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Mursid Fadli
Korelasi Quick of Blood (Qb) dihubungkan dengan adekuasi haemodialisis pada arterovenous fistula yang matur = Correlation between Quick of Blood (Qb) and adequacy of hemodialysis in mature arterovenous fistula
"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."
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Zwageri Argo Pitoyo
Evaluasi penatalaksanaan bedah pada fistel enterokutan di RSUPN Cipto Mangunkusumo Tahun 2014-2015 = Evaluation of surgical management of enterocutaneous fistula at Cipto Mangunkusumo Hospital 2014-2015
"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%)."
Fakultas Kedokteran Universitas Indonesia, 2016
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UI - Tugas Akhir  Universitas Indonesia Library
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Ika Megatia
Hubungan antara faktor risiko stenosis vena sentral dengan keberhasilan neoplastic di RSCM = Correlation between central vein stenosis risk factors with success rate of venoplasty in Cipto Mangunkusumo Hospital
"ABSTRAK
Latar belakang Dalam lima tahun terakhir, pengunaan kateter pada pasien penyakit ginjal kronis PGK di RSCM kerap diikuti stenosis vena sentral SVS , 60-70 . Sejak 2013 SVS ditangani melalui prosedur venoplasti, namun belum ada evaluasi keberhasilan. Penelitian ini ditujukan melakukan evaluasi keberhasilan venoplasti dan faktor risiko terjadinya stenosis. Metode Dilakukan studi deskriptif analitik dengan desain potong lintang melibatkan pasien PGK stadium 4-5 yang terdiagnosis simtomatik SVS, secara klinis dan radiologis, yang memiliki risiko stenosis, memenuhi kriteria inklusi dan ekslusi serta menjalankan venoplasti. Variabel independen yaitu onset gejala, jenis, lokasi, durasi dan frekuensi pemasangan kateter. Variabel dependen adalah keberhasilan venoplasti dinilai dengan residual stenosis 60 tahun, 61,8 laki-laki dan 70,6 memiliki hipertensi sebagai etiologi PGK. Angka berhasilan venoplasti 85,3 , nilai rerata initial stenosis adalah 79,1 13,8 dan median residual stenosis 24,5 dengan range 10-90 . Letak stenosis terbanyak di vena subklavia 47,1 . Tidak didapatkan hubungan bermakna terhadap keberhasilan venoplasti, namun angka ketidakberhasilan venoplasti yang lebih tinggi ditemukan pada lokasi di vena subklavia OR 2,45; p = 0,627 dan frekuensi pemasangan kateter >2 kali OR 1,85; p = 0,648 . Kesimpulan Keberhasilan venoplasti pada SVS 85,3 dengan keberhasilan ditemukan dua kali lebih tinggi pada implantasi di vena subklavia dan frekuensi > 2 kali. Namun pada studi ini tidak bermakna secara statistik. Ketidakberhasilan venoplasti lebih sering ditemukan pada subjek dengan pemasangan kateter di vena subklavia, durasi pemasangan panjang, onset gejala lambat dan riwayat pemasangan berulang. ABSTRACT Background In the last five years, the use of deep vein catheter in chronic kidney disease CKD often leads to central vein stenosis CVS at Cipto Mangunkusumo Hospital 60 70 . Since 2013, CVS has been managed with venoplasty, and has never been evaluated. The study aimed to evaluate of its success rate and the risk factors might be correlated. Method A descriptive analytic study with cross sectional design conducted enrolling of stage 4 5 CKD patients with symptomatic CVS who underwent venoplasty. Independent variables are onset of symptoms, type, location, duration and frequency of catheter implantation. Dependent variable is venoplasty success, which was determined by residual stenosis 60 years old, 61.8 were male and 70.6 with hypertension. Venoplasty success rate found on this study was 85.3 , mean initial stenosis was 79.1 13.8 and median residual stenosis was 24.5 ranged of 10 90 . The most common stenosis was found in subclavian vein 47.1 . There was no significant correlation with venoplasty success rate. Nevertheless, higher venoplasty success rate found in subjects with catheter located in subclavian vein OR 2.45 p 0.627 and the frequency of implantation 2 times OR 1.85 p 0.648 . Conclusion Venoplasty success rate on CVS patients was 85.3 with success rate found twice higher with implantation at subclavian vein and frequency 2 times. However, there was no statistically significant correlation between stenosis risk factors with this success rate. Venoplasty failure is often found on CVS subjects with catheter implantation on subclavian vein, prolonged duration, delayed onset of symptoms and history of recurrent implantation. Keywords Central vein stenosis, venoplasty, risk factors."
Fakultas Kedokteran Universitas Indonesia, 2017
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UI - Tugas Akhir  Universitas Indonesia Library
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Juwita Cresti Rahmaania
Hubungan sepsis dengan waktu tercapainya fungsi peristaltik usus pascabedah pada obstruksi duodenum kongenital = The relationship between sepsis and timing achievement of peristaltic function in congenital duodenal obstruction
"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."
2018
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UI - Tugas Akhir  Universitas Indonesia Library
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Novrizal Saiful Basri
Komplikasi infeksi pemasangan kateter lumen ganda sebagai akses hemodialisis = Infection as complication of double lumen catheter as hemodialysis access
"ABSTRAK
Pendahuluan. Salah satu komplikasi tersering dari pemasangan kateter lumen ganda adalah infeksi aliran darah. Tujuan penelitian ini adalah mengetahui angka komplikasi infeksi pada kateter lumen ganda dan faktor yang berhubungan.Metode. Dilakukan studi potong lintang analitik yang melibatkan semua subjek berusia ge;18 tahun yang telah menjalani tindakan pemasangan kateter lumen ganda untuk hemodialisis tahun 2015 di RSCM. Variabel yang dinilai adalah infeksi aliran darah, usia, jenis kelamin, diabetes melitus, riwayat kateter, riwayat infeksi, lokasi, dan lama pemakaian, untuk selanjutnya dilakukan uji statistik. Hasil statistik akan bermakna bila nilai p ABSTRACT
Introduction. One of the most common complication in vascular access was bacteremia or bloodstream infection. The purpose of this study was to know the infection rate in dialysis double lumen catheter DLC and its relating factors.Method. This was a cross sectional analytical study that was carried out by enrolling all ge 18 year old subjects who had underwent surgical insertion of double lumen catheter for hemodialysis in 2015 at Cipto Mangunkusumo Hospital. Variables of bloodstream infection, age, gender, diabetes mellitus, history of previous DLC infection, history of catheter related bacteremia, site of insertion and duration were subjected to statistical analysis. Significance was achieved if p value "
Fakultas Kedokteran Universitas Indonesia, 2017
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UI - Tugas Akhir  Universitas Indonesia Library
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Duta Liana
Faktor-faktor yang berhubungan dengan keterlambatan operasi di instalasi bedah pusat Rsupn Dr. Cipto Mangunkusumo
"ABSTRACT
The Factors Which Related with the Operation Delay in Central Surgery Installation at Dr.Cipto Mangunkusumo General HospitalIn accordance with scientific and technology development, surgery procedures are becoming a specialist and expensive health services.
There is a trend to minimize the cost of hospital services by establishing centralized of the high cost units such as operation rooms.
Dr. Cipto Mangunkusumo general hospital is the type A and National top referral hospital which has full array of experts/specialists physician while the tariff of the services is relatively lower than the surrounding private hospitals. The consequence of this condition, bring this hospital has to serve patients beyond its capacity which in turn overburdened the services. This condition is also affected at the central operation room, i.e. Central Surgery Installation.
In performing elective surgery procedures, the patients should wait for operation schedule. The preliminary observation showed that there were many delayed and canceled of the scheduled surgery, so that affected the hospital management and hospital performance.
The aim of this study is to know the percentage of delayed operations and affecting factors. This is a cross sectional study using observation and interviews. The sample is all of the surgery procedures during 6 working days at 12 operation rooms, in June 1996. The data was collected as primary data by filling the form and questionnaires.
The results:
1. Delayed surgery level is 90.9 %.
The delayed percentage of the arrival of consultant surgeon who needed for teaching the resident is 80.8 %, with average time of delay is 40 minutes. Then the delayed percentage of the arrival of anesthesiology resident is 60.6 % with the average time of delay is 36.6 seconds and the delayed percentage of arrival of patients is 62.1 % with the average time of delay is 4.2 minutes.
There is statistically significant correlation between the operation delay and the arrival delay of paramedic, anesthesiology resident, surgeon assistant, surgeon, surgeon consultant, the patients and the duration of operation. But there is no statistically significant correlation between the operation delay and the kind of surgery. This study is also revealed the percentage of operation cancel lance by 12.4 % with the common cause is patient subjectivity (28.6 %).
2. There are many operations which its duration are not appropriate with allocated time.
3. Lack of appropriate and adequate amount of linen, both for patients and provider, i.e. surgery linen such as jas pack, lap pack.
Suggestions :
1. Good communication between provider inside and outside of Central Surgery Installation.
2. It is necessary to make the evaluation about the report of tasks and responsibility of Central Surgery Installation and the procedure of surgery especially about the arrival of the provider.
3. It is necessary to make good cooperation with the medical committee of the hospital to take an appropriate action in case of any mistakes.
4. It is necessary to give special attention from the hospital administrator according to linen budgeting in the Central Surgery Installation.
5. It is necessary to make the longitudinal study about surgery duration according to the kind of surgery, to increase the optimal utilization of the operation room.
Bibliography : 24 ( 1969 - 1995 )
xi + 124 pages + 36 tables + 2 figures + 5 annexes;Sejalan dengan perkembangan IPTEK maka kebutuhan pelayanan kesehatan melalui tindakan bedah menjadi bentuk pelayanan kesehatan yang spesialistik, mahal.
ABSTRAK
Terdapatnya kecenderungan penghematan biaya pada pelayanan Rumah Sakit dengan melakukan sentralisasi unit-unit yang memerlukan biaya tinggi atau unit sebagai cost center diantaranya adalah kamar operasi.
Rumah Sakit Dr. Cipto Mangunkusumo sebagai rumah sakit tipe A dan rujukan tingkat nasional mempunyai tenaga ahli yang lengkap dan tarif yang relatif murah menyebabkan pasien yang datang melebihi kapasitas dan perlu mengalami antrian yang panjang. Hal ini dapat terjadi di kamar operasi yang dikenal dengan nama Instalasi Bedah Pusat. Dalam melaksanakan tindakan operasi efektif pasien harus menunggu antrian jadwal operasi, sedangkan dari pengamatan awal didapatkan masih adanya keterlambatan atau pembatalan operasi sehingga pasien harus menunggu jadwal antrian berikutnya. Tentunya hal ini selain mempunyai dampak kepada pasien juga terhadap manajemen rumah sakit serta penampilan kerja rumah sakit.
Penelitian ini bertujuan untuk mengetahui persentase keterlambatan/pernbatalan operasi dan faktor-faktor yang mempengaruhinya. Penelitian ini merupakan studi cross sectional dengan cara pengamatan kegiatan operasi dan wawancara. Adapun sampel pada penelitian ini adalah seluruh operasi pada 12 kamar operasi selama 6 hari kerja pada bulan Juni 1996 di Instalasi Bedah Pusat RSCM. Pengumpulan data dilakukan dengan menggunakan data primer berupa formulir pengisian dan kuesioner. Analisa statistik yang dilakukan adalah analisis univariat dan bivariat.
Hasil penelitian yang didapat :
1. Tingkat keterlambatan operasi 90,9%.
Diantara anggota provider, kedatangan konsulen operator yang dibutuhkan untuk bimbingan/ujian pada 26 operasi mempunyai persentase keterlambatan sebesar 80,8% dengan rata-rata waktu keterlambatan yaitu 40 menit, diikuti keterlambatan PPDS Anestesi 60,6% dengan rata-rata waktu keterlambatan 37,6 menit. Sedangkan pasien mempunyai persentase keterlambatan 62,1% dengan rata-rata waktu keterlambatan 4,2 menit. Adanya hubungan bermakna secara statistik antara keterlambatan operasi dengan keterlambatan kedatangan paramedik, PPDS anestesi, asisten operator, operator, konsulen operator, pasien, lama operasi. Sedangkan tidak ada hubungan bermakna secara statistik antara keterlambatan operasi dengan jenis operasi. Pada penelitian ini juga terdapat pembatalan operasi sebesar 12,4%. Dimana alasan terbanyak disebabkan faktor subyektivitas pasien (28,6%).
2. Adanya lama operasi yang belum sesuai dengan alokasi waktu (rencana) yang di tentukan.
3. Kurang tersedianya linen khususnya linen pasien, linen operasional (Jas pack, Lap pack) didalam kegiatan operasi.
Saran-saran yang diusulkan antara lain :
1. Adanya hubungan komunikasi (HAM) yang baik antara anggota provider baik yang berada di bawah atau yang tidak berada di bawah Instalasi Bedah Pusat, begitu pula dengan ruang rawat yang terkait.
2. Perlunya evaluasi terhadap laporan tertulis tentang tugas/tanggung jawab IBP dan tata tertib laksana tindakan bedah khususnya mengenai kedatangan provider yang telah disetujui oleh semua pihak yang terkait.
3. Perlunya bekerja sama dengan Direktur RSCM (komite medik) untuk mengambil langkah-langkah yang dianggap perlu apabila peraturan tertulis tersebut tidak dipatuhi.
4. Perlunya perhatian administrator Rumah Sakit terhadap anggaran pengadaan linen di Instalasi Bedah Pusat.
5. Perlu diadakan suatu survai lama operasi (alokasi waktu) berdasarkan jenis operasi untuk memudahkan dalam pembuatan waktu rencana operasi, sehingga dapat meningkatkan utilisasi kamar operasi.
Daftar Pustaka : 24 (1969-1995)
xi + 124 halaman + 36 tabel + 2 gambar + 5 lampiran"
Depok: Universitas Indonesia, 1996
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Dhita Kurniasari
Computer aided Surgery Versus Conventional Freehand Surgery for Presurgical Planning in Mandibular Reconstruction using Free Fibular Flap: A Systematic Review and Meta-Analysis = Perencanaan Operasi dengan Bantuan Komputer Versus Metode Konvensional pada Rekonstruksi Mandibula menggunakan Flap Bebas Fibula: Kajian Sistematis dan Meta Analisis
"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."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2021
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Aryono D. Pusponegoro
Sumbangan ilmu bedah digestif pada penanggulangan trauma berat abdomen
Jakarta: UI-Press, 2004
PGB 0174
UI - Pidato  Universitas Indonesia Library
cover
Wuri Iswarsigit
Efek Peregangan Donor FTSG terhadap Take dan Lebarnya Parut: Uji Eksperimental Pada Hewan
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2001
T58786
UI - Tesis Membership  Universitas Indonesia Library
cover
Glenda Angeline T.
Faktor risiko tingginya angka sindrom pascakolesistektomi spk di Rumah Sakit dr. Cipto Mangunkusumo pada tahun 2015 = Risk factors for high incidence of postcholecystectomy syndrome pcs in dr Cipto Mangunkusumo Hospital at 2015
"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."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2017
T55686
UI - Tugas Akhir  Universitas Indonesia Library
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