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Hasil Pencarian

Ditemukan 39 dokumen yang sesuai dengan query
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Rifatul Fani
Analisis faktor yang berhubungan dengan kejadian rawat inap ulang pada pasien pascalaparoskopi kolesistektomi = Factors analysis associated with readmission of patients post laparoscopic cholecystectomy
"ABSTRAKTeknik laparoskopi kolesistektomi merupakan baku emas untuk penanganan kolelitiasis simptomatik. Angka kejadian rawat inap ulang merupakan representasi dari kualitas perawatan yang diberikan Rumah Sakit. Kejadian rawat inap ulang dapat dipengaruhi oleh berbagai macam faktor, baik faktor fisik, sosial budaya, dan medikal pasien. Tujuan penelitian: Menganalisis faktor-faktor yang berhubungan dengan kejadian rawat inap ulang pada pasien paska laparoskopi kolesistektomi. Penelitian ini menggunakan desain cross-sectional dengan pendekatan retrospektif dan memilih 80 responden dengan tehnik consecutive sampling. Metode pengumpulan data dengan kuesioner dan lembar pengumpulan data. Analisis hasil penelitian menggunakan uji korelasi Spearman dan Coefficient contingency, serta uji komparasi Mann-Whitney. Analisis multivariat menggunakan regresi linier. Hasil penelitian menunjukkan bahwa faktor kejadian rawat inap ulang pasien paska laparoskopi kolesistektomi ditentukan usia, tingkat ekonomi, kepatuhan diet, dan tingkat aktivitas pasien sebesar 54,1%, sedangkan sisanya ditentukan oleh faktor lain. Faktor yang paling dominan berhubungan dengan kejadian rawat inap ulang paska laparoskopi kolesistektomi adalah tingkat aktivitas (β= -0,383).
ABSTRACT
Laparoscopic cholecystectomy is the gold standard for the treatment of symptomatic cholelithiasis. The incidence of readmission is a representation of the quality of care provided by the Hospital. Readmission can be influenced by various factors, both physical, socio-cultural, and medical factors. Objective: To analyze factors associated with readmission patients with laparoscopic cholecystectomy. This study used cross-sectional design with retrospective approach and recruited 80 respondents by consecutive sampling technique. Methods of data collection with questionnaires and data collection sheets. Analysis used Spearman and Contingency coefficient correlation, and Mann-Whitney comparison test. Multivariate analysis used linear regression. The results showed that readmission patients pasca laparoscopic cholecystectomy determined by age, economic level, diet adherence, and activity level amounted to 54.1%, while the rest is determined by other factors. The most dominant factor associated with the incidence of readmission pasca laparoscopic cholecystectomy is the level of activity (β = -0,383)."
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2019
T52245
UI - Tesis Membership  Universitas Indonesia Library
cover
Halauwet, Marisha Friska
Timing kolesistektomi laparoskopik pasien dengan kolesistolitiasis dan koledokolitiasis pasca endoscopic retrograde cholangiopancreatography-sphincterectomy dan faktor-faktor yang memengaruhinya = Timing of laparoscopic cholecystectomy in patients with cholecystolithiasis and choledocholithiasis post endoscopic retrograde cholangiopancreatography-sphincterectomy and the factors that affect it
"Latar Belakang: Penanganan batu empedu dapat dilakukan melalui intervensi bedah atau non-bedah. Untuk penanganan bedah, kolesistektomi dapat dilakukan dengan teknik terbuka maupun laparoskopik. Tindakan ERCP yang diikuti oleh kolesistektomi dianggap sebagai modalitas terapi terbaik saat ini. Teknik ini bisa dilakukan sebelum tindakan kolesistektomi laparoskopik atau dilakukan secara bersamaan. Saat ini masih belum disepakati alur strategi yang terbaik, mengenai interval waktu untuk melakukan tindakan kolesistektomi laparoskopik pascaERCP.
Metode: Deskriptif analitik dengan desain studi potong-lintang (cross-sectional study) dengan mengambil data rekam medis subjek pada 2 rumah sakit di Jakarta. Tatalaksana interval waktu tindakan kolesistektomi laparoskopik pascaERCP diketahui melalui telusur rekam medis.
Hasil: Pada penelitian ini didapatkan lebih banyak subjek yang dilakukan tindakan operasi lebih dari 72 jam dibandingkan dengan kurang dari sama dengan 72 jam pascaERCP (27 subjek (56,2%) dibandingkan 21 subjek (43,8%). Total sampel pada penelitian ini adalah 48 subjek, melebihi jumlah sampel minimal yaitu 20 subjek. Pankreatitis terjadi pada 7 subjek (33%) pada kelompok kurang dari sama dengan 72 jam dan pada 7 subjek (26%) pada kelompok lebih dari 72 jam. Berdasarkan uji Chi-square, tidak ditemukan hubungan yang bermakna antara komplikasi pankreatitis dengan durasi kolesistektomi laparoskopik pascaERCP (p = 0,75).
Kesimpulan: Tidak didapatkan perbedaan yang bermakna antara kelompok interval laparoskopik kolesistektomi awal (kurang dari sama dengan 72 jam) dan lambat (lebih dari 72 jam) pascaERCP dengan terjadinya komplikasi pascaERCP berupa pankreatitis. Tidak didapatkan perbedaan bermakna antara kelompok interval laparoskopik kolesistektomi awal (kurang dari sama dengan 72 jam) dan lambat (lebih dari 72 jam) pascaERCP dengan lama rawat pasien.
Background: Gallstones can be managed through surgical or non-surgical intervention. Cholecystectomy can be performed with open or laparoscopic techniques. Endoscopic retrograde cholangiopancreatography followed by cholecystectomy is considered the best treatment modality at this time. This technique can be performed before laparoscopic cholecystectomy or done simultaneously. At present the best strategy path has not been agreed upon, regarding the time interval to perform post ERCP laparoscopic cholecystectomy.
Methods: Analytical descriptive with cross-sectional study design by taking the medical record from two hospitals in Jakarta. The timing of Post- laparoscopic cholecystectomy post ERCP time interval is obtained through medical record search.
Result: More subjects were treated with surgery after 72 hours compared to before72 hours post-ERCP (27 subjects (56.2%) compared to 21 subjects (43.8%). The total sample in this study was 48 subject, exceeding the minimum sample size of 20 subjects. Pancreatitis occurred in 7 subjects (33%) in the group before 72 hours and in 7 subjects (26%) in the group after 72 hours post ERCP. Based on the Chi-square test, there is no significant association between pancreatitis complications and the duration of post-CP laparoscopic cholecystectomy (p = 0.75).
Conclusion: There is no significant difference between the early laparoscopic cholecystectomy group (before 72 hours) and the late laparoscopic cholecystectomy group (less 72 hours) post-ERCP with the occurrence of complications post-ERCP determined as pancreatitis. There is no significant differences in the length of stay of the patient between the early laparoscopic cholecystectomy group (before 72 hours) and the late laparoscopic cholecystectomy group (less 72 hours) post-ERCP."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Kitano, Seigo
Laparoscopic gastrectomy for cancer : standard techniques and clinical evidences
"The first laparoscopy-assisted gastrectomy for gastric cancer was performed in Japan in 1991. In the ensuing 20 years, at first through a process of trial and error, then through the sharing of master surgeons’ accumulated experience, the procedure has been honed and refined to its current high level. From the beginning, it soon became evident that this much less invasive form of gastrectomy, in comparison with traditional open surgery, led to improved quality of life for postsurgical patients, and use of the procedure spread rapidly among gastric surgeons. Early on, however, there were calls for the establishment of standard techniques and procedures to be followed, with a recognized need to improve the level of safety and the quality of lymph node dissection for local control in cancer treatment. Toward that end, the Laparoscopy-Assisted Gastrectomy Club was formed in 1999. In the following year, because both Japan and Korea experience a high rate of gastric cancer, specialists from those two nations came together to form the Japan–Korea Laparoscopic gastrectomy joint seminar, to facilitate and encourage the exchange of vital information. The result has been to achieve an evolving consensus among specialists in the field of endoscopic surgery in Japan and Korea with expertise that can be shared worldwide. A compilation of the current state-of-the-art is now presented in this volume, with accompanying DVD, which will be of great value to all endoscopic surgeons who perform laparoscopic gastrectomy.
"
Tokyo: Springer, 2012
e20426084
eBooks  Universitas Indonesia Library
cover
Cundiff, Geoffrey W.
Te Linde's atlas of gynecologic surgery
"Gynecology has always been a surgical specialty, yet the breadth and complexity of gynecologic surgery continues to expand. Telinde's Atlas of Gynecologic Surgery helps both the gynecologist in training and those already in practice to master this field. The text provides clear and detailed, step-by-step descriptions involved in performing techniques. Each prose is accompanied by meticulous, colorized drawings to maximize the surgeons' understanding of the technique. Included with the text, is access to an online site. The online site provides fully searchable text and narrated videos from most chapters to demonstrate the techniques anytime, anywhere. While specialists perform many of the procedures included in this text each year, in general practices these procedures are done relatively infrequently and consequently, these surgeons look for means to refresh their memories prior to performing them. This text will also serve as a treasured resource for new surgeons and residents who are just incorporating these procedures into their surgical repertoire"
Philadelphia: Lippincott Williams & Wilkins, 2014
616.105 9 CUN l
Buku Teks SO  Universitas Indonesia Library
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Raya Henri Batubara
Kolesistektomi laparoskopi di Rumah Sakit Cipto Mangunkusumo 2014 : Studi retrospektif observasional = Laparoscopic cholecystectomy experience at Cipto Mangunkusumo Hospital 2014 : A retrospective study
"ABSTRAK
Latar belakang: Kolesistektomi merupakan tindakan abdomen tersering dan saat ini
kolesistektomi laparoskopi (KL) merupakan baku emas dan telah dilakukan pada 90% kasus
kolesistitis simtomatik. Tujuan penelitian ini adalah untuk mengetahui hasil KL di RSCM,
Jakarta.
Metode: Penelitian retrospektif observasional ini menggunakan data dari departemen bedah
divisi digestif RSCM dari bulan Januari hingga Desember 2014. Partisipan penelitian ini
adalah pria atau wanita yang berusia 23-66 tahun yang menjalani KL. Tindakan bedah
dilakukan baik berupa perawatan 1 hari (one day care (ODC)) maupun elektif. Data yang
dikaji adalah temuan preoperatif dan intraoperatif, durasi operasi, lama rawat inap, dan angka
konversi ke tindakan kolesistektomi terbuka (open). Kemudian kami menganalisis faktor
yang mempengaruhi angka konversi.
Hasil: Jumlah pasien yang masuk inklusi adalah 90 orang. Usia rata-rata 43,9 tahun (SE=1,26
tahun) dengan jumlah pasien wanita 61 orang (67,8%). Median durasi operasi adalah 90±36,9
menit dimana pasien yang konversi membutuhkan operasi lebih dari 2 jam lebih banyak
(12% vs 1,5%), namun tidak bermakna secara statistik (p= 0,63). Median lama rawat inap
adalah 9±27.2 hari dan meningkat bermakna pada kasus yag konversi (24±9 hari, p = 0.011).
Median lama pre-operasi = 7±26,8 hari, dan pasca-operasi = 2±3.8 hari, dengan 13,3% pasien
dilakukan endoscopic retrograde cholangio-pancreatography (ERCP) sebelum KL. Cedera
duktus biliaris komunis (CBDK) ditemukan pada 3 kasus (3,33%). Konversi menjadi
laparotomi dibutuhkan pada 4,44% kasus. Faktor yang mempengaruhi angka konversi hanya
pada kasus adhesi (RR (95%IK) = 25,7 (2,4-273,5); p=0,007.
Kesimpulan temuan: kolesistektomi laparoskopi menawarkan lama rawat inap yang lebih
singkat. Durasi operasi pendek dan prosedur ini standard, aman, dan efektif di institusi kami. ABSTRACT
Background: Cholecystectomy is the most frequently performed abdominal operation and
currently laparoscopic cholecystectomy (LC) is considered gold standard being performed in
90% cases of symptomatic gallstones. The aim of the study was to determine results obtained
with LC at our hospital, RSCM, Jakarta.
Methods: This retrospective observational study was conducted in digestive divison in
surgery department of RSCM using data from January to December 2014. The study
participants were patients of both gender aged 23?66 years undergoing LC. Surgery was
performed either in one day care (ODC) or elective schedule. Demographic variables,
preoperative and intraoperative findings, mean operation time, hospital stay, and conversion
rate were evaluated. Factors influencing rate of conversion were also studied.
Results: A total of 90 patients were included. Mean age was 43.9 years (SE=1.26 years) with
a female 61 (67.8%). Median operative time was 90±36.9 minutes which converted cases
patient needed to operate in more than 2 hours (12% vs 1.5%), but not statistically significant
(p= 0.63). Median hospital stay was 9±27.2 days that significantly increased in converted
cases (24±9 days, p-value= 0.011). Median of pre-operation = 7±26.8 days, and postoperation
= 2±3.8 days, with 13.3% patients underwent endoscopic retrograde cholangiopancreatography
(ERCP). Common bile duct injury (CBDI) was found in 3 cases (3.33%).
Conversion to laparotomy was required in 4.44% cases. Factors that influenced the rate of
conversion included was only adhesion (RR (95%CI) = 25.7 (2.4-273.5), p=0.007.
Findings: Laparoscopic cholecystectomy offers shorter hospital stay. The operative time is
short and procedure is standard, safe and effective in our institution.;Background: Cholecystectomy is the most frequently performed abdominal operation and
currently laparoscopic cholecystectomy (LC) is considered gold standard being performed in
90% cases of symptomatic gallstones. The aim of the study was to determine results obtained
with LC at our hospital, RSCM, Jakarta.
Methods: This retrospective observational study was conducted in digestive divison in
surgery department of RSCM using data from January to December 2014. The study
participants were patients of both gender aged 23?66 years undergoing LC. Surgery was
performed either in one day care (ODC) or elective schedule. Demographic variables,
preoperative and intraoperative findings, mean operation time, hospital stay, and conversion
rate were evaluated. Factors influencing rate of conversion were also studied.
Results: A total of 90 patients were included. Mean age was 43.9 years (SE=1.26 years) with
a female 61 (67.8%). Median operative time was 90±36.9 minutes which converted cases
patient needed to operate in more than 2 hours (12% vs 1.5%), but not statistically significant
(p= 0.63). Median hospital stay was 9±27.2 days that significantly increased in converted
cases (24±9 days, p-value= 0.011). Median of pre-operation = 7±26.8 days, and postoperation
= 2±3.8 days, with 13.3% patients underwent endoscopic retrograde cholangiopancreatography
(ERCP). Common bile duct injury (CBDI) was found in 3 cases (3.33%).
Conversion to laparotomy was required in 4.44% cases. Factors that influenced the rate of
conversion included was only adhesion (RR (95%CI) = 25.7 (2.4-273.5), p=0.007.
Findings: Laparoscopic cholecystectomy offers shorter hospital stay. The operative time is
short and procedure is standard, safe and effective in our institution.;Background: Cholecystectomy is the most frequently performed abdominal operation and
currently laparoscopic cholecystectomy (LC) is considered gold standard being performed in
90% cases of symptomatic gallstones. The aim of the study was to determine results obtained
with LC at our hospital, RSCM, Jakarta.
Methods: This retrospective observational study was conducted in digestive divison in
surgery department of RSCM using data from January to December 2014. The study
participants were patients of both gender aged 23?66 years undergoing LC. Surgery was
performed either in one day care (ODC) or elective schedule. Demographic variables,
preoperative and intraoperative findings, mean operation time, hospital stay, and conversion
rate were evaluated. Factors influencing rate of conversion were also studied.
Results: A total of 90 patients were included. Mean age was 43.9 years (SE=1.26 years) with
a female 61 (67.8%). Median operative time was 90±36.9 minutes which converted cases
patient needed to operate in more than 2 hours (12% vs 1.5%), but not statistically significant
(p= 0.63). Median hospital stay was 9±27.2 days that significantly increased in converted
cases (24±9 days, p-value= 0.011). Median of pre-operation = 7±26.8 days, and postoperation
= 2±3.8 days, with 13.3% patients underwent endoscopic retrograde cholangiopancreatography
(ERCP). Common bile duct injury (CBDI) was found in 3 cases (3.33%).
Conversion to laparotomy was required in 4.44% cases. Factors that influenced the rate of
conversion included was only adhesion (RR (95%CI) = 25.7 (2.4-273.5), p=0.007.
Findings: Laparoscopic cholecystectomy offers shorter hospital stay. The operative time is
short and procedure is standard, safe and effective in our institution.;Background: Cholecystectomy is the most frequently performed abdominal operation and
currently laparoscopic cholecystectomy (LC) is considered gold standard being performed in
90% cases of symptomatic gallstones. The aim of the study was to determine results obtained
with LC at our hospital, RSCM, Jakarta.
Methods: This retrospective observational study was conducted in digestive divison in
surgery department of RSCM using data from January to December 2014. The study
participants were patients of both gender aged 23?66 years undergoing LC. Surgery was
performed either in one day care (ODC) or elective schedule. Demographic variables,
preoperative and intraoperative findings, mean operation time, hospital stay, and conversion
rate were evaluated. Factors influencing rate of conversion were also studied.
Results: A total of 90 patients were included. Mean age was 43.9 years (SE=1.26 years) with
a female 61 (67.8%). Median operative time was 90±36.9 minutes which converted cases
patient needed to operate in more than 2 hours (12% vs 1.5%), but not statistically significant
(p= 0.63). Median hospital stay was 9±27.2 days that significantly increased in converted
cases (24±9 days, p-value= 0.011). Median of pre-operation = 7±26.8 days, and postoperation
= 2±3.8 days, with 13.3% patients underwent endoscopic retrograde cholangiopancreatography
(ERCP). Common bile duct injury (CBDI) was found in 3 cases (3.33%).
Conversion to laparotomy was required in 4.44% cases. Factors that influenced the rate of
conversion included was only adhesion (RR (95%CI) = 25.7 (2.4-273.5), p=0.007.
Findings: Laparoscopic cholecystectomy offers shorter hospital stay. The operative time is
short and procedure is standard, safe and effective in our institution.;Background: Cholecystectomy is the most frequently performed abdominal operation and
currently laparoscopic cholecystectomy (LC) is considered gold standard being performed in
90% cases of symptomatic gallstones. The aim of the study was to determine results obtained
with LC at our hospital, RSCM, Jakarta.
Methods: This retrospective observational study was conducted in digestive divison in
surgery department of RSCM using data from January to December 2014. The study
participants were patients of both gender aged 23?66 years undergoing LC. Surgery was
performed either in one day care (ODC) or elective schedule. Demographic variables,
preoperative and intraoperative findings, mean operation time, hospital stay, and conversion
rate were evaluated. Factors influencing rate of conversion were also studied.
Results: A total of 90 patients were included. Mean age was 43.9 years (SE=1.26 years) with
a female 61 (67.8%). Median operative time was 90±36.9 minutes which converted cases
patient needed to operate in more than 2 hours (12% vs 1.5%), but not statistically significant
(p= 0.63). Median hospital stay was 9±27.2 days that significantly increased in converted
cases (24±9 days, p-value= 0.011). Median of pre-operation = 7±26.8 days, and postoperation
= 2±3.8 days, with 13.3% patients underwent endoscopic retrograde cholangiopancreatography
(ERCP). Common bile duct injury (CBDI) was found in 3 cases (3.33%).
Conversion to laparotomy was required in 4.44% cases. Factors that influenced the rate of
conversion included was only adhesion (RR (95%CI) = 25.7 (2.4-273.5), p=0.007.
Findings: Laparoscopic cholecystectomy offers shorter hospital stay. The operative time is
short and procedure is standard, safe and effective in our institution."
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
cover
Siregar, Moammar Andar Roemare
Adrenalektomi per laparoskopi: kurva pembelajaran di pusat pelayanan volume rendah = laparoscopic adrenalectomy: learning curve in a low volume center
"ABSTRAK
Adrenalektomi per laparoskopi telah diterima secara umum sebagai prosedur bedah standar untuk sebagian besar tumor adrenal dalam dua dekade terakhir. Adrenalektomi per laparoskopi telah menunjukkan beberapa keuntungan dibandingkan dengan operasi terbuka dalam hal mengurangi rasa nyeri pasca operasi, waktu rawatan di rumah sakit lebih cepat, lebih cepat kembali dalam aktivitas sebelum operasi, dan meningkatkan kosmesis. Penelitian ini bertujuan untuk menggambarkan karakteristik pasien dan evaluasi dari kurva pembelajaran dalam prosedur adrenalektomi per laparoskopi di Rumah Sakit Cipto Mangunkusumo, Jakarta, Indonesia. Studi ini meninjau karakteristik tumor, status intraoperatif, dan variabel pasca operasi dari semua pasien yang menjalani adrenalektomi per laparoskopi mulai dari 2007 hingga 2014. Penelitian ini melaporkan 14 pasien yang menjalani adrenalektomi per laparoskopi dengan usia rata-rata 41.3 ± 10.1 tahun and BMI rata-rata 23.6 ± 2.5. Lokasi tumor 50% berada di sisi kanan dan 50% di sisi kiri. Ukuran rata-rata tumor 4.4 ± 2.6, 71.4% pada kelompok ≤ 6 cm dan 28.6% dalam kelompok ≥ 6 cm. Sebagian besar pasien (42.9%) secara klinis didiagnosis dengan Conn syndrome, dengan hasil histopatologis sebagian besar menunjukkan adenoma kortikal adrenal (78,6%). Tidak ada perbedaan rata-rata signifikan dalam perdarahan intraoperatif pada sisi dan ukuran tumor yang berbeda, dan tidak ada perbedaan waktu operasi pada sisi tumor yang berbeda. Terdapat perbedaan dalam waktu operasi dimana waktu operasi pada kelompok tumor < 6 cm lebih cepat (172 ± 45.1 minutes) dibandingkan kelompok tumor ≥ 6 cm (222.5 ± 23.9 minutes) dengan p < 0.05. Laparoskopi adrenalektomi adalah teknik minimal invasif yang dapat dilakukan dengan aman dan efisien dengan keunggulan yang signifikan dibandingkan dengan operasi terbuka.
ABSTRACT
Laparoscopic adrenalectomy has become generally accepted as the standard surgical procedure for the vast majority of adrenal tumors over the past two decades. Laparoscopic adrenalectomy has shown several advantages compared to the open approach in terms of reduced postoperative pain, shorter hospital stay, faster return to preoperative activity level, and improved cosmesis. This study was aimed to describe patients characteristics and evaluate our learning curve of laparoscopic adrenalectomy at Cipto Mangunkusumo Hospital, Jakarta, Indonesia. This study reviewed tumor characteristics, intraoperative status, and postoperative variables of all patients who underwent laparoscopic adrenalectomy starting from 2007 until 2014. This study reported 14 patients who had underwent laparoscopic adrenalectomy with mean of age was 41.3 ± 10.1 years and mean BMI was 23.6 ± 2.5. The tumor were 50% on the right side and 50% on the left side. The mean size of the tumor was 4.4 ± 2.6, 71.4% in ≤ 6 cm group and 28.6% in ≥ 6 cm group. Most of the patients (42.9%) were clinically diagnosed with Conn syndrome, with histopathological result mostly showing adrenal cortical adenoma (78.6%). There were no significant mean differences of intraoperative bleeding on different sides and sizes of tumor, and no differences in operation time on different sides of tumor. There were lower operating time in tumor size <6 cm group (172 ± 45.1 minutes) compared to size ≥ 6 cm group (222.5 ± 23.9 minutes) with p < 0.05. Laparoscopic adrenalectomy is a minimally invasive technique that can be performed safely and efficiently with significant advantages compare to open approach."
Jakarta: Fakultas Kedokteran Universitas Indonesia , 2019
T59200
UI - Tesis Membership  Universitas Indonesia Library
cover
Spontaneous uterine rupture in a patient who had previously undergone laparoscopic myomectomy (Case report)
"Tulisan ini membahas dan melaporkan ruptura uteri saat kehamilan dan persalinan pada kasus pasca miomektomi perlaparoskopi. Laporan kasus kejadian ruptur uterus pada pasien yang sebelumnya mengalami laparoskopi operatif miomektomi miom intramural Æ 3.5 cm, yang 6 bulan kemudian mengalami kehamilan. Tidak ada gejala ke arah ruptura uteri saat kehamilan namun pada saat usia gestasi 34 minggu, pasien mengalami gejala ruptura uteri. Pada saat laparotomi; ditemukan fetus 2100 gram mati, dan robekan jaringan 5 cm pada sikatriks bekas miomektomi. Pada pasien yang mengalami miomektomi per laparoskopi khususnya miom intramural mempunyai risiko ruptura uteri pada saat persalinan. (Med J Indones 2004; 14: 113-6)
Following laparoscopic myomectomy, uterine rupture during pregnancy or delivery in the area of the scar is a very rare but dangerous complication. Individual cases of uterine rupture during pregnancy are described in the literature. Case report of uterine rupture during delivery in a patient who had previously undergone laparoscopic myomectomy. In the case presented here, the patient conceived 6 months after an 3.5 cm intramural myoma, had been laparoscopically removed. No symptoms suggesting uterine rupture were observed during the pregnancy, but in the first stage of delivery the condition of the patient deteriorated and symptoms of oligaemic shock developed. A laparotomy was performed, which showed the presence of 2100 gr fresh dead fetus in the abdominal cavity and ruptured uterine muscle in the scarred area about 5 cm. In patients who have previously undergone a laparoscopic myomectomy, there is some risk of uterine rupture at delivery. This is also the case where unappropriate suturing of the uterine muscle had been required. (Med J Indones 2004; 14: 113-6)"
Medical Journal of Indonesia, 14 (2) April Juni 2005: 113-116, 2005
MJIN-14-2-AprJun2005-113
Artikel Jurnal  Universitas Indonesia Library
cover
Nurmalasari
Edukasi diet rendah lemak pada pasien pasca laparoskopi kolesistektomi = Low fat diet education with post laparoscopic cholecystectomy patients
"[ABSTRAK
Kolelitiasis merupakan salah satu kasus keperawatan kesehatan masyarakat
perkotaan yang prevalensinya cenderung meningkat. Hal ini berkaitan dengan faktor
pola makan masyarakat perkotaan dalam mengkonsumsi makanan cepat saji yang
cenderung tinggi lemak dan kolesterol. Karya ilmiah akhir ini menggambarkan
pelaksanaan asuhan keperawatan pada pasien pasca laparoskopi kolesistektomi.
Metode penelitiaan dari karya ilmiah akhir ini menggunakan studi kasus. Diet rendah
lemak yaitu pembatasan asupan lemak karena pasien tidak memproduksi cairan
empedu lagi dan jika diet pasien tidak tepat akan mengakibatkan gangguan
metabolisme lemak. Hasil yang diperoleh setelah pemberian edukasi diet rendah
lemak pada klien kolelitiasis adalah peningkatan pemahaman klien yang akan
mengubah pola makan klien setelah pulang dari rumah sakit. Perawat sebagai
edukator berperan penting dalam memberikan edukasi diet rendah lemak yang
merupakan salah satu asuhan keperawatan pada pasca laparaskopi kolesistektomi.ABSTRACT Cholelithiasis is one of the urban public health cases which the prevalence tends to
increase. This case related to the urban dietary habit in consumpting fast food which
contains high fat and cholesterol. This paper describes the implementation of nursing
care to post laparoscopic cholecystectomy patients. The method of this paper uses
case study. Low fat diet is the restriction of fat intake because the patient is not
produce bile again and if the patient?s diet is not right will result in fat metabolism
disorder. The result after low fat education is to enhanced understanding of the
patient that will change dietary habit of patients after discharge from the hospital.
Nurses as educator have an important role in educating low fat diet which one of
nursing care with post laparascopic cholecystectomy patients.;Cholelithiasis is one of the urban public health cases which the prevalence tends to
increase. This case related to the urban dietary habit in consumpting fast food which
contains high fat and cholesterol. This paper describes the implementation of nursing
care to post laparoscopic cholecystectomy patients. The method of this paper uses
case study. Low fat diet is the restriction of fat intake because the patient is not
produce bile again and if the patient?s diet is not right will result in fat metabolism
disorder. The result after low fat education is to enhanced understanding of the
patient that will change dietary habit of patients after discharge from the hospital.
Nurses as educator have an important role in educating low fat diet which one of
nursing care with post laparascopic cholecystectomy patients.;Cholelithiasis is one of the urban public health cases which the prevalence tends to
increase. This case related to the urban dietary habit in consumpting fast food which
contains high fat and cholesterol. This paper describes the implementation of nursing
care to post laparoscopic cholecystectomy patients. The method of this paper uses
case study. Low fat diet is the restriction of fat intake because the patient is not
produce bile again and if the patient?s diet is not right will result in fat metabolism
disorder. The result after low fat education is to enhanced understanding of the
patient that will change dietary habit of patients after discharge from the hospital.
Nurses as educator have an important role in educating low fat diet which one of
nursing care with post laparascopic cholecystectomy patients., Cholelithiasis is one of the urban public health cases which the prevalence tends to
increase. This case related to the urban dietary habit in consumpting fast food which
contains high fat and cholesterol. This paper describes the implementation of nursing
care to post laparoscopic cholecystectomy patients. The method of this paper uses
case study. Low fat diet is the restriction of fat intake because the patient is not
produce bile again and if the patient’s diet is not right will result in fat metabolism
disorder. The result after low fat education is to enhanced understanding of the
patient that will change dietary habit of patients after discharge from the hospital.
Nurses as educator have an important role in educating low fat diet which one of
nursing care with post laparascopic cholecystectomy patients.]"
Fakultas Ilmu Keperawatan Universitas Indonesia, 2015
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Ilham Wahyudi Soamole
Efek analgesia penambahan deksametason 8 mg pada blok tranversus abdominal plane tiga titik dibandingkan dengan epidural kontinyu pascalaparoskopi nefrektomi = Analgesia effect of adding dexamethasone 8 mg in three point plane tranversus abdominis block compared to continuous epidural for postoperative laparoscopic nephrectomy
"Latar Belakang: Tatalaksana nyeri pascabedah pada pasien pascalaparoskopi nefrektomi merupakan salah satu kunci pemulihan dini pasien. Di RSUPN Cipto Mangunkusomo, hampir semua pasien donor ginjal pascabedah laparoskopi nefrektomi mendapatkan analgesia epidural kontinyu. Masih tingginya persentase pasien dengan derajat nyeri berat, serta terdapatnya efek samping retensi urin pascaanalgesia epidural kontinyu, membuka kemungkinan untuk digunakannya teknik analgesia berbasis anestesia regional lain yang lebih baik. Blok tranversus abdominis plane dapat digunakan sebagai analgesia pascabedah abdomen, aman digunakan pada pasien dengan gangguan fungsi koagulasi dan tidak menyebabkan terjadinya retensi urin dibandingkan dengan teknik blok neuraksial. Metode: Penelitian ini bersifat uji klinis terkendali tidak tersamar tunggal, dengan populasi semua pasien donor ginjal yang menjalani laparoskopi nefrektomi pada bulan Mei-Oktober 2017 di RSUPN Cipto Mangunkusumo. Sebanyak 25 subyek pada dua kelompok diambil dengan metode consecutive sampling. Analisa statistik dilakukan untuk mengetahui efek analgesia penambahan deksametason 8 mg pada blok TAP tiga titik, rata-rata derajat nyeri gerak dan kebutuhan morfin pascabedah pada kedua kelompok dengan menggunakan uji Mann-Whitney dan uji Friedman dan post hoc Wilcoxon.Hasil: Uji Mann-Whitney rata-rata nyeri diam tidak berbeda signifikan p 0,066-0,716 . Uji Mann-Whitney Kebutuhan PCA morfin pada 24 jam pascabedah tidak berbeda signifikan p 0,072-0,200 . Perubahan derajat nyeri pada blok TAP dengan uji Friedman dan post hoc Wilcoxon bermakna signifikan p 0,002 dan 0,020 . Kebutuhan morfin pada blok TAP dengan uji Friedman dan post hoc Wilcoxon bermakna signifikan p 0,023 . Saat pertama menggunakan tambahan morfin dan awal mobilisasi pascabedah tidak ada perbedaan pada kedua kelompok. Kekerapan retensi urin pascabedah lebih tinggi pada epidural kontinyu 58.01 .Simpulan: Penambahan deksametason 8 mg tidak memberikan efek analgesia yang lebih baik pada blok TAP tiga titik dibanding epidural kontinyu. Jumlah penggunaan morfin, saat pertama membutuhkan tambahan morfin, rata-rata derajat nyeri gerak dan awal mobilisasi pascabedah tidak berbeda signifikan pada blok TAP tiga titik dengan epidural kontinyu. Kekerapan retensi urin pascabedah lebih tinggi pada epidural kontinyu.
Abstract Background Postoperative pain management in laparoscopic nephrectomy is one key to early recovery. At RSUPN Cipto Mangunkusomo, almost all postoperative laparoscopic donor nephrectomy patients acquire continuous epidural analgesia. High percentage of patients with severe degree of pain and presence of postoperative urinary retention related to continuous epidural opens the possibility of better use of other regional anesthesia analgesia techniques. Tranversus abdominis plane block can be used as postoperative analgesia in abdominal surgery, safe in patients with impaired coagulation function and does not cause urinary retention compared with neuraxial block technique. Methods Randomized control trial in all kidney donor patients undergoing laparoscopic donor nephrectomy in RSUPN Cipto Mangunkusomo during May October 2017. Consecutive sampling and random allocation was done to put 25 patients in each TAP block and Continuous Epidural group. Statistical analysis was performed to determine the effect of adding 8 mg of dexamethasone in three point TAP block on degree of pain at rest and with movement and postoperative morphine requirements using Mann Whitney, Friedman and post hoc Wilcoxon test. Results Mann Whitney test showed no significant difference in pain at rest p 0,066 0,716 and 24 hours postoperative morphine requirements p 0,072 0,200 between two groups. Friedman and post hoc Wilcoxon test showed a significant difference in degree of pain p 0,002 and 0,020 and morphine requirement p 0,023 in TAP block group. There is no difference in time to first dose of morphine rescue and early postoperative mobilization. There is higher incidence of postoperative urinary retention in continuous epidural group 58.01 .Conclusion The addition of dexamethasone 8 mg on three point TAP block did not provide better analgesia than continuous epidural. The amount of morphine requirement, time to first dose of morphine rescue, degree of pain at rest and with movement and early postoperative mobilization did not differ significantly between two groups. The frequency of postoperative urinary retention is higher with continuous epidural."
Depok: Universitas Indonesia, 2017
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Safety and feasibility of laparoscopic gastrectomy for gastric cancer patients with a history of abdominal surgery
"PURPOSE: To assess the safety and feasibility of laparoscopic gastrectomy (LG) for gastric cancer patients with a history of abdominal surgery (HAS).
METHODS: This retrospective study analyzed data collected from gastric cancer patients with HAS, who underwent LG between 2004 and 2015. We compared the clinicopathological features that correlated with conversion to open surgery and the development of severe postoperative complications (Clavien-Dindo classification of grade III or higher).
RESULTS: Of the 41 patients identified, 6 (14.6%) required conversion to open surgery. The incidence of conversion to open surgery was associated with a history of lower gastrointestinal tract surgery (p = 0.009), attempted laparoscopic total gastrectomy (p = 0.002), and excessive blood loss (p < 0.001). Severe postoperative complications developed in six patients (14.6%). Although the development of complications was associated with high postoperative serum C-reactive protein, the type of past abdominal surgery was not significantly correlated with severe complications.
CONCLUSIONS: LG was feasible for gastric cancer patients with a HAS, but for those with a history of lower abdominal surgery or those who require total gastrectomy, surgeons should carefully consider the indications for LG."
Tokyo: Springer, 2017
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