Hasil Pencarian  ::  Simpan CSV :: Kembali

"[Pendahuluan:
Hydrofiber merupakan materi balutan luka yang memiliki kemampuan absorbsi dan memberikan suasana lembab yang baik, namun belum diketahui potensi kemampuannya sebagai hemostat. Penelitian ini bertujuan untuk melihat potensi kemampuan hemostasis hydrofiber.
Metode:
Studi eksperimental in-vitro dan in-vivo menggunakan kontrol dan randomisasi dilakukan pada 7 ekor tikus (in-vitro) dan 14 ekor tikus (in-vivo) Rattus novergicus strain Sprague-Dawley yang sehat dengan berat 200-300 gram. Pada penelitian in-vitro didapatkan 32 sampel darah 1mL. Pada 16 sampel kelompok perlakuan ditambahkan 5mg hydrofiber; 16 sisanya berfungsi sebagai kontrol. Waktu koagulasi dihitung dan dianalisis menggunakan independent t-test. Pada penelitian in-vivo subjek dikelompokkan menjadi 3 grup yang masing-masing terdiri dari 9 buah luka dan ditutup dengan hydrofiber, alginat atau kasa lembab salin. Selisih berat darah yang diserap tiap balutan dihitung dan dianalisis menggunakan uji Kolmogorv-Smirnov, sedangkan selisih luas area perdarahan dihitung dengan uji Anova (p<0.05)
Hasil:
Dari penelitian in-vitro didapatkan hasil tidak terdapat perbedaan antara waktu koagulasi sampel darah dengan hydrofiber dibandingkan dengan tanpa hydrofiber [p=0.119 (CI -7.47-62.28)]. Sedangkan pada penelitian kedua didapatkan hasil tidak terdapat perbedaan pada selisih berat [p=0.163 (CI 31.41-54.83)] dan selisih luas (p=0.788 (CI 2.83-3.28)] antara kelompok hydrofiber, alginate, dan kasa lembab salin.
Diskusi:
Hydrofiber tidak memiliki perbedaan dalam hal hemostasis bila dibandingkan dengan alginat dan kasa lembab salin yang sudah lama diketahui memiliki kemampuan hemostasis; dapat disimpulkan bahwa hydrofiber berpotensi memiliki kemampuan hemostasis., Background:
Hydrofiber is a highly absorbent dressing with its ability to promote wound healing. Because of its structure similarity with alginate, hemostatic property of hydrofiber is being questioned. This study was aimed to explore hemostatic property of hydrofiber.
Methods:
In-vitro and in-vivo experimental study was performed in healthy Sprague- Dawley rats weighing 200-300 gram. A number of 32 blood samples were collected from 7 animals for in-vitro study; 16 samples were added with hydrofiber, while the rest functioned as control. Coagulation time between hydrofiber and control were analyzed using independent t-test. The in-vivo study involved 27 deep dermal wounds that were divided into 3 groups where each group of wounds was covered with hydrofiber, alginate, and saline gauze dressing respectively. Amount of blood that was absorbed by each dressing were analyzed using Kolmogorv-Smirnov test, while bleeding surface area after dressing were analyzed with Anova test (p<0.05)
Results:
There is no significant difference in terms of coagulation time between hydrofiber and control [p 0.119 (CI -7.47-62.28)]. The amount of blood that was absorbed by each dressing [p 0.163 (CI 31.41-54.83)] and the bleeding surface area after dressing [p 0.788 (CI 2.83-3.28)] were also not significantly different between hydrofiber, alginate, and saline soaked gauze.
Conclusion:
Hydrofiber shows potential hemostasis property, as it has no difference in its profile of coagulation time and amount of absorbed blood with the profiles shown by alginate and saline soaked gauze.]"

"AbstrakDespite the advancement of bone reconstruction in the past decade, large bone defect remains a challenge for orthopedic surgery. As mesenchymal stem cells (MSCs) emerges as one of the possible treatment of these defects, we evaluate the effect of its transplantation, particularly in combination with hydroxyapatite-calcium sulphate pellets. Methods: Twenty eight rabbits were randomly assigned into four different treatment groups. Each group received a different type of grafts (Autograft, hydroxyapatite-calcium sulphate [HA-CaSO4], HA-CaSO4 combined with marrow aspirate, or HA-CaSO4 combined with 2x106 MSCs). One centimeter long bone defects were created then immediately fixated with mini plate-screw and two cerclage wires. It was followed by the graft transplantation. Callus thickness was measured from the x-rays taken at 4, 8, 12 week after transplantation by two authors working independently. At the end of the study, histological staining along with osteocyte index were obtained by sacrificing the rabbits. These data were analyzed by one-way ANOVA test.Results: At the fourth week, callus thickness showed significant difference (p = 0.018). Although statistically insignificant, callus in MSCs group at the eighth week seemed to be thicker than any other groups of intervention (p = 0.546). The MSCs group also tend to have a higher osteocyte index at the follow-up weeks.Conclusion: MSC transplantation on bone defect results in faster callus formation and tends to generate a thicker callus."

"Latar belakang: Stenosis mitral (SM) merupakan peyempitan dari orifisium katup mitral, dimana SM berat didefinisikan sebagai area katup mitral (AKM) <1 cm² dan biasanya berhubungan dengan gradien transmitral >10 mmHg. Pada praktik klinis, ketidaksesuaian antara hasil pengukuran AKM dan gradien transmitral sering ditemukan. Pasien SM berat dengan gradien transmitral rendah (≤10 mmHg) memiliki kecenderungan menetapnya gejala klinis paska tindakan pembedahan katup mitral dan kurangnya perbaikan klinis paska tindakan komisurotomi mitral transkateter perkutan (KMTP). Namun hingga saat ini, belum banyak studi mengenai faktor yang berhubungan dengan gradien transmitral rendah pada SM berat. Tujuan:Penelitian ini bertujuan untuk mengetahui faktor yang berhubungan dengan gradien transmitral rendah pada SM berat. Metode: Studi potong lintang pada 322 pasien SM berat. Dilakukan evaluasi catatan rekam medik dan hasil pemeriksaan ekokardiografi transtorakal. SM berat didefinisikan sebagai SM dengan AKM <1 cm² yang diukur secara planimetri dan gradien transmitral rendah didefinisikan sebagai gradien transmitral ≤10 mmHg. Hasil: Dari 322 subjek penelitian, sebanyak 36% memiliki gradien transmitral ≤10 mmHg, 68,9% perempuan dan 72% memiliki irama fibrilasi atrium (FA). Berdasarkan analisis multivariat, didapatkan faktor independen gradien transmitral rendah pada SM berat adalah net atrioventricular compliance (IK 95% 3,57–11,02, OR 6,27), maximal tricuspid regurgitation velocity (IK 95% 0,14–0,45, OR 0,26), irama fibrilasi atrium (IK 95% 1,20–4,91, OR 2,43) dan jenis kelamin perempuan (IK 95% 1,07–3,69, OR 1,99). Kesimpulan: Net atrioventricular compliance, maximal tricuspid regurgitation velocity, irama fibrilasi atrium dan jenis kelamin perempuan berhubungan dengan gradien transmitral rendah pada stenosis katup mitral berat.

---

Background: Mitral stenosis (MS) is the narrowing of mitral valve orifice, in which severe MS is defined as planimetered mitral valve area (MVA) <1 cm² with transmitral gradient >10 mmHg. However, discrepancy between planimetered MVA and transmitral gradient is not uncommon in patients with severe MS, suggesting the presence of low gradient (LG) severe MS. Patients in this group display less benefit from valvuloplasty and a greater risk for persistent symptoms after mitral valve replacement (MVR). Yet, factors associated with LG severe MS has not been studied extensively. Objective: Aim of this study is to determine factors associated with LG severe MS. Methods: This is a cross-sectional study in 322 patients with severe MS. Medical records and transthoracic echocardiography examination results were evaluated. Severe MS was defined as planimetered MVA <1 cm² and LG was defined as transmitral gradient ≤10 mmHg. Results: Of 322 subjects, 36% had transmitral gradient ≤10 mmHg, 68,9% were women, and 72% had atrial fibrillation. According to multivariate analysis, several independent factors to LG severe MS were net atrioventricular compliance (95% CI 3,57–11,02, OR 6,27), maximal tricuspid regurgitation velocity (95% CI 0,14–0,45, OR 0,26), atrial fibrillation (95% CI 1,20–4,91, OR 2,43) and women (95% CI 1,07–3,69, OR 1,99). Conclusion: Net atrioventricular compliance, maximal tricuspid regurgitation velocity, AF and women were associated with LG severe MS."

"ABSTRAK Keberhasilan proses haemodialisis ditentukan oleh terpenuhinya dosis HD sesuai dengan kebutuhan pasien. Pemberian dosis HD yang sesuai dengan kebutuhan pasien dapat dinilai dari adekuasi atau kecukupan haemodialisis yang dicapai pasien HD. Dengan nilai Qb yang berbeda memberi pengaruh terhadap bersihan ureum yang dicapai. Penelitian ini diharapkan berguna dalam pengaturan dan pemantauan terhadap Qb sehingga dapat mengoptimalkan kecukupan dialisis pasien dan terciptanya kualitas hidup pasien yang lebih baik.Tujuan :Penelitian ini diharapkan dapat memberikan gambaran bagaimana korelasi antara Qb dengan adekuasi haemodialisis pada pasien dengan Arterovenous Fistula (AVF) yang matur. Selain itu mengidentifikasi karakteristik pasien (umur, jenis kelamin dan berat badan interdialisis), Qb pasien dengan AVF yang matur, mengidentifikasi adekuasi haemodialisis yang dicapai oleh pasien dengan AVF yang matur, menganalisa korelasi antara Qb dengan adekuasi haemodialisis pada pasien AVF yang matur dan menganalisa korelasi antara faktor perancu dengan adekuasi haemodialisis pada pasien dengan AVF yang matur.Metode :Penelitian ini merupakan penelitian kuantitatif dengan pendekatan studi cross-sectional. Hasil tersebut ditulis dalam lembar pengumpulan data. Selanjutnya dilakukan pengolahan data hasil observasi dengan menggunakan penghitungan secara statistik melalui SPSS 20.0. Pengambilan sampel dengan tehnik total sampling yang memenuhi kriteria inklusi. Penelitian dilakukan di Divisi Vaskular & Endovaskular FKUI-RSCM Jakarta dan ruang haemodialisa RSCM dan dilakukan pada bulan September sampai November 2015.Hasil :Hasil analisis hubungan antara Qb dengan adekuasi haemodialisis (nilai Kt/V) menunjukkan hasil yang tidak signifikan, dimana p value sebesar 0,227 (p > 0,05). Hasil penelitian ini menyimpulkan bahwa tidak ada hubungan yang bermakna antara Qb dengan adekuasi haemodialisis (p = 0,227).Kesimpulan :Tidak ada hubungan yang bermakna antara Qb dengan adekuasi haemodialis (nilai Kt/V). Pada penelitian ini terdapat banyak kekurangan diantaranya penilaian adekuasi haemodialisis hanya dengan melihat hasil Kt/V tanpa dilakukan pengukuran URR. Keterbatan lain yaitu ruang HD RSCM menggunakan membran dialyzer jenis low flux, hal ini tentunya mempengaruhi pencapaian bersihan ureum yang pada akhirnya berpengaruh terhadap pencapaian adekuasi haemodialisis.ABSTRACT Background:The success of the process is determined by the fulfillment hemodialysis HD dose according to the patient's needs. HD dosing according to patient needs can be assessed from the adequacy or adequacy of hemodialysis patients who achieved HD. Qb different with giving effect to the urea clearance is achieved. This study is expected to be useful in setting up and monitoring of the Qb so as to optimize the adequacy of dialysis patients and the creation of quality of life of patients better.Aim:This study is expected to provide an overview of how the correlation between Qb and adequacy of hemodialysis in patients with Arterovenous Fistula (AVF) that mature. Besides identifying patient characteristics (age, sex and weight interdialisis), Qb patients with AVF were mature, identify the adequacy of hemodialysis achieved by patients with AVF were mature, analyzing the correlation between Qb and adequacy of hemodialysis in patients with AVF were mature and analyzing the correlation Among the factors confounding the adequacy of hemodialysis in patients with AVF were mature.Method:This research is a quantitative approach cross-sectional study. The result is written in the data collection sheets. Furthermore, the data processing of observation results using statistical calculation by SPSS 20.0. Sampling with total sampling technique that met the inclusion criteria. The study was conducted at the Division of Vascular & Endovascular Faculty of medicine-RSCM Jakarta and space Haemodialisa RSCM and conducted from September to November 2015.Results:The results of the analysis of the relationship between Qb and adequacy of hemodialysis (value Kt / V) showed significant results, where the p value of 0.227 (p> 0.05). Results of this study concluded that there was no significant relationship between Qb and adequacy of hemodialysis(p=0.227).Conclusion:There is no significant relationship between Qb and adequacy haemodialis (value Kt / V). In this study, there are many shortcomings including hemodialysis adequacy assessment just by looking at the Kt / V without a measurement of URR. Another Keterbatan namely HD space RSCM use dialyzer membrane type of a low flux, it is certainly affect the achievement of urea clearance which ultimately affect the achievement of the adequacy of hemodialysis.;Background:The success of the process is determined by the fulfillment hemodialysis HD dose according to the patient's needs. HD dosing according to patient needs can be assessed from the adequacy or adequacy of hemodialysis patients who achieved HD. Qb different with giving effect to the urea clearance is achieved. This study is expected to be useful in setting up and monitoring of the Qb so as to optimize the adequacy of dialysis patients and the creation of quality of life of patients better.Aim:This study is expected to provide an overview of how the correlation between Qb and adequacy of hemodialysis in patients with Arterovenous Fistula (AVF) that mature. Besides identifying patient characteristics (age, sex and weight interdialisis), Qb patients with AVF were mature, identify the adequacy of hemodialysis achieved by patients with AVF were mature, analyzing the correlation between Qb and adequacy of hemodialysis in patients with AVF were mature and analyzing the correlation Among the factors confounding the adequacy of hemodialysis in patients with AVF were mature.Method:This research is a quantitative approach cross-sectional study. The result is written in the data collection sheets. Furthermore, the data processing of observation results using statistical calculation by SPSS 20.0. Sampling with total sampling technique that met the inclusion criteria. The study was conducted at the Division of Vascular & Endovascular Faculty of medicine-RSCM Jakarta and space Haemodialisa RSCM and conducted from September to November 2015.Results:The results of the analysis of the relationship between Qb and adequacy of hemodialysis (value Kt / V) showed significant results, where the p value of 0.227 (p> 0.05). Results of this study concluded that there was no significant relationship between Qb and adequacy of hemodialysis(p=0.227).Conclusion:There is no significant relationship between Qb and adequacy haemodialis (value Kt / V). In this study, there are many shortcomings including hemodialysis adequacy assessment just by looking at the Kt / V without a measurement of URR. Another Keterbatan namely HD space RSCM use dialyzer membrane type of a low flux, it is certainly affect the achievement of urea clearance which ultimately affect the achievement of the adequacy of hemodialysis."

"ABSTRAK Penatalaksanaan Fistel Enterokutan masih sangat beragam dan sulit dengan tingkat kekambuhan dan kematian pasca pembedahan yang masih tinggi. Tujuan dari penatalaksanaan pasien dengan fistel enterokutan adalah koreksi defisit metabolik dan nutrisi, penutupan fistel dan mengembalikan kesinambungan saluran cerna. Tujuan dari penelitian ini adalah untuk melakukan evaluasi penatalaksanaan bedah pada fistel enterokutan yang dirawat di RSUPN Cipto Mangunkusumo selama tahun 2014-2015. Penelitian ini dirancang secara retrospektif analitik dengan mengambil data rekam medik penderita di RSUPN Cipto Mangunkusumo pada periode 2014-2015. Ditemukan 27 kasus fistel enterokutan, dimana 21 kasus yang di evaluasi, rentang umur 27-65 tahun, terbanyak pada kelompok 40-60 tahun (52,38%), letak fistel terbanyak di ileum (57,14%), high output (71,43%), gizi buruk (52,38%), dilakukan tindakan operatif (85,71%), lama rawat <20 hari (66,67%), rekurensi fistel (19,05%) dan angka kematian (14,29%).ABSTRACT Management of enterocutaneous fistula still varies and frustrating with high recurrence and mortality rate. The goal of management for patient with enterocutaneous fistula are correct metabolic and nutritional deficits, close the fistula and reestablish continuity of the gastrointestinal tract. The purpose of this study was to evaluate the surgical management of the enterocutaneous fistula treated at Cipto Mangunkusumo Hospital during 2014-2015. This study designed analytic retrospectively by taking the patient medical record data at Cipto Mangunkusumo Hospital ini the period 2014-2015. Found 27 cases of enterocutaneous fistula which 21 cases were evaluated, age range 40-60 years (52,38%), the location of the fistula largest in the ileum (57,14%), high output (71,43%), malnutrition (52,38%), operative management (85,71%), length of stay in hospital <20 days (66,67%), fistula recurrence (19,05%) and mortality rate (14,29%).;Management of enterocutaneous fistula still varies and frustrating with high recurrence and mortality rate. The goal of management for patient with enterocutaneous fistula are correct metabolic and nutritional deficits, close the fistula and reestablish continuity of the gastrointestinal tract. The purpose of this study was to evaluate the surgical management of the enterocutaneous fistula treated at Cipto Mangunkusumo Hospital during 2014-2015. This study designed analytic retrospectively by taking the patient medical record data at Cipto Mangunkusumo Hospital ini the period 2014-2015. Found 27 cases of enterocutaneous fistula which 21 cases were evaluated, age range 40-60 years (52,38%), the location of the fistula largest in the ileum (57,14%), high output (71,43%), malnutrition (52,38%), operative management (85,71%), length of stay in hospital <20 days (66,67%), fistula recurrence (19,05%) and mortality rate (14,29%).;Management of enterocutaneous fistula still varies and frustrating with high recurrence and mortality rate. The goal of management for patient with enterocutaneous fistula are correct metabolic and nutritional deficits, close the fistula and reestablish continuity of the gastrointestinal tract. The purpose of this study was to evaluate the surgical management of the enterocutaneous fistula treated at Cipto Mangunkusumo Hospital during 2014-2015. This study designed analytic retrospectively by taking the patient medical record data at Cipto Mangunkusumo Hospital ini the period 2014-2015. Found 27 cases of enterocutaneous fistula which 21 cases were evaluated, age range 40-60 years (52,38%), the location of the fistula largest in the ileum (57,14%), high output (71,43%), malnutrition (52,38%), operative management (85,71%), length of stay in hospital <20 days (66,67%), fistula recurrence (19,05%) and mortality rate (14,29%)."

"Latar belakang : Insiden sindrom pascakolesistektomi SPK di RS dr.Cipto Mangunkusumo RSCM pada tahun 2012 sebesar 54.29 , lebih tinggi daripada penelitian di negara lain.Tujuan : Studi ini bertujuan mencari faktor risiko SPK untuk mengupayakan turunnya insiden SPK.Metode : Dilakukan suatu studi cross-sectional terhadap subjek yang menjalani kolesistektomi pada periode Januari - Desember 2015.Hasil : Total 112 pasien menjalani laparoskopik kolesistektomi. Insiden SPK didapatkan sebesar 45,5 . Pada analisis bivariat didapatkan hubungan signifikan antara SPK dengan lama keluhan praoperasi p=0,033, OR=2,29 , flatulens praoperasi p=0,000, OR=16,48 , gejala non-spesifik praoperasi p=0,000, OR=6,93 , persepsi pasien p=0,000, OR=5,723 . Pada analisis regresi logistik didapatkan flatulens praoperasi p=0,000, OR=17,152 , gejala non-spesifik praoperasi p=0,012, OR=3,984 dan persepsi pasien praoperasi p=0,003, OR=5,907 merupakan faktor risiko untuk SPK. Rerata lama observasi pascaoperasi adalah 14,95 bulan.Kesimpulan : Tingginya angka SPK di RSCM akibat jumlah subjek dengan gejala praoperasi non-spesifik yang lebih tinggi, persepsi praoperasi yang buruk, dan perbedaan lama observasi pascaoperasi.

---

Background: Incidence of postcholecystectomy syndrome in Cipto Mangunkusumo Hospital at 2012 is 54.29 , higher than ever reported.

Objective: The objective of the study was to identify risk factors of PCS and decrease its incidence.

Method: A cross sectional study was performed enroll all subjects that underwent cholecystectomy from January to December 2015.

Result: All 112 subjects underwent laparoscopic cholecystectomy. We found the incidence for PCS to be 45.5 . Bivariate analysis showed there were significant correlation between PCS and preoperative symptom duration p 0.033, OR 2.29 , preoperative flatulence p 0.000, OR 16.48 , non specific preoperative symptoms p 0.000, OR 6.93 , poor preoperative perception p 0.000, OR 5.723 . Multivariate logistic regression analysis showed that only preoperative flatulence p 0.000, OR 17.152 , non specific preoperative symptoms p 0.012, OR 3.984 , and poor preoperative perception p 0.003, OR 5.907 were independent predictive factors for PCS. Mean of postoperative observation was 14.95 months.

Conclusion: High incidence of PCS in RSCM was influenced by larger number of subject with non specific preoperative symptoms, poor preoperative perception and the difference in duration for postoperative observation."

"ABSTRAK Pendahuluan:Obstruksi duodenum kongenital merupakan salah satu kelainan bawaan pada saluran cerna yang tersering. Fungsi peristaltik merupakan hal yang ingin dicapai pada pascabedah. Resiko terjadinya translokasi bakteri pada kasus obstruksi membuat pasien jatuh dalam kondisi sepsis hal ini akan memengaruhi waktu tercapainya fungsi peristaltik dan pada akhirnya akan meningkatkan morbiditas dan mortalitas. Selain itu, infeksi nosokomial yang mengancam neonatus menyebabkan sepsis pada neonatus juga akan memengaruhi waktu tercapainya fungsi peristaltik. Penelitian ini ditujukan untuk mencari hubungan sepsis dengan waktu tercapainya fungsi peristaltik. Metode: Desain penelitian ini adalah potong lintang menggunakan data sekunder yaitu pasien obstruksi duodenum tanpa disertai kelainan bawaan berupa gastroschizis, omphalocele dan atresia intestinal lain yang telah dilakukan operasi di RSCM periode bulan Januari 2010-Juli 2016. Subjek dikelompokkan menjadi sepsis dan non sepsis kemudian dilakukan analisis untuk melihat hubungan dengan waktu tercapainya fungsi peristaltik serta menganalisis variabel perancu yaitu, usia gestasi, berat badan lahir, kelainan bawaan, kondisi hipoksia dan ketidakseimbangan elektrolit. Analisis data dilakukan univariat, bivariat Mann Whitney, Chi Square atau Fischer dan multivariat (regresi linier) dengan nilai p <0,05 dianggap bermakna. Hasil: Dari 31 subjek didapatkan bahwa median waktu tercapainya fungsi peristaltik pada subjek sepsis dan non sepsis yaitu 12,5 dan 5 hari (p <0,0001). Hubungan antara waktu tercapainya fungsi peristaltik dengan sepsis (p <0,0001), usia gestasi (p = 0,004) dan kondisi hipoksia (p = 0,02). Pada analisis multivariat didapatkan hasil antara sepsis dengan waktu tercapainya fungsi peristaltik dengan nilai p = 0,011 dan nilai R Simpulan: Pada penelitian ini sepsis merupakan faktor utama yang memengaruhi waktu tercapainya fungsi peristaltik. Mengingat cukup jauhnya perbedaan waktu yang dicapai antara kelompok sepsis dan non sepsis maka perlu dilakukan pengontrolan maupun pencegahan kondisi sepsis baik dalam prabedah maupun pascabedah sehingga dapat menurunkan morbiditas dan mortalitas. ABSTRACT Introduction: A common site for congenital duodenal obstruction is the duodenum. Peristaltic function is to be achieved in the postoperative, respectively. Intestinal obstruction has been shown to induce bacterial translocation and that event would be associated with an increased risk of sepsis conditions. That condition would affecting the achievement of peristaltic function and ultimately increased morbidity  and mortality. In addition, nosocomial infections that threaten neonates cause sepsis also will affect the achievement of a peristaltic function. Therefore, the aim of this study was to investigate the relationship between sepsis with timing achievement of peristaltic function postoperatively. Methods: This study is cross sectional study design. The research data was obtained from medical records of patients with duodenal obstruction without congenital abnormalities such as gastroschizis, omphalocele and other intestinal atresia that have underwent operations in RSCM period January 2010 to July 2016. Subject are grouped into sepsis and without sepsis. The relationships between sepsis and timing achievement of peristaltic function also confounding variabels (gestational age, birth weight, congenital abnormalities, conditions of hypoxia and electrolyte imbalance) were analyzed. Data analysis was performed using univariate, bivariate (Mann Whitney, Chi Square or Fischer) and multivariate (linear regression) with significance p Results: The study included 31 subjects. Time were needed to achieved peristaltic function (median value) are 12,5 days in patients with sepsis and 5 days in patients without sepsis. Bivariate analysis between timing achievement of peristaltic function are sepsis with p <0,0001, gestational age with p = 0,004 and hypoxic conditions with p = 0,02. Multivariate analysis have shown relationship between sepsis and timing achievement of peristaltic function with p = 0,011 and R Conclusion: In this study, sepsis is a major factor affecting the achievement of a peristaltic function . Considered the differences time to achieved peristaltic function between sepsis and without sepsis is significant. Therefore,it is necessary to control and prevent sepsis preoperatively and postoperatively thus reducing morbidity and mortality."

"Pendahuluan: Masalah fungsional dan kosmetik semakin meningkat akibat adanya defek pada area craniofacial termasuk mandibula yang membentuk bagian bawah wajah. Rekonstruksi mandibula bertujuan memberikan kemungkinan maksimal dari hasil fungsional dan estetik. Hasil yang optimal dari fungsi rekonstruksi mandibula adalah salah satu tujuan dari penggunaan teknik flap bebas fibula. Dengan bantuan dari perkembangan system proses komputer dalam desain dan pembuatan, operasi craniomaxillofacial dapat dilakukan dengan bantuan komputer melalui berbagai bentuk dan variasi tujuan. Dalam rangka menelaah kualitas dari penelitian yang telah tersedia dan memberikan informasi untuk pengambilan keputusan, kajian mengenai perbadingan operasi dengan bantuan komputer (CAS) dengan metode konvensional freehand (CFS) menjadi penting untuk dilakukan. Metode: Pencarian pustaka sistematis dilakukan pada pusat data PubMed, ProQuest, Cochrane Library, EBSCOhost, Wiley Library, Science Direct, dan Scopus, mencakup semua studi dengan data utama yang membandingkan hasil akurasi, efisiensi, komplikasi, dan fungsional diantara kelompok CAS dan CFS. Risiko bias studi dinilai menggunakan Newcastle-Ottawa Scale (NOS). Meta-analisis dilakukan melalui Review Manager. Hasil: Enam belas studi kohort memenuhi kriteria eligibilitas dari 355 studi pada pencarian awal. Studi dengan hasil yang sama (akurasi, efisiensi, komplikasi, dan fungsional) dibandingkan antara kelompok CAS dan CFS. Sebanyak 13 studi menunjukkan hasil signifikan secara statistik pada penilaian efisiensi: waktu ischemia lebih singkat (-34.84 menit, 95% CI: -40.04 to -29.63; p<0.00001; I2=94%), total waktu operasi lebih singkat (-70.04 menit, 95% CI: -84.59 to -55.49; p<0.00001; I2=77%), waktu rekonstruksi lebih singkat (-41.86 minutes, 95% CI: -67.15 to -16.56; p=0.001; I2=93%), dan lama rawat inap yang lebih singkat(-2.98 days, 95% CI: -4.35 to -1.61; p=0.0001; I2=7%) pada kelompok CAS dibanding kelompok CFS. Kesimpulan: Kajian sistematis dan meta-analysis menunjukkan hasil yang lebih baik pada kelompok CAS dibandingkan dengan CFS yang signifikan pada hasil efisiensi, Namun beberapa studi melaporkan berbagai analisis statistik dengan berbagai parameter untuk kategori hasil komplikasi, akurasi, dan fungsional. Seluruh studi sepakat bahwa CAS memberikan manfaat yang lebih dibandingkan CFS, walaupun CFS masih dapat menjadi pilihan.

---

Background: Major functional and cosmetic problems will arise from defects in craniofacial regions, including mandible which constructs the shape of lower third of the face. The aim of mandibular reconstruction is to achieve the best possible functional and aesthetic outcomes. The optimal return of mandibular bone function is one of the reconstruction goals using free fibular flap (FFF). With aid of the evolving computer processing system for design and manufacturing, craniomaxillofacial surgery can be conducted with computer-aided surgery in many forms and varied proposes. In order to evaluate the quality of available article and to provide information for decision-making, review of comparison between computer-aided surgery (CAS) and conventional freehand surgery (CFS) need to be evaluated.

Methods: A systematic search was conducted on PubMed, ProQuest, Cochrane Library, EBSCOhost, Wiley Library, Science Direct, and Scopus, including all studies with primary data that compared accuracy, efficiency, complication, and functional outcomes between CAS and CFS group. Risk of bias for included studies were assessed based on Newcastle-Ottawa Scale. Meta-analysis was performed in Review Manager.

Results: Sixteen cohort studies were included that meet the eligibility criteria from initial searches of 355 studies. Studies with the same outcome (accuracy, efficiency, complication, and functional) are compared in CAS and CFS group. Thirteen studies demonstrated statistically significant efficiency outcomes: shorter ischemia time (-34.84 minutes, 95% CI: -40.04 to -29.63; p<0.00001; I2=94%), shorter total operative time (-70.04 minutes, 95% CI: -84.59 to -55.49; p<0.00001; I2=77%), shorter reconstruction time (-41.86 minutes, 95% CI: -67.15 to -16.56; p=0.001; I2=93%), and shorter length of hospital stay (-2.98 days, 95% CI: -4.35 to -1.61; p=0.0001; I2=7%) in CAS group than CFS group.

Conclusion: Systematic review and meta-analysis demonstrated higher outcomes CAS group compared to conventional group significantly in efficiency outcomes. However, some studies performed diverse statistical analysis on several parameters for outcomes category such as complications, accuracy, and functional. All studies agreed that CAS group has higher benefits than conventional method, although the conventional method is still an option."