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Lie H, Irawan A, Sudirman T, Budiono BP, Prabowo E, Jeo WS, Rudiman R, Sitepu RK, Hanafi RV, Hariyanto TI. Efficacy and Safety of Near-Infrared Florescence Cholangiography Using Indocyanine Green in Laparoscopic Cholecystectomy: A Systematic Review and Meta-Analysis. J Laparoendosc Adv Surg Tech A 2023; 33:434-446. [PMID: 36576572 DOI: 10.1089/lap.2022.0495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background: Achieving critical view of safety is a key for a successful laparoscopic cholecystectomy (LC) procedure. Near-infrared fluorescence cholangiography using indocyanine green (NIF-ICG) in LC has been extensively used and accepted as beneficial auxiliary tool to visualize extrahepatic biliary structures intraoperatively. This study aimed to analyze its safety and efficacy. Materials and Methods: Searching for potential articles up to March 25, 2022 were conducted on PubMed, Europe PMC, and ClinicalTrials.gov databases. Articles on the near infrared fluorescence during laparoscopy cholecystectomy were collected. Review Manager 5.4 software was utilized to perform the statistical analysis. Results: Twenty-two studies with a total of 3457 patients undergo LC for the analysis. Our meta-analysis revealed that NIF-ICG technique during LC was associated with shorter operative time (Std. Mean Difference -0.86 [95% confidence interval (CI) -1.49 to -0.23], P = .007, I2 = 97%), lower conversion rate (risk ratio [RR] 0.28 [95% CI 0.16-0.50], P < .0001, I2 = 0%), higher success in identification of cystic duct (CD) (RR 1.24 [95% CI 1.07-1.43], P = .003, I2 = 94%), higher success in identification of common bile duct (CBD) (RR 1.31 [95% CI 1.07-1.60], P = .009, I2 = 90%), and shorter time to identify biliary structures (Std. Mean Difference -0.52 [95% CI -0.78 to -0.26], P < .0001, I2 = 0%) compared with not using NIF-ICG. Conclusions: NIF-ICG technique beneficial for early real-time visualization of biliary structure, shorter operative time, and lower risk of conversion during LC. Larger randomized clinical trials are still needed to confirm the results of our study.
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Affiliation(s)
- Hendry Lie
- Department of Surgery, Faculty of Medicine, Pelita Harapan University, Siloam General Hospitals, Tangerang, Indonesia
| | - Andry Irawan
- Department of Surgery, Faculty of Medicine, Pelita Harapan University, Siloam General Hospitals, Tangerang, Indonesia
| | - Taufik Sudirman
- Department of Surgery, Faculty of Medicine, Pelita Harapan University, Siloam General Hospitals, Tangerang, Indonesia
| | - Bernardus Parish Budiono
- Division of Digestive Surgery, Department of General Surgery, Faculty of Medicine, Diponegoro University, Dr. Kariadi General Hospital, Semarang, Indonesia
| | - Erik Prabowo
- Division of Digestive Surgery, Department of General Surgery, Faculty of Medicine, Diponegoro University, Dr. Kariadi General Hospital, Semarang, Indonesia
| | - Wifanto Saditya Jeo
- Division of Digestive Surgery, Department of General Surgery, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Reno Rudiman
- Division of Digestive Surgery, Department of General Surgery, School of Medicine, Padjadjaran University, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Ryanto Karobuana Sitepu
- Department of Surgery, Faculty of Medicine, Pelita Harapan University, Siloam General Hospitals, Tangerang, Indonesia
| | - Ricarhdo Valentino Hanafi
- Department of Surgery, Faculty of Medicine, Pelita Harapan University, Siloam General Hospitals, Tangerang, Indonesia
| | - Timotius Ivan Hariyanto
- Department of Surgery, Faculty of Medicine, Pelita Harapan University, Siloam General Hospitals, Tangerang, Indonesia
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Lie H, Lukito PP, Sudirman T, Purnama AA, Sutedja R, Setiawan A, Jeo WS, Irawan A, Satriya W, Koerniawan HS, Hariyanto TI. Utility of botulinum toxin injection for post-operative pain management after conventional hemorrhoidectomy: a systematic review and meta-analysis of clinical trials. Scand J Gastroenterol 2023; 58:116-122. [PMID: 36048469 DOI: 10.1080/00365521.2022.2116292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Botulinum Toxin (BTX) has been found to have anti-spasm and analgesic effects. The utility of BTX after conventional hemorrhoidectomy remains unclear. Thus, a systematic review and meta-analysis are required to find out its utility after conventional hemorrhoidectomy. METHODS Using specific keywords, we comprehensively go through the potential articles on PubMed, ClinicalTrials.gov, and Europe PMC sources until March 27th, 2022. All published studies on botulinum toxin anal sphincter injection after conventional hemorrhoidectomy were collected. We were using Review Manager 5.4 software to conduct statistical analysis. RESULTS Five clinical trial studies with a total of 260 patients undergoing hemorrhoidectomy were included in the analysis Our pooled analysis revealed that BTX injection after hemorrhoidectomy was associated with lower VAS at 24 h post-operative [Mean Difference -1.35 (95% CI -1.90, -0.80), p < 0.00001, I2 = 0%] and shorter time to return work [Mean Difference -8.94 days (95% CI -12.57, -5.30), p < 0.00001, I2 = 0%]. However, BTX injection did not differ significantly from placebo in terms of time to first defecation (p = 0.22), fecal incontinence (p = 0.91) and urinary retention incidence (p = 0.18). CONCLUSION BTX sphincter injection may offer some benefit after conventional hemorrhoidectomy in reducing pain from the first day after the procedure and promoting wound healing without complication. Further randomized clinical trials are still needed to confirm the results of our study.
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Affiliation(s)
- Hendry Lie
- Surgery Department, Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
| | - Patrick Putra Lukito
- Surgery Department, Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
| | - Taufik Sudirman
- Surgery Department, Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
| | | | - Rudy Sutedja
- Surgery Department, Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia
| | - Andre Setiawan
- Surgery Department, Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia
| | - Wifanto Saditya Jeo
- Surgery Department, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Andry Irawan
- Surgery Department, Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
| | - Willi Satriya
- Surgery Department, Gunung Maria General Hospitals, Tomohon, Indonesia
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Lie H, Caesarini EF, Purnama AA, Irawan A, Sudirman T, Jeo WS, Budiono BP, Prabowo E, Rivai MI, Sitepu RK. Laser hemorrhoidoplasty for hemorrhoidal disease: a systematic review and meta-analysis. Lasers Med Sci 2022; 37:3621-3630. [PMID: 36094598 DOI: 10.1007/s10103-022-03643-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/06/2022] [Indexed: 12/01/2022]
Abstract
Laser hemorrhoidoplasty (LHP) is known as a new minimally invasive and painless procedure for symptomatic hemorrhoids. However, Milligan-Morgan (MM) may offer the best result of long-term cure rates. In this study, we aim to compare the efficacy between LHP and MM for hemorrhoidal disease treatment. Using specific keywords, we comprehensively go through the potential articles on PubMed, Europe PMC, and Google Scholar sources until April 19, 2022. All published studies on LHP and MM hemorrhoidectomy were collected. Statistical analysis was done by using Review Manager 5.4 software. Twelve studies with a total of 1756 patients with hemorrhoid grades II-IV were included for the analysis. Our pooled analysis revealed that LHP was associated with shorter operative time (p < 0.00001), shorter length of hospital stay (p = 0.0005), lower risk of urinary retention (p = 0.005) and anal stenosis (p = 0.0004), and lower VAS 24-h post-operative (p < 0.00001) when compared with MM. However, LHP and MM did not differ in terms of recurrence rate (p = 0.70). LHP was superior to MM procedure in terms of shortening the recovery time and minimizing post-operative complications for patients with hemorrhoidal disease.
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Affiliation(s)
- Hendry Lie
- Department of Surgery, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia.
| | - Evelyn Franca Caesarini
- Department of Surgery, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia
| | - Antonius Agung Purnama
- Department of Surgery, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia
| | - Andry Irawan
- Department of Surgery, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia
| | - Taufik Sudirman
- Department of Surgery, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, Indonesia
| | - Wifanto Saditya Jeo
- Division of Digestive Surgery, Department of General Surgery, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Bernardus Parish Budiono
- Division of Digestive Surgery, Department of General Surgery, Faculty of Medicine, Diponegoro University, Semarang, Jawa Tengah, Indonesia
| | - Erik Prabowo
- Division of Digestive Surgery, Department of General Surgery, Faculty of Medicine, Diponegoro University, Semarang, Jawa Tengah, Indonesia
| | - M Iqbal Rivai
- Division of Digestive Surgery, Department of General Surgery, Faculty of Medicine, Andalas University, Padang, Sumatera Barat, Indonesia
| | - Ryanto Karobuana Sitepu
- Division of Digestive Surgery, Department of Surgery, Siloam Hospitals Lippo Cikarang, Bekasi, Jawa Barat, Indonesia
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Sudirman T, Hatta M, Prihantono P, Bukhari A, Tedjasaputra TR, Lie H. Vitamin E administration as preventive measures for peritoneal/intra-abdominal adhesions: A systematic review and meta-analysis. Ann Med Surg (Lond) 2022; 80:104225. [PMID: 36045847 PMCID: PMC9422189 DOI: 10.1016/j.amsu.2022.104225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/16/2022] [Accepted: 07/20/2022] [Indexed: 12/09/2022] Open
Abstract
Background Peritoneal adhesion still becoming a common complication after abdominal surgeries and become a significant threat to digestive surgeons nowadays. Vitamin E might offer benefits for preventing peritoneal adhesions because of its antioxidant, anti-inflammatory, and anti-fibroblastic properties. This study sought to analyze the relationship between vitamin E administration and peritoneal/intra-abdominal adhesions in rat models. Methods Potential articles were searched by using specific keywords on Scopus, PubMed, PMC, and Cochrane Library databases until March 12th, 2022. All published studies on vitamin E and peritoneal/abdominal adhesions in rat models were collected. Statistical analysis was performed by using Review Manager 5.4 software. Results A total of 9 studies were included in the final analysis. Pooled analysis of the evidences yielded an association between vitamin E and decreased incidence of substantial peritoneal/intra-abdominal adhesions (RR 0.46; 95%CI: 0.33–0.64, p < 0.00001, I2 = 61%, random-effect modeling); and reduction in the mean grade of adhesions (Mean Difference −1.53; 95%CI: −2.00, −1.06, p < 0.00001, I2 = 98%, random-effect modeling). Conclusions This study proposes that vitamin E supplementation might offer benefits in the prevention of peritoneal/intra-abdominal adhesions. More in-vivo studies with larger sample sizes and proper methods are still needed to confirm the results of our study. If possible, studies on humans might also be warranted. Peritoneal adhesion still become common problem after abdominal surgery. Our study indicates vitamin E can reduce incidence of peritoneal adhesions. Vitamin E can also reduce the mean grade of abdominal adhesions.
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Widysanto A, Wahyuni TD, Simanjuntak LH, Sunarso S, Siahaan SS, Haryanto H, Pandrya CO, Aritonang RCA, Sudirman T, Christina NM, Adhiwidjaja B, Gunawan C, Angela A. Happy hypoxia in critical COVID-19 patient: A case report in Tangerang, Indonesia. Physiol Rep 2020; 8:e14619. [PMID: 33112512 PMCID: PMC7592488 DOI: 10.14814/phy2.14619] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/29/2020] [Accepted: 09/29/2020] [Indexed: 01/16/2023] Open
Abstract
Coronavirus Disease 2019 (COVID-19) is a public health emergency of international concern with increasing cases globally, including in Indonesia. COVID-19 clinical manifestations ranging from asymptomatic, acute respiratory illness, respiratory failure that necessitate mechanical ventilation and support in an intensive care unit (ICU), to multiple organ dysfunction syndromes. Some patients might present with happy hypoxia, a condition where patients have low oxygen saturations (SpO2 < 90%), but are not in significant respiratory distress and often appear clinically well, which is confusing for the doctors and treatment strategies. Most infections are mild in nature and have a relatively low case fatality rate (CFR); however, critical COVID-19 patients who need support in ICU have high CFR. We would like to report a case of happy hypoxia in a critical COVID-19-positive ICU hospitalized patient who survived from Indonesia.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Catherine Gunawan
- Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia
| | - Angela Angela
- Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia
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