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"ABSTRAKPelaksanaan praktek klinik selama masa residensi keperawatan peminatan onkologi bertujuan untuk mampu menampilkan peran perawat spesialis sebagai pemberi asuhan keperawatan lanjut, pendidik, advokat, konselor, kolaborator, pembaharu dan peneliti, Peran pemberi asuhan keperawatan lanjut dilakukan dengan menggunakan Model Adaptasi Roy pada pasien Leiomyosarcoma Uterus dan 30 pasien kanker lainnya. Perilaku maladaptif paling banyak adalah mode adaptasi fisiologis dengan diagnosa keperawatan nyeri kronis. Intervensi keperawatan berupa manajemen nyeri ditujukan untuk meningkatkan adaptasi pasien dalam mengontrol nyeri kanker. Evidence Based Nursing dilakukan dengan menerapkan instrumen pengkajian MASCC Antiemesis Tool pada tujuh belas pasien yang menjalani program kemoterapi dan mengalami keluhan mual muntah akibat kemoterapi dengan hasil MASCC Antiemesis Tool merupakan instrumen pengkajian yang spesifik dan sensitif untuk mengkaji mual muntah akibat kemoterapi. Program inovasi kelompok berupa pembuatan media video panduan dan pelaksanaan intervensi kombinasi Progressive Muscle Relaxation dan Guided Imagery terbukti efektif sebagai tindakan mandiri keperawatan dalam manajemen nyeri kanker.

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ABSTRACT<>br>Implementation of clinical practice during the residency of nursing oncology aims to be able to showcase the role of specialist nurse as advanced nursing care provider , educator, advocator, counselor, collaborator, innovator and researcher. Role of specialist as advance nursing care provider is done by using Roy Adaptation Model on Leiomyosarcoma Uterus and 30 other cancer patients. Maladaptive behavior at most is a physiological adaptation mode with a chronic pain nursing diagnosis. Nursing outcome of pain management are aimed at improving patient adaptation in controlling cancer pain. Evidence Based Nursing was performed by applying the MASCC Antiemesis Tool assessment instrument to seventeen patients undergoing chemotherapy and experiencing chemotherapy induced nausea and vomiting. The MASCC Antiemesis Tool is a specific and sensitive instrument for assessing chemotherapy induced nausea and vomiting. The innovation program was making of video guide media and implementation of combination interventions of Progressive Muscle Relaxation and Guided Imagery proved effective as nursing intervention in the management of cancer pain."

"PURPOSE: A triplet regimen of docetaxel, cisplatin, and S-1(DCS) is highly effective against metastatic gastric cancer. We performed this study to clarify the safety and efficacy of surgical resection in patients with initially unresectable gastric cancer, after down-staging or disease control was achieved by DCS chemotherapy.METHODS: The subjects of this retrospective study were 31 consecutive patients with initially unresectable gastric cancer, who underwent surgical resection between October, 2006 and December, 2012, after downstaging or disease control was achieved by DCS chemotherapy. We evaluated the clinicopathological factors and clinical outcomes and assessed radiographic response based on the RECIST criteria, not by central review.RESULT: Before DCS chemotherapy, 18 patients had extraregional lymph node metastasis, 5 had liver metastasis, 8 had macroscopic peritoneal metastasis, and 8 had pancreatic head invasion. Twenty-three (74.2%) of the 31 patients underwent R0 resection. Postoperative morbidity and mortality rates were 16.1 and 0%. During chemotherapy, grade 3/4 toxicities included neutropenia (54.8%), leukopenia (32.3%), and anemia (16.1%). Median progression-free survival and median overall survival (OS) were 42.1 and 56.1 months, respectively. These results were similar for all patients, except those with locally advanced disease alone. In the multivariate analysis for OS, ypN remained an independent negative prognostic factor (p = 0.018).CONCLUSION: Surgical resection after DCS chemotherapy for initially unresectable gastric cancer was safe and provided a reasonable R0 resection rate and good midterm survival."

"Pendahuluan. Saat ini, infeksi daerah operasi (IDO) tetap menjadi komplikasi paling umum dari prosedur bedah. Dalam pencegahannya, antibiotik profilaksis menjadi pilihan pertama dan menyebabkan penggunaan antibiotik yang tinggi. Namun, pemberian antibiotik harus didasarkan pada strategi, yaitu stewardship. Oleh karena itu, penelitian ini bertujuan untuk menilai penggunaan antibotik menggunakan metode Gyssens. Metode Studi kohort retrospektif menganalisis pemberian antibiotik pada sebagian besar operasi elektif besar, termasuk tiroidektomi, mastektomi, dan kolesistektomi yang dilakukan di Rumah Sakit Umum Dr. Cipto Mangunkusumo, Jakarta, Indonesia dari Januari hingga Juli 2023. Indikasi, jenis, dosis, waktu, interval, durasi, dan rute pemberian adalah variabel yang diteliti. Hasil Dari 191 subjek yang menjalani prosedur bedah elektif paling umum, 30 menggunakan antibiotik kombinasi. Kategori Gyssens 0 terdiri dari 165 subjek (86,5%), dan 11 subjek (5,8%) diklasifikasikan sebagai kategori IIA, yang menunjukkan dosis yang tidak sesuai (tidak memadai, tidak mencukupi). Ketidakakuratan penggunaan antibiotik teridentifikasi sebagai pemberian pada waktu yang salah (5,8%), pemilihan antibiotik yang kurang tepat (3,1%), dosis yang salah (2,6%), dan waktu pemberian yang tidak tepat (2,1%). Hubungan antara kategori Gyssens dengan SSI menunjukkan nilai p > 0,05 dengan odds ratio 1, yang menunjukkan bahwa pemberian antibiotik yang sesuai maupun tidak sesuai dari kategori Gyssens tidak menunjukkan hubungan pada kejadian IDO atau non-IDO. Kesimpulan Tingkat kepatuhan penatagunaan antibiotik pada kasus bedah elektif terbanyak di Departemen Bedah RSUPN dr. Cipto Mangunkusumo yang dinilai menggunakan alur Gyssens mencapai 86,4% dan memerlukan perbaikan.

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Introduction. Nowadays, surgical site infections (SSI) remain the most common complication of surgical procedures. In prevention, the prophylactic antibiotic is the first option and somehow leads to the high use of antibiotics. However, antibiotic administration should be based on the strategies, which is the stewardship. Thus, the study aimed to assess using Gyssens' method. Method. A retrospective cohort study analyzed the antibiotic administration of most major elective surgeries, including thyroidectomy, mastectomy, and cholecystectomy proceeded in Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia from January to July 2023. Indication, type, dosage, timing, interval, and duration and route of administration were the variables of interest. Results. Of 191 subjects who underwent the most common elective surgery procedures, 30 used combination antibiotics. Gyssens category 0 consists of 165 subjects (86.5%), and 11 subjects (5.8%) were classified as category IIA, indicating inappropriate dose (inadequate, insufficient). Inaccuracies were identified as mistimed administration (5.8%), less effective antibiotic selection (3.1%), incorrect dosage (2.6%), and inappropriate timing (2.1%). The association of Gyssens categories with SSIs showed a p–value of > 0.05 with an odds ratio of 1, indicating that both appropriate and inappropriate antibiotics of the Gyssens category showed no impact on SSIs or non–SSIs. Conclusion. The adherence to antimicrobial stewardship in the most common elective surgery in the Department of Surgery, dr. Cipto Mangunkusumo General Hospital was 86.4 and subjected to improvement."

"Latar belakang : Pembedahan abdomen secara laparotomi menyebabkan penurunan kadar albumin. Kadar albumin di bawah 3,00 g/dL berperan dalam terjadinya mortalitas dan morbiditas pasca-operasi.Tujuan: Mengetahui hubungan antara kadar albumin pre-operasi dan pasca-operasi terhadap luaran klinis pasca-operasi laparotomi.Metode : Penelitian ini dengan desain kohort retrospektif menggunakan data rekam medis Departemen Ilmu Kesehatan Anak tahun 2015-2017. Total sampling pada pasien pasca-laparotomi di PICU dengan rentang usia 1 bulan hingga 18 tahun, dikelompokan ke dalam dua kategori, yaitu: albumin ≤ 3,0 g/dL dan > 3,00 g/dL. Subyek diambil data luaran klinis pasca-operasi seperti sepsis pasca-operasi, infeksi luka operasi, dehisens, relaparotomi, dan lama rawat di PICU.Hasil : Dua ratus satu subyek pasca-laparotomi diikutsertakan dalam penelitian ini. Kadar albumin pre-operasi ≤ 3,0 g/dL meningkatkan risiko terjadinya sepsis pasca-operasi (RR 3,40(95%IK: 1,54-7,51), relaparotomi (RR 3,84(95%IK: 1,28-11,49), dan lama rawat PICU 2 kali lebih lama daripada normoalbuminemia. Kadar albumin pasca-operasi ≤ 3,0 g/dL meningkatkan risiko terjadinya sepsis pasca-operasi (RR 2,55(95%IK: 1,40-4,63) dan lama rawat PICU 1 hari lebih lama daripada normoalbuminemia. Mortalitas pada kelompok hipoalbuminemia sebesar 19,2% dengan RR 3,44(95%IK: 1,07-11,07).Simpulan : Hipoalbuminemia pre-operatif atau pasca-operatif meningkatkan risiko kejadian sepsis pasca-operatif. Hipoalbuminemia pre-operatif atau pasca-operatif tidak berhubungan dengan infeksi luka operasi. Hipoalbuminemia pre-operatif atau pasca-operatif tidak berhubungan dengan risiko kejadian dehisens. Hipoalbuminemia pre-operatif meningkatkan risiko untuk menjalani relaparotomi. Hipoalbuminemia pre-operatif atau pasca-operatif memperpanjang lama rawat di PICU. Hipoalbuminemia pre-operatif meningkatkan angka mortalitas.

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Backgrounds : Laparotomy abdominal surgery decreasing serum albumin. Serum albumin concentration below 3,00 g/dL associated with postoperative morbidity and mortality.

Aim: To determine the relationship between serum albumin (preoperative and postoperative) and postoperative clinical course.

Methods : Retrospesctive observational study in pediatric patients undergoing laparotomy and hospitalized in Pediatric Intensive Care Unit during January 2015- December 2017. Post-laparotomy patients over the age range 1 month to 18 years, classified according to serum albumin concentration: ≤ 3,0 g/dL and > 3,00 g/dL. Postoperative outcome measured by postoperative sepsis, surgical site infection, dehiscence, relaparotomy, PICU length of stay, and mortality.

Results : Two hundred and one subjects undergone laparotomy participated. Preoperative serum albumin ≤ 3,0 g/dL increase risk of postoperative sepsis (RR 3,40 (95%CI: 1,54-7,51)), relaparotomy (RR 3,84 (95%CI: 1,28-11,49)), and twice longer in Pediatric Intensive Care Unit length of stay. Postoperative albumin ≤ 3,0 g/dL increase risk of postoperative sepsis (RR 2,55(95%CI: 1,40-4,63)) and Pediatric Intensive Care Unit length of stay. Mortality rate in hypoalbuminemic group is 19,2% with RR 3,44(95%CI: 1,07-11,07).

Conclusions : Preoperative and postoperative hypoalbuminemia increase risk of postoperative sepsis. Preoperative and postoperative hypoalbuminemia not associated with risk of surgical site infection and wound dehiscense. Preoperative hypoalbuminemia increase risk of relaparotomy. Preoperative and postoperative albumin concentration inversely related with Pediatric Intensive Care Unit length of stay. Preoperative hypoalbuminemia increase mortality rate."

"Latar Belakang. Virchow pada 1851 mendefinisikan kraniosinostosis sebagai penutupan prematur sutura kranialis. Pasien kraniosinostosis tidak hanya mengalami kelainan kalvaria, tetapi juga gangguan lainnya. Hingga saat ini, belum ada evaluasi baku pascaoperasi. Studi ini bertujuan mengajukan metode evaluasi pascaoperasi menggunakan volume otak dari CT Scan dan aspek tumbuh kembang. Metode. Studi bersifat retrospektif menggunakan data rekam medis dan radiologis pasien kraniosinostosis yang dilakukan operasi. Variabel independen mencakup jenis kelamin, usia saat operasi, jenis kraniosinostosis, dan sutura yang terlibat. Variabel dependen mencakup volume otak dan status perkembangan. Hasil. Terdapat delapan pasien memenuhi kriteria. Nilai median usia pasien saat menjalani operasi adalah 9,5 bulan, terdiri dari lima laki-laki (62%) dan tiga perempuan (38%). Seluruh pasien mengalami peningkatan volume otak dengan rentang 0,4% hingga 29%. Terdapat lima pasien (62%) memiliki volume otak sesuai usianya dan tiga pasien lainnya memiliki volume otak yang tidak sesuai usia pascaoperasi. Tiga pasien dengan volume otak tidak normal ditemukan mencapai volume normal pascaoperasi. Tidak ada perubahan tumbuh kembang pascaoperasi. Kesimpulan. Studi ini dapat menjadi referensi bagi studi lainnya untuk mengevaluasi volume otak dan tumbuh kembang pascaoperasi pasien kraniosinostosis. Evaluasi volume otak berdasarkan CT scan dan status tumbuh kembang pasien dapat digunakan sebagai salah satu pilihan standar dalam manajemen kraniosinostosis.

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Background. Craniosynostosis defined by Virchow as premature closure of cranial sutures. These patients not only have abnormal calvaria, but also other disorders. Until now, postoperative evaluation has not been standardized. This study aims to describe postoperative evaluation using brain volume and development aspects of the patients. Methods. This is a retrospective study using records and radiological examinations of patients who underwent surgery. The Independent variables are sex, age of operation, type of craniosynostosis and sutures involved. The dependent variables assessed are brain volume and developmental aspects. Results. This study includes 8 patiens. Age during surgery has median of 9.5 months that consists of 5 male (62%) and 3 female (38%). All patients experienced increased brain volume with changes from 0.4% to 29%. There were 5 patients (62%) with normal brain volume and 3 patients with abnormal brain volume at postoperative control. There were 3 patients that had preoperative abnormal brain volume who achieved normalization. There was no change in developmental aspects postoperatively. Conclusion. This study can be used as reference for assessing brain volume and growth in craniosynostosis. Study of brain volume evaluation based on CT scans and developmental status can be used as standard procedures in management of craniosynostosis."

"ABSTRACTPurpose: The development of surgical site infection (SSI) after biliary reconstruction is highly influenced by the presence of preoperative bacteria in the bile juice. We selected vancomycin and piperacillin/tazobactam (VCM + PIPC/TAZ) as perioperative prophylactic antibiotics for patients undergoing pancreaticoduodenectomy. This study aimed to retrospectively analyze the effectiveness of VCM + PIPC/TAZ compared to cefmetazole.Methods: Seventy-two patients who underwent pancreaticoduodenectomy between April 2015 and March 2017 at our department were evaluated. Forty patients were administered cefmetazole as the perioperative prophylactic antibiotic, and 32 were administered VCM + PIPC/TAZ. The intraoperative VCM blood concentration (incision, biliary reconstruction, and wound closure) was measured during surgery to confirm the hemodynamics.Results: The frequency of SSIs was significantly lower in the VCM + PIPC/TAZ group (8/32 patients) than in the cefmetazole group (20/40 patients, P = 0.031). Postoperatively, significantly fewer patients in the VCM + PIPC/TAZ group (4/32 patients) required ≥ 15 days of additional antibiotic administration compared to those in the cefmetazole group (14/40 patients, P = 0.033). Six of 32 patients in the VCM + PIPC/TAZ group showed redneck syndrome symptoms. There was no significant difference in the VCM blood concentration between patients with and without SSIs.Conclusions: The use of VCM + PIPC/TAZ can reduce the incidence of SSI after pancreaticoduodenectomy and also reduce the need for the additional administration of antibiotics for ≥ 15 days after surgery."

"ASBTRACTPurpose: We developed a microwave energy-based scissors device (MWCX) that is capable of performing cutting and coagulation using 2.45 GHz microwave energy. This paper aims to present the concept of the device and assess the basic functions including the hemostasis, cutting, and sealing abilities.Methods: Seven beagle dogs were used in our experiments. In six dogs, we measured the coagulation time (CT), lateral thermal injury (LTI), bursting pressure (BP). The dogs were then subjected to re-laparotomy 1 week later to allow us to investigate the results. In one dog, the same factors and the quantities of smoke and mist emitted were compared to those observed when using a Harmonic Focus (HF) device.Results: At 60 W, the MWCX could cut and seal small (5 s, diameter 1-2 mm) and medium-sized (10 s, 3-4 mm) vessels with complete hemostasis. The liver (length 2 cm) was cut for 30 s. Harvested vessels were sealed for 10 s (artery, 17 times; vein, six times). The mean BP was 887. 8 ± 41.5 mmHg in the medium arteries and 457.2 ± 118.0 mmHg in veins, with a mean diameter of 4.5 ± 1.3 mm. In a comparative study, the MWCX showed similar results to the HF with regard to the CT, BP and LTI, and emitted less smoke and mist.Conclusion: The MWCX showed similar levels of functionality and safety to HF, as well as the advantages offered by the use of microwave energy. Microwave devices might be used in the majority of applications for which traditional energy devices are used."

"Latar belakang: Obesitas telah menjadi masalah kesehatan yang serius di negara berkembang. Obesitas menyebabkan perubahan fisiologis yang kompleks dan peningkatan risiko penyakit kardiovaskular, diabetes, dan paru. Pasien obesitas dengan luka bakar lebih rentan mengalami perubahan fisiologis akibat penyakit penyerta yang sudah ada sebelumnya. Tujuan dari penelitian ini adalah untuk mengetahui apakah terdapat perbedaan mortalitas, lama rawat inap dan jumlah prosedur pembedahan antara pasien obesitas dan non-obesitas.Metode: Penelitian ini merupakan penelitian analitik observasional dengan rancangan penelitian kohort retrospektif. Terdapat dua kelompok yang diidentifikasi secara retrospektif dari data rekam medis, dan kemudian dibandingkan secara prospektif. Kami membandingkan hasil (tingkat kematian, jumlah prosedur bedah, dan lama rawat inap) pada pasien luka bakar obesitas dan non-obesitas.Hasil: Dominasi laki-laki ditemukan dalam penelitian ini dengan jumlah subjek 68 laki-laki (61,8%) dan 42 perempuan (38,2%). Kami menemukan bahwa tidak terdapat perbedaan mortalitas pada kelompok pasien luka bakar obesitas dibandingkan dengan kelompok non-obesitas (p=0,207, CI 95% 0,286-1,315). Dengan Mann-Whitney Test, juga tidak terdapat perbedaan antara lama rawat inap (p-value 0,332) dan jumlah prosedur pembedahan (p-value 0,521) pada pasien obesitas dibandingkan pasien non-obesitas.Kesimpulan: Kami tidak menemukan perbedaan yang signifikan secara statistik pada mortalitas, lama perawatan dan jumlah prosedur bedah antara pasien luka bakar obesitas dan pasien luka bakar non-obesitas. Namun proporsi pasien meninggal lebih tinggi pada kelompok obesitas. Jangka waktu yang lebih lama dengan jumlah subjek yang lebih besar diperlukan untuk mengatasi bias statistik dan memberikan hasil yang lebih kuat dalam analisis statistik.

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Background: obesity has become serious health issue in developing country. obesity causes complex physiologic alteration and increased risk for diabetes cardiovascular and pulmonary diseases. Obese patient with burn injury are more prone to have physiologic alteration resulting from pre-existing comorbid. The aim of this study is to investigate mortality, length of stay and number of surgical procedure between obese and non-obese patient.

Methods: This is an observational analytical study using the retrospective cohort study design. There are two groups which are retrospectively identified from the medical records, and then prospectively compared. We compare the outcomes (mortality rate, numbers of surgical procedure, and hospital length of stay) of obese and non-obese burn patients.

Results: Male predominance was found in this study with 68 males (61.8%) and 42 females (38.2%). We found out that there was no difference in mortality in obese burn patient groups compared to non-obese group (p=0.207, CI 95% 0.286-1.315). With Mann-Whitney Test, there were also no difference between length of stay (p-value 0.332) and number of surgical procedures (p-value 0.521) in obese patient compared to non-obese patient.

Conslusion: We did not find any statistically significant difference in mortality, length of stay and number of surgical procedures between obese burn patient and non-obese burn patient. However the proportion of deceased patient is higher in obese group. Longer period of time with larger number of subjects is needed to overcome statistical bias and provide more powerfull result in statistical analysis."

"Latar Belakang: Prosedur pembedahan dapat memicu perubahan aktivitas metabolisme yang ditandai dengan respon inflamasi, serta terjadinya peningkatan proses katabolisme protein yang dapat mengakibatkan penurunan kapasitas fungsional. Asupan protein selama periode pra laparotomi elektif merupakan hal yang dapat membantu mencegah penurunan kapasitas fungsional. Berbagai studi sebelumnya menunjukkan adanya hubungan antara asupan protein terhadap luaran klinis pasca laparotomi elektif, namun hasil penelitian ini menunjukkan hasil yang tidak konsisten. Penilaian kapasitas fungsional melalui pengukuran kekuatan genggam, disebut memiliki hubungan dengan luaran klinis pasca laparotomi elektif. Belum ada penelitian yang menilai hubungan asupan protein pra-operasi dengan perubahan kapasitas fungsional pada pasien pasca laparotomi elektif di RSCM.Metode: Studi potong lintang dilakukan pada 85 pasien pasca laparotomi elektif di RSUPN Dr. Cipto Mangunkusumo, Jakarta. Dilakukan pengambilan data berupa pengukuran kekuatan genggam pada hari ke-6 pasca laparotomi elektif. Data-data pra-operasi lain didapatkan melalui rekam medis pasien seperti data demografis, etiologi pembedahan, analisis asupan, dan komposisi tubuh. Analisis bivariat untuk menilai korelasi dilakukan dengan uji Pearson pada data berdistribusi normal dan uji Rank Spearman pada data tidak berdistribusi normal.Hasil: Didapatkan sebanyak 85 subjek dengan mayoritas perempuan. Etiologi pembedahan mayoritas berupa keganasan. Berdasarkan status gizi, sebagian besar subjek memiliki status gizi normal, diikuti dengan obesitas derajat I, dan berat badan lebih. Prosedur ERAS tidak dilakukan pada mayoritas subjek. Sebanyak 36,5% subjek memiliki nilai FFMI yang rendah. Rerata total asupan energi pra-operasi subjek penelitian sebesar 26 kkal/kg BB, rerata total asupan protein pra-operasi sebesar 50,8 g, dengan total asupan protein per kg BB berkisar 0,5–1,8 g/kgBB. Rerata perubahan kekuatan genggam pra dan pasca laparotomi elektif tangan kanan sebesar 1,1 kg dan tangan kiri sebesar 0,8 kg. Ditemukan korelasi positif lemah antara asupan protein pra operasi dengan perubahan kekuatan genggam kanan (r = 0,18, p = 0,099) dan perubahan kekuatan genggam kiri (r = 0,166, p =0,129). Uji analisis multivariat dengan regresi linear berganda didapatkan bahwa FFMI pra-operasi merupakan faktor yang paling memengaruhi perubahan kekuatan genggam kanan (p = 0,042).Kesimpulan: Tidak didapatkan korelasi signifikan antara asupan protein pra operasi dengan perubahan kekuatan genggam tangan kanan dan kiri.

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Background: Surgical procedures trigger metabolic changes involving inflammatory, hormonal, and immunological responses. Increased protein breakdown can lead to reduced functional capacity. Preoperative protein intake has been suggested as a preventive measure against functional decline. However, research on the relationship between preoperative protein intake and postoperative outcomes has shown conflicting results. Grip strength measurement is a potential surrogate marker for postoperative outcomes, but its association with preoperative protein intake remains unexplored in elective laparotomy patients at RSCM.

Methods: We conducted a cross-sectional study on 85 patients who underwent elective laparotomy at RSUPN Dr. Cipto Mangunkusumo, Jakarta. Grip strength was measured on the 6th day postoperatively, and preoperative data on demographics, surgical etiology, intake analysis, and body composition were collected from medical records. Bivariate analysis was performed to assess correlations using Pearson's test for normally distributed data and Spearman's rank correlation test for non-normally distributed data

Results: The majority of the 85 subjects were female, with malignancy being the primary surgical cause. Most subjects had normal nutritional status and did not follow Enhanced Recovery After Surgery (ERAS) protocols. The mean preoperative energy intake was 1374 kcal (26 kcal/kg body weight), and mean preoperative protein intake was 50.8 g. Weak positive correlations were found between preoperative protein intake and changes in grip strength for the right (r = 0.18, p = 0.099) and left (r = 0.166, p = 0.129) hands. Multivariate analysis showed that preoperative FFMI had the most significant impact on changes in grip strength for the right hand (p = 0.042).

Conclusion: There was no significant correlation between preoperative protein intake and changes in grip strength for the right and left hands in patients following elective laparotomy."

"Latar Belakang: Meningioma adalah tumor intrakranial yang lazim dijumpai sebagai tumor jinak karena pertumbuhannya yang lambat, memiliki tingkat kelangsungan hidup yang cukup tinggi, dan memiliki peluang besar untuk dilakukan pembedahan secara lengkap.1,2 Namun, komplikasi dan disabilitas jangka panjang sering terjadi yang dapat menurunkan kualitas hidup.2 Penelitian ini meneliti luaran jangka panjang status neurologis pasca pembedahan dan bagaimana hubungan antara tingkat ekstensi pembedahan terhadap status neurologis pasca pembedahan meningioma di RSUPN Dr. Cipto Mangunkusumo sebagai rumah sakit rujukan nasional di Indonesia.Metode: Penelitian kohort historis terhadap 142 pasien dengan menggunakan rekam medis dan data registrasi onkologi dari Departemen Bedah Saraf RSUPN Dr. Cipto Mangunkusumo dari Januari 2014 hingga Desember 2021. Tingkat ekstensi pembedahan dikategorikan menjadi (1)Tingkat reseksi tinggi dan (2)Tingkat reseksi rendah. Fungsi saraf kranialis, motorik, dan sensorik dikategorikan menjadi (1) Defisit tambahan atau persisten dan (2)Tidak ada defisit atau perbaikan. Penelitian ini menggunakan data yang diolah secara deskriptif dan analitik.Hasil: Sebagian besar responden yang menjalani pembedahan memperoleh tingkat reseksi tinggi (62%). Berdasarkan follow up 2 tahun pasca pembedahan, sebagian besar responden tetap tidak terdapat defisit atau mengalami perbaikan fungsi nervus kranialis (67,6%), fungsi motorik (95,1%), dan fungsi sensorik (99,3%) dibandingkan sebelum pembedahan. Analisis bivariat menunjukkan bahwa proporsi kejadiannya tetap tidak terdapat defisit atau mengalami perbaikan fungsi nervus kraniaisl (p = 0,114) dan fungsi motorik (p = 0,295) pasca pembedahan pada responden dengan angka reseksi tinggi.Kesimpulan: Terdapat peningkatan status neurologis, yaitu fungsi nervus kranialis, motorik dan sensorik, yang lebih baik diperoleh pada tingkat ekstensi pembedahan tinggi (Simpson grade I-II) daripada tingkat ekstensi pembedahan rendah (Simpson grade III- V), meskipun secara statistik perbedaannya tidak signifikan.

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Background: Meningioma, is an intracranial tumor that is commonly found as a benign tumor because of its slow growth, has a fairly high survival rate, and has a great chance for complete removal.1,2 However, complications and long-term disabilities often occur which can reduce the quality of life.2 This study examines the long-term outcome of postoperative neurological status and how the relationship between the degree of surgical extension and the postoperative neurologic status of meningioma at Dr. Cipto Mangunkusumo General Hospital as a National Referral Hospital in Indonesia.

Methods: Historical cohort of 142 patients using medical records and oncology registration data from the Department of Neurosurgery Dr. Cipto Mangunkusumo Hospital from January 2014 to December 2021. The degree of Surgical extension was categorized into (1) High resection rates and (2) Low resection rates. Cranial nerve, motor, and sensory functions were categorized into (1) Additional or persistent deficit and (2) No deficit or had improved. The study used data that was processed descriptively and analytically.

Results: Most of the respondents underwent surgery obtained a high resection rate (62%). Based on the 2-year follow-up after surgery, respondents still had no deficit or had improved cranial nerve function (67.6%), motor function (95.1%), and sensory function (99.3%) compared with before surgery. Bivariate analysis showed that the proportion of the occurrence was still no deficit or had improved cranial nerve function (p = 0.114) and motor function (p = 0.295) after surgery in respondents with a high resection rate.

Conclusion: There was an improvement in neurological status, namely cranial nerve function, motor and sensory, which was better obtained at a high level of surgical extension (Simpson grade I-II) than at a low level of surgical extension (Simpson grade III-V), although statistically, the difference was not significant."