Sriwijaya Journal of Surgery

Efficacy of Randu Honey Supplementation on Callus Formation in Closed Fractures of the Tibia in Wistar Rats

Afifurrahman — 2024-03-27

Introduction: Tibial fracture is one of the most common injuries. Randu honey has the potential to speed up fracture healing. This study aims to determine the efficacy of randu honey supplementation on callus formation in closed fractures of the tibia in Wistar rats.

Methods: This research uses a true experimental design with post test only control group design. A total of 36 Wistar rats were divided into two groups, namely the control group and the treatment group which were given 200g/BW(gram)/day of randu honey. Fractures were made on the rat tibia and callus diameter was measured at 3 weeks after treatment.

Results: The callus diameter in the treatment group was significantly larger than the control group (p<0.05) in radiological and macroscopic measurements.

Conclusion: Supplementation with randu honey is effective in the formation of callus in closed fractures of the tibia in Wistar rats.

Analysis of the Relationship between Patient Family Knowledge about Infections in Post-Operative Wounds in Supporting the Post-Operative Patient Wound Healing Process: Study at dr. Soekardjo Regional General Hospital, Tasikmalaya, Indonesia

Eet Sumiati — 2024-03-27

Introduction: Post-operative wound infection is a serious complication that can hinder the healing process. The patient's family's knowledge about post-operative wound infections can play an important role in supporting the healing process. This study aims to analyze the relationship between the patient's family's knowledge about infections in post-operative wounds and the process of wound healing in post-operative patients at dr. Soekardjo Regional General Hospital Tasikmalaya.

Methods: This research used a cross-sectional design with a total of 52 respondents selected by purposive sampling. Data was collected using a questionnaire to measure the patient's family's knowledge about post-operative wound infections and observation sheets to assess the wound healing process. Data analysis was carried out using the Chi-square test.

Results: The majority of respondents were 32 years or older. Respondents' education was dominated by secondary level. The majority of respondents have incomes greater than or equal to the UMR. The majority of respondents had sufficient knowledge about post-operative wound infections, but there were still 17.31% of respondents who had insufficient knowledge. The results of the study showed that there was a significant relationship between the patient's family's knowledge about post-operative wound infections and the wound healing process (p-value < 0.05).

Conclusion: The patient's family's knowledge about post-operative wound infections can support the patient's post-operative wound healing process.

Analysis of the Role of Age Factors on Hemoglobin, Leukocyte and Platelet Levels in Breast Cancer Patients Post Chemotherapy 3 Cycles at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia

Suci Rahmaniar — 2024-03-29

Introduction: Breast cancer is one of the most common cancers in women. Chemotherapy is one of the main modalities in the treatment of breast cancer, but it can cause hematological side effects such as anemia, leukopenia, and thrombocytopenia. Age is one factor that is thought to influence these side effects.

Methods: This study used an analytical observational design with data collected from medical records of breast cancer patients who had undergone 3 cycles of chemotherapy at Dr. Mohammad Hoesin General Hospital Palembang. Data on hemoglobin, leukocyte, and platelet levels before and after chemotherapy were analyzed using the t-test and ANOVA.

Results: A significant decrease in hemoglobin levels was observed in patients aged > 60 years after chemotherapy (p < 0.05). Leukocyte levels showed fluctuations, especially in patients aged <40 years, while platelet levels fluctuated more in patients aged <40 years and decreased in the age group 40-60 years after chemotherapy.

Conclusion: Age does not significantly influence the decrease in hemoglobin, leukocyte, and platelet levels in breast cancer patients after chemotherapy.

Accuracy of the Chest Trauma Score (CTS) as a Predictor of Acute Respiratory Distress Syndrome (ARDS) in Blunt Chest Trauma Patients: Single Center Study at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia

Billy Peter — 2024-05-27

Introduction: Chest trauma is the third most common cause of death due to trauma worldwide, with a mortality rate reaching 60%. Chest Trauma Score (CTS) is a chest trauma assessment score that can predict patient complications and death, including acute respiratory distress syndrome (ARDS). This study aims to determine the relationship and assess the accuracy of CTS as a predictor of ARDS in patients with blunt chest trauma.

Methods: Medical records of 32 patients with blunt chest trauma were analyzed. Subjects were assessed for CTS, with components including age, number of rib fractures, presence of bilateral rib fractures, and lung contusion. Data were divided into two groups, CTS<5 and CTS≥5. Data were analyzed to determine the relationship between CTS and ARDS.

Results: 62.5% of subjects had CTS ≥5 and 37.5% had CTS<5. As many as 68.8% of subjects with blunt chest trauma experienced ARDS. Analysis using the Fischer Exact Test showed that there was a significant relationship (p<0.05) between the CTS value and ARDS. The sensitivity of this study was 77.3%, specificity 70%, positive predictive value 85%, negative predictive value 58.3%.

Conclusion: Statistically there is a significant relationship between the chest trauma score and ARDS, so the chest trauma score is considered accurate as a predictor of ARDS in patients with blunt chest trauma.

Study Analysis on Knowledge, Attitude, and Behavior of Colorectal Cancer Patients: A Single-Center Observational Study at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia

Kiki Lukman — 2024-05-31

Introduction: Colorectal cancer (CRC) is the second deadliest cancer with the second highest mortality rate (9.2%) after lung cancer (11.4%) and breast cancer (6.9%). CRC is more prevalent in developed countries and more prevalent among men, with incidence rates per 100,000 in both sexes at 19.7, 23.6, and 16.3 respectively. Majority of the patients came to the hospital with diagnosis of loco regional and metastatic colorectal cancer. Therefore, information and education regarding CRC are important to the patient and their family to assure optimal screening and management. This study aimed to determine the effect of education on knowledge, attitudes, behavior of colorectal cancer patients.

Methods: A descriptive-analytic research study design was conducted, including all patients diagnosed with colorectal cancer coming to Dr. Hasan Sadikin Hospital Bandung, a tertiary referral hospital, in the period August 2021 to August 2022. The pre and post-education questionnaire were used to evaluate the knowledge, attitude, and behaviour of the respondent regarding the colorectal cancer. An informational leaflet with verbal explanation was utilized as educational material. Data was analyzed using SPSS version 24.

Results: Fifty-two respondents were recruited and more than half of the respondents (73.1%) showed a high mark in the post-test knowledge of CRC. Furthermore, behavior aspect also showed a dramatic increase and almost all the subjects (98.1%) scored high on behavior aspect.

Conclusion: The education provided to CRC patients significantly enhances their knowledge, attitude, and behavior.

Overview and Prevalence of Eating Disorder in Post-Bariatric Surgery Patients: A Single Center Observational Study at Sumber Waras Hospital, Jakarta, Indonesia

Daniel Goh — 2024-06-06

Introduction: The prevalence of obesity continues to increase, and society needs to pay attention to it. One effective treatment that is also included in the pillars of obesity management is bariatric surgery. Apart from the many benefits of bariatric surgery, there are side effects that need to be considered, one of which is eating disorders. This study aims to determine the prevalence of eating disorders in post-bariatric surgery patients in Indonesia, especially at Sumber Waras Hospital, Jakarta.

Methods. This research is a descriptive study with cross-sectional methods in post-bariatric surgery patients with a minimum BMI of 30 kg/m².

Results. A total of 54 patients after bariatric surgery at Sumber Waras Hospital, Jakarta filled out a questionnaire to assess tendencies towards eating disorders, namely EDE-Q 6.0 (Eating Disorder Examination Questionnaire) after 6 months of undergoing bariatric surgery. The results showed that 17 respondents (31.48%) experienced eating disorder tendencies.

Conclusion. Eating disorders are one of the side effects of bariatric surgery that needs to be considered. Further research is still needed on this matter, considering the small number of samples in this study. Research on related topics is expected to expand its reach so might obtain a larger sample size.

Analysis of Risk Factors for Continence Post Posterior Sagittal Anorectoplasty (PSARP) in Anorectal Malformation Patients: A Single Center Observational Study at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia

Maleakhi Hasudungan Sinaga — 2024-06-08

Introduction: Anorectal malformation (MAR) is a congenital abnormality with a significant incidence rate. Posterior sagittal anorectoplasty (PSARP) is the standard surgical procedure for MAR correction. However, achieving post-operative continence remains a major challenge. This study aims to identify risk factors associated with continence in MAR patients after PSARP at Dr. Mohammad Hoesin General Hospital Palembang.

Methods: This prospective observational study involved MAR patients who underwent PSARP at Dr. Mohammad Hoesin General Hospital Palembang between January 2018 to December 2023. Demographic, clinical data, and RINTALA questionnaire results were collected. Statistical analysis was performed using a chi-square test, independent t-test, and logistic regression to identify significant risk factors associated with continence.

Results: A total of 120 post-PSARP MAR patients met the inclusion criteria and participated in this study. The mean age of patients was 8.5 years (SD = 3.2). The results of the RINTALA questionnaire showed a mean score of 45.3 (SD = 12.8), with 42.5% of patients experiencing poor continence (RINTALA score < 40). Univariate analysis showed a significant association between poor continence and high MAR type (p = 0.002), age at PSARP < 1 year (p = 0.031), and the presence of a history of related surgery (p = 0.017). In multivariate analysis, MAR type was high (OR = 4.21; 95% CI: 1.54-11.52; p = 0.005) and age at PSARP < 1 year (OR = 2.87; 95% CI: 1, 05-7.89; p = 0.040) remained an independent predictor of poor continence.

Conclusion: This study succeeded in identifying the type of MAR high and age at PSARP < 1 year as significant independent risk factors associated with poor continence in MAR patients after PSARP at Dr. Mohammad Hoesin General Hospital Palembang. These findings provide valuable information for surgeons and patient families in anticipating and managing post-PSARP continence problems.

Migration of the Plastic Clips of the Cystic Ducts to the Bile Duct Post-Laparoscopic Cholecystectomy: A Case Report

Peter Ian Limas — 2024-06-24

Introduction: Migration of the cystic duct clip into the common bile duct is a rare but significant complication following laparoscopic cholecystectomy. This condition can cause biliary obstruction, cholangitis, and gallstone formation.

Case presentation: A 60-year-old man presented with symptoms of cholangitis. His medical history included laparoscopic cholecystectomy with choledochoscopy and intraoperative cholangiography. MRCP showed stones and sludge in the common bile duct (CBD), but did not identify a migrated clip. Endoscopic retrograde cholangiopancreatography (ERCP) successfully extracted the migrated clip causing the obstruction.

Conclusion: Migration of the clip into the common bile duct should be considered in the differential diagnosis of biliary obstruction following laparoscopic cholecystectomy. Early identification through careful imaging and ERCP can facilitate appropriate management and prevent further complications.

Comparison of the Incidence of Dumping Syndrome in Post-Bariatric Surgery Patients with Roux-en-Y Gastric Bypass (RYGB) Techniques and Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S)

Gracienne — 2024-06-25

Introduction: Dumping syndrome (DS) is a common post-bariatric surgery complication. This study aims to compare the incidence of DS between Roux-en-Y gastric bypass (RYGB) and single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) at Sumber Waras Hospital, Jakarta, Indonesia.

Methods: This single-center retrospective observational study included 187 patients who underwent RYGB or SADI-S between January 2018 and December 2023. Demographic, clinical, and DS-related data were collected from patients' medical records. Statistical analysis was carried out using SPSS version 25.

Results: The overall incidence of DS was 21.4%, with 23.2% in the RYGB group (n=95) and 19.6% in the SADI-S group (n=92). There was no significant difference in the incidence of DS between the two groups (p = 0.56). Young age (OR 2.18; 95% CI 1.05-4.53; p = 0.04) and history of type 2 diabetes mellitus (OR 3.05; 95% CI 1.21-7.70; p = 0.02) is an independent risk factor for DS.

Conclusion: There was no significant difference in the incidence of DS between RYGB and SADI-S. Young age and a history of type 2 diabetes mellitus are independent risk factors for DS.

Comparison of Upper Extremity Function After Operative and Non-operative Management of Distal Radius Intra-Articular Fractures with Clinical Assessment of QuickDASH Score

Ridnia Nur Istiqomah — 2024-06-27

Introduction: Intra-articular fracture of the distal radius is a common injury and can disrupt upper extremity function. This study aims to compare upper extremity function after treatment of intra-articular distal radius fractures in productive age between operative and non-operative procedures using the QuickDASH score.

Methods: This observational analytical study with a retrospective cohort design involved 80 patients with intra-articular distal radius fractures who were managed operatively (60 patients) and non-operatively (20 patients) at Dr. Mohammad Hoesin General Hospital Palembang. Data was collected from patient medical records and analyzed using the independent t-test and Chi-Square test.

Results: The mean QuickDASH score in the operative group (10.53 ± 17.25) was significantly lower than the non-operative group (23.29 ± 23.82) (p = 0.012). There was a significant relationship between operative management and QuickDASH score (p = 0.023). Patients treated operatively were 1.5 times more likely to have normal upper extremity function (QuickDASH score ≤ 20).

Conclusion: Operative treatment of intra-articular distal radius fractures in productive age provides better upper extremity functional outcomes compared to non-operative treatment, based on QuickDASH score assessment.

Reconstruction of Chronic Monteggia Fracture with Radial Head Excision: A Case Report

Nur Khumaira Baharuddin — 2024-07-08

Introduction: Chronic Monteggia fracture is a rare and clinically challenging condition, characterized by a non-union fracture of the proximal ulna with dislocation of the radial head. This case report presents the case of a 42-year-old woman with a chronic Monteggia fracture diagnosed 21 years after the initial injury, highlighting the importance of a careful patient history and radiographic investigation.

Case presentation: A 42-year-old woman presented with left elbow pain and a history of significant trauma 21 years previously. Physical examination revealed limited range of motion and radiographic examination revealed a nonfused fracture of the proximal ulna with dislocation of the radial head. The patient underwent open reduction and internal fixation (ORIF) reconstruction of the ulna and excision of the radial head.

Conclusion: Successful surgical reconstruction of chronic Monteggia fractures results in significant improvements in the patient's function and quality of life. This case report emphasizes the importance of early diagnosis and timely surgical intervention to prevent long-term complications and achieve optimal functional outcomes.

Resection or Ablation for Early Hepatobiliary Carcinoma: A Meta-Analysis of Treatment Outcomes

Jamaludin — 2024-09-02

Introduction: The optimal treatment for early hepatobiliary carcinoma (EHBC) remains controversial, with surgical resection and ablation offering distinct advantages and disadvantages. This meta-analysis aimed to compare the long-term outcomes of these two modalities in patients with EHBC.

Methods: A systematic search of PubMed, Scopus, and Google Scholar was conducted for studies published between 2018 and 2024 that reported on the outcomes of resection or ablation in EHBC. The primary outcomes were overall survival (OS) and recurrence-free survival (RFS). The secondary outcomes included complication rates and length of hospital stay.

Results: A total of 25 studies (n=4,512 patients) were included in the meta-analysis. The pooled analysis showed that resection was associated with significantly better OS (HR 0.62, 95% CI 0.51-0.75, p<0.001) and RFS (HR 0.58, 95% CI 0.47-0.71, p<0.001) compared to ablation. However, resection was also associated with a higher risk of complications (OR 1.83, 95% CI 1.32-2.54, p<0.001) and a longer hospital stay (MD 3.2 days, 95% CI 2.1-4.3, p<0.001).

Conclusion: Resection offers superior long-term oncological outcomes compared to ablation in patients with EHBC. However, the choice of treatment should be individualized based on patient factors and tumor characteristics, considering the higher risk of complications and longer hospital stay associated with resection.

Maxillary Intercanine Width in a South Sumatran Population: Implications for Maxillofacial Reconstruction

Mufida Muzakkie — 2024-11-12

Introduction: The maxilla is a crucial bone in the facial skeleton, contributing significantly to both aesthetics and function. Understanding the morphometric variations of the maxilla, particularly the intercanine width (ICW), is vital for successful maxillofacial reconstruction procedures. This study aimed to investigate the ICW in a South Sumatran population, considering its implications for reconstructive surgeries.

Methods: This retrospective study analyzed computed tomography (CT) scans of 96 adult patients (60 males, 36 females) from South Sumatra. The ICW was measured using 3D reconstruction software, and the data were analyzed for gender-based differences. The findings were compared with existing literature to understand regional variations in maxillary morphology.

Results: The mean ICW for males was 3.58 ± 0.27 cm and for females was 3.44 ± 0.18 cm. Males exhibited a significantly larger ICW than females (p < 0.05). These findings are consistent with previous studies indicating sexual dimorphism in maxillary morphology.

Conclusion: This study provides valuable data on maxillary intercanine width in a South Sumatran population. The observed gender-based differences highlight the importance of considering patient demographics in maxillofacial reconstruction. This information can aid surgeons in achieving optimal functional and aesthetic outcomes.