. The final pathology result of the mass showed TB of the pancreatic head tissue. The patient did not have a history of TB before, and a complete TB workup by the pulmonary team did not suggest TB in any other organ. He was immediately started on anti-tuberculosis medicine after surgery with a good response. Conclusions: Isolated pancreatic head TB is rare and can be misdiagnosed as malignancy. A multidisciplinary approach is essential in diagnosing and managing such a curious case. In addition, as we are a high-volume center, the indications of Whipple's procedure have been extended to cases with unclear biopsy results or even benign diseases with good results.

Research paper thumbnail of Hepatic vascular anatomy and intrahepatic bile duct variation: Donor’s characteristic of liver transplantation in Indonesia

Annals of Hepato-Biliary-Pancreatic Surgery

Research paper thumbnail of Successful hiatal hernia repair with Nissen fundoplication by laparoscopic approach: a case report

Intisari Sains Medis, Dec 1, 2020

Background: Hiatus hernias represent a herniation of viscera, most commonly the stomach, into the... more Background: Hiatus hernias represent a herniation of viscera, most commonly the stomach, into the mediastinum through the esophageal hiatus of the diaphragm. There are two main classifications, sliding hernias and paraesophageal hernias. This case study aims to evaluate the successful hiatal hernia repair with Nissen fundoplication by a laparoscopic approach. Case Presentation: We present a case of a 60-year-old male who presented with recurrent abdominal discomfort 6 months prior to the consultation. This was accompanied by loose stools, bloating, nausea, and vomiting. An initial diagnosis of Gastroesophageal Reflux Disease (GERD) was made. Conservative treatment was initiated with limited success. Endoscopy was then performed, revealing a hiatal hernia. Surgical intervention was then chosen as a therapeutic option via a laparoscopic approach and additional Nissen fundoplication with favorable outcomes. Conclusion: Symptomatic paraesophageal hernias are indicated for surgical repair. Paraesophageal hernias can be repaired transthoracically and transabdominal. Repairs via the transabdominal route can be performed with an open approach or laparoscopically, with the laparoscopic approach suggesting lower mortality and morbidity. Nissen fundoplication has been proven as an effective measure in GERD's control and in maintaining an intraabdominal location of the gastroesophageal junction (GEJ).

Research paper thumbnail of Analysing 11 years of incidence trends, clinicopathological characteristics, and forecasts of colorectal cancer in young and old patients: a retrospective cross-sectional study in an Indonesian national referral hospital

BMJ Open

ObjectiveTo obtain annual incidence trends, understand clinicopathological characteristics, and f... more ObjectiveTo obtain annual incidence trends, understand clinicopathological characteristics, and forecast the future burden of colorectal cancer (CRC) in Indonesia.Design11-year retrospective cross-sectional study.SettingA national referral hospital in Jakarta, Indonesia.ParticipantsData from 1584 eligible cases were recorded for trends and forecasting analyses; 433 samples were analysed to determine clinicopathological differences between young (<50 years) and old (≥50 years) patients.MethodsTrend analyses were done using Joinpoint software, expressed in annual percentage change (APC), and a regression analysis was executed to generate a forecasting model. Patients’ characteristics were compared using χ2or non-parametric tests.Main outcomesAnalysis of trends, forecasting model, and clinicopathological features between the age groups.ResultsA significant increase in APC was observed among old patients (+2.38%) for CRC cases. Colon cancer increased remarkably (+9.24%) among young p...

Research paper thumbnail of Pedunculated hepatocellular carcinoma masquerading as a giant GIST: A case report

International Journal of Surgery Case Reports

Research paper thumbnail of Efficacy and Safety of Near-Infrared Florescence Cholangiography Using Indocyanine Green in Laparoscopic Cholecystectomy: A Systematic Review and Meta-Analysis

Journal of Laparoendoscopic & Advanced Surgical Techniques

Research paper thumbnail of Correlation between microsatellite instability and metachronous disease recurrence after endoscopic mucosal resection in patients with early stage gastric carcinoma

Cancer, 2001

Correlation between RAS gene mutation and microsatellite instabi lity (MSI) status in cancer tiss... more Correlation between RAS gene mutation and microsatellite instabi lity (MSI) status in cancer tissues and clinicopathological parameters of patients with stage Ⅲ colorectal cancer (CRC) were investigated. Tissues were collected from 180 patients diagnosed with stage Ⅲ CRC in the Department of Gastrointestinal Surgery of the Fourth Hospital of Hebei Medical University from 2012 to 2016. RAS gene mutations in paraffin sections were detected by PCR and Sanger sequencing. Expression of mismatch repair proteins MLH1, MSH2, MSH6 and PMS2 was detected by immunohistochemistry, and MSI status was determined based on the positive and negative expression combinations of the above proteins, and the correlation with clinicopathological parameters of CRC was analyzed. Mutation rates of KRAS and NRAS were 48.33% (87/180) and 2.78% (5/180), respectively. Mutation rate of p.G12D in codon 12 of exon 2 in KRAS gene was the highest (31/87, 35.63%). Mutation rate of p.G12D in codon 12 of exon 2 in NRAS gene was the highest (2/5, 40%). Mutation rate of KRAS gene in right colon was higher than that in left colon and rectum (p<0.05), and mutation rate in N2b phase was higher than that in N2a and N1 phases (p<0.01). In low degree of microsatellite instability (MSI-L) and high degree of microsatellite instability (MSI-H) status, negative MKH1 protein expression was dominant (18/32, 56.25%). MSI-H in CRC patients aged ≥50 years was higher than that of CRC patients <50 years. Rates of MSI-H in N1, N2a, and N2b were 1.75, 12.82, and 1.11% (p<0.05). Mutation rate of KRAS gene in MSI-H status of stage Ⅲ CRC patients was significantly higher than that in MSI-L/microsatellite stability (MSS) (p<0.05). Mutation of RAS gene and the status of MSI are involved in the occurrence and development of stage Ⅲ CRC. Detection of RAS gene has important significance for the individual treatment of CRC in clinic.

Research paper thumbnail of Perioperative evaluation of liver donor – An initial experience of the living donor liver transplant (LDLT) program in Indonesia

HPB, 2018

Overall survival curve of the study groups Introduction: Portal vein thrombosis (PVT) is a common... more Overall survival curve of the study groups Introduction: Portal vein thrombosis (PVT) is a common complication for patients with end-stage liver disease. The presence of PVT used to be a contraindication to LDLT. This is related to technical difficulties of PV reconstruction, increased blood loss, and the risk for postoperative PV complications. Methods: We reviewed the data of LDLT patients at Liver Transplantation Unit, Mansoura University, Egypt during the period between May 2004 till March 2017. Patients were divided into three groups. Group I: patients without PVT, Group II: attenuated PV patients (PV diameter <8 mm), and Group III PVT patients. Results: During the study period, 500 cases underwent LDLT. Group I included 446 patients (89.2%), Group II included 26 patients (5.2%), and Group III included 28 patients (5.6%). Higher incidence of hematemesis and encephalopathy was detected in Group III. Longer anhepatic phase duration was found in Group III. There were no significant differences regarding operation time, blood loss, and transfusion requirements. Higher incidence of postoperative vascular complications was found in Group III. The median OS was 33 months (4-169). The 1-, 3-, and 5years OS survival rates of Group I were 80.5%, 77.7%, and 75%, while for Group II were 84.6%, 79.6%, and 73.5%, and for Group III were 88.3%, 64.4%, and 64.4% respectively. There was no significant difference between the groups regarding OS rates (Log-Rank: 0.793). Conclusion: Preoperative PVT increases the complexity of LDLT operation and the operative trauma to the patient, but it does not reduce the OS rates.

Research paper thumbnail of Correlation Between Serum Level of Alpha-Fetoprotein and Histological Differentiation Grade of Hepatocellular Carcinoma

Journal of Physics: Conference Series, 2018

Research paper thumbnail of Utility of botulinum toxin injection for post-operative pain management after conventional hemorrhoidectomy: a systematic review and meta-analysis of clinical trials

Scandinavian Journal of Gastroenterology, Sep 1, 2022

Research paper thumbnail of Global economic burden of unmet surgical need for appendicitis

British Journal of Surgery

Background There is a substantial gap in provision of adequate surgical care in many low- and mid... more Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality wa...

Research paper thumbnail of Laser hemorrhoidoplasty for hemorrhoidal disease: a systematic review and meta-analysis

Lasers in Medical Science

Research paper thumbnail of Decentralisation of mobile single-team approach for superior outcomes on pancreaticoduodenal resection in Indonesia

Research paper thumbnail of Infected hemorrhagic pancreatic pseudocyst: A rare complication of acute pancreatitis

Introduction: Pancreatitis is an uncommon disease defined as an inflammatory disorder of the panc... more Introduction: Pancreatitis is an uncommon disease defined as an inflammatory disorder of the pancreas that can be acute or chronic. After four weeks, unresolved acute pancreatitis can result in pancreatic pseudocyst. Usually pancreatic pseudocyst formed in the absence of pancreatic necrosis, although rare but exception has been reported and it affects the treatment of choice. Pseudocyst must be managed correctly due to its high mortality complication, such as bleeding pseudoaneurysm. Case Report: A 51-year-old man presented to the emergency room with his third episode of abdominal pain. In one month prior, the patient had already been hospitalized twice with acute pancreatitis. He came with severe abdominal pain three hours prior to admission. Patient had a history of alcohol abuse. Physical examination revealed tachycardia, afebrile, distended, and rigid abdomen with no bowel sound. Laboratory examination revealed high leucocyte (35,200/ uL), high amylase (1063 U/L), and high lipase (540 U/L). Abdominal computed tomography (CT) scan revealed enlargement of pancreas body and tail with heterogenous density (necrotic), with around 11 cm mass containing fluid mean 70 HU (blood) in pancreas body. Dian Daniella1, Candra Wiguna2, WIfanto Saditya Jeo3 Affiliations: 1General Practitioner, Department of Internal Medicine, Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia; 2Internist, Department of Internal Medicine, Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia; 3Digestive Surgeon, Department of Surgery, Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia. Corresponding Author: Dian Daniella, Jalan Bisma 6 blok B 12 nomor 17, Jakarta Utara, DKI Jakarta, Indonesia; Email: dian.daniella@gmail.com Received: 06 October 2019 Accepted: 04 December 2019 Published: 31 December 2019 One week before the abdominal CT scan showed acute pancreatitis with no cyst. The patient was kept fasting with parenteral nutrition, antibiotic, octreotide subcutaneously, opioid, and laparoscopic drainage and debridement was scheduled. During surgery, mass containing approximately 1000 mL of fluid and blood clot was seen and drained. The patient did well after the surgery. Conclusion: Diagnosis and prompt treatment of pseudocyst is important. In a patient with pseudocyst and necrotizing pancreatitis, surgical drainage is the treatment of choice.

Research paper thumbnail of Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

The Lancet. Infectious diseases, Jan 13, 2018

Surgical site infection (SSI) is one of the most common infections associated with health care, b... more Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with e...

Research paper thumbnail of IDDF2022-ABS-0196 The role of circulating tumor cells in peripheral blood as an adjunctive non-invasive diagnostic methods for colorectal cancer

Clinical Gastroenterology

Research paper thumbnail of Model Prediksi Kejadian Pneumonia 30 Hari Pasca Bedah Abdomen pada Pasien Usia Lanjut

Jurnal Penyakit Dalam Indonesia, Apr 2, 2022

Pendahuluan. Perubahan fisiologis sistem pernapasan pada usia lanjut meningkatkan risiko kejadian... more Pendahuluan. Perubahan fisiologis sistem pernapasan pada usia lanjut meningkatkan risiko kejadian pneumonia pasca bedah. Pneumonia pasca bedah non-toraks ditemukan paling tinggi pada bedah abdomen. Tujuan penelitian ini adalah mendapatkan model prediksi pneumonia 30 hari pasca bedah abdomen pada pasien usia lanjut. Metode. Penelitian dengan desain kohort retrospektif dilakukan dengan menggunakan rekam medis pasien usia lanjut yang menjalani bedah abdomen di Rumah Sakit Cipto Mangunkusumo. Analisis multivariat dengan regresi logistik digunakan untuk mendapatkan nilai odds ratio (OR). Performa kalibrasi dinilai dengan uji Hosmer-Lemeshow. Performa diskriminasi dinilai dengan menghitung area under the curve (AUC).

Research paper thumbnail of Cancer-associated fibroblast (CAF) secretomes-induced epithelial-mesenchymal transition on HT-29 colorectal carcinoma cells associated with hepatocyte growth factor (HGF) signalling

JPMA. The Journal of the Pakistan Medical Association, 2021

OBJECTIVE The aim of this study was to investigate the effect of cancer-associated fibroblasts (C... more OBJECTIVE The aim of this study was to investigate the effect of cancer-associated fibroblasts (CAF) secretomes on the epithelial-mesenchymal transition (EMT) of colorectal carcinoma (CRC) cells and its association with hepatocyte growth factor (HGF) signalling focussing on the HGF receptor, c-Mesenchymal epithelial transition (c-Met), and the EMT markers, vimentin and e-cadherin, in CRC cells. Methods Conditioned mediums (CM) containing secretomes from colorectal CAFs and their counterpart normal fibroblasts (NFs) of three CRC patients were collected and supplemented to the HT-29 CRC cells. The mRNA levels of a-smooth muscle actin (a-SMA) and HGF in both fibroblasts, as well as c-Met, vimentin, and e-cadherin in HT-29 cells after supplemented with CAF- and NF-CM were determined using quantitative reverse transcription-polymerase chain reaction (qRT-PCR). HGF protein level in the CM of CAFs and NFs was measured using enzyme-linked immunosorbent assay (ELISA). Vimentin and e-cadherin...

Research paper thumbnail of Five-Year Cancer Epidemiology at the National Referral Hospital: Hospital-Based Cancer Registry Data in Indonesia

JCO Global Oncology, 2021

PURPOSE In 2016, there were 1,308,061 cases of cancer being treated in Indonesia, with 2.2 trilli... more PURPOSE In 2016, there were 1,308,061 cases of cancer being treated in Indonesia, with 2.2 trillion rupiahs spent, amounting to $486,960,633 in US dollars (purchasing power parity 2016). The high burden of cancers in Indonesia requires a valid data collection to inform future cancer-related policies. The purpose of this study is to report cancer epidemiological data from 2008 to 2012 based on Hospital-Based Cancer Registry (HBCR) data from Cipto Mangunkusumo Hospital, Indonesia. METHODS This was a descriptive study with cross-sectional design. Data were collected from Cipto Mangunkusumo Hospital HBCR 2008-2012. Demographical, diagnostic, stages of cancer, and histopathological types of cancer data were extracted. RESULTS After screening, 18,216 cases were included. A total of 12,438 patients were older than 39 years of age (68.3%), with a female-to-male ratio of 9:5. Most patients have cancers at advanced stages (stages III and IV, 10.2%). The most common sites of cancer were cervix...

Research paper thumbnail of Global variation in anastomosis and end colostomy formation following left‐sided colorectal resection

BJS Open, 2019

Background: End colostomy rates following colorectal resection vary across institutions in high-i... more Background: End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods: This study comprised an analysis of GlobalSurg-1 and-2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle-and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results: In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6⋅9 per cent) from low-HDI, 254 (15⋅5 per cent) from middle-HDI and 1268 (77⋅6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57⋅5, 40⋅9 and 35⋅4 per cent; P < 0⋅001) and subsequent use of end colostomy (52⋅2, 24⋅8 and 18⋅9 per cent; P < 0⋅001) in low-compared with middle-and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3⋅20, 95 per cent c.i. 1⋅35 to 7⋅57; P = 0⋅008) after risk adjustment for malignant disease (OR 2⋅34, 1⋅65 to 3⋅32; P < 0⋅001), emergency surgery (OR 4⋅08, 2⋅73 to 6⋅10; P < 0⋅001), time to operation at least 48 h (OR 1⋅99, 1⋅28 to 3⋅09; P = 0⋅002) and disease perforation (OR 4⋅00, 2⋅81 to 5⋅69; P < 0⋅001). Conclusion: Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone.