Prostate cancer is a malignant disease of urogenital system which is the second most common type of cancer in men after lung cancer. Prostate cancer is also one of the most common cause of death in male population. There is no database regarding profiles of prostate cancer in Manado. This study was aimed to determine the profile of prostate cancer patients treated at Prof. Dr. R. D. Kandou Hospital Manado in the period 2013 to 2015. This was a descriptive retrospective study in October to November 2016. Samples were taken based on secondary data of the medical record. The results showed that there were 54 patients with prostate cancer, most were found in 2015 (38.9%), age group 61-70 years old (37.0%), lived in Manado (33.3%), graduated Senior High School (64.8%), retirees (50.0%), difficult urination (44.4%), PSA levels >100 ng/ml (50.0%), histopathological of adenocarcinoma (100.0%), and Gleason score ranging from 8-10 (46.7%). Based on metastasis, 14 patients had metastasis (25.9%).Keywords: prostate cancer, profile, PSA, histopatology, Gleason score Abstrak: Kanker prostat ialah penyakit keganasan sistem urogenital yang merupakan kanker kedua terbanyak pada pria setelah kanker paru. Kanker prostat juga merupakan salah satu penyebab terbanyak kematian pada populasi pria. Belum ditemukan data tentang profil kanker prostat di Manado. Penelitian ini bertujuan untuk mengetahui profil penderita kanker prostat yang dirawat di RSUP Prof. Dr. R. D. Kandou pada periode 2013–2015. Jenis penelitian ialah deskriptif retrospektif yang dilakukan pada bulan Oktober sampai November 2016. Sampel diambil berdasarkan data sekunder dari catatan rekam medik. Hasil penelitian mendapatkan 54 penderita kanker prostat, paling banyak ditemukan pada tahun 2015 (38,9%), kelompok usia 61-70 tahun (37,0%), berdiam di Kota Manado (33,3%), tamat SMA (64,8%), pensiunan (50,0%), keluhan utama sulit buang air kecil (44,4%), kadar PSA >100 ng/ml (50,0%), jenis adenokarsinoma (100,0%), dan skor Gleason 8-10 (46,7%). Berdasarkan metastasis, sebanyak 14 penderita (25,9%) mengalami metastasis. Kata kunci: kanker prostat, profil, psa, histopatologi, skor gleason
Introduction Several modalities are used to improve the outcome of liver resection surgery. Laser-based surgery may become promising option; therefore we aim to report our experience regarding the efficacy and safety of Thulium-Doped Fiber Laser (TDFL) 1940 nm in liver parenchyma resection. Methods A cross sectional study in which patients with pre-existing liver pathology during July 2019 and July 2020 were randomly assigned to receive liver resection using TDFL integrated with raman laser emitting at 1940 nm and 1470 nm wavelength. Data on estimated blood loss during liver transection, liver transection speed, morbidity rate, and postoperative variables including complications, length of hospital stay (days), and mortality were analyzed. Results A total of 17 consecutive liver resections were performed, among them are 7 major and 11 minor hepatectomies. The Multipulse TM+1470 were used on 8 procedures consisted of 1 major and 7 minor hepatectomies, the mean amount of blood loss during operation and liver transection was 628.13 ± 141.31 mL and 294.63 ± 94.81 ml, respectively. The mean liver transection speed was 1.52 ± 0.27 cm 2 /min. No biliary leak, post-hepatectomy-liver failure, and mortality were reported. Conclusion TDFL provided by Multipulse TM+1470 is an effective and safe tool for liver surgery, providing good hemostasis and allowing for safe and effective exposure of vascular. Further study with larger samples might be needed proved the efficacy and safety of TDFL in liver surgery.
Background: Colorectal cancer (CRC) is ranked as the third most common cancer worldwide.One of the leading causes of death in CRC patients is due to its metastasis. The liver is the most common site of metastasis. The best treatment to achieve long-term survival and cure patients with CRC liver metastasis is surgery, whether it’s sequential, delayed, or simultaneous resection.This case study aims to evaluate the simultaneous resection on the patient with synchronous colorectal liver metastasis.Case Presentation: From January-June 2020, in Prof. Dr. R. D. Kandou General Hospital, Manado, 2 patients were treated with simultaneous resection for CRC with resectable synchronous liver metastasis. Blood loss, bile leak, ascites, and post hepatectomy liver failure (PHLF) were observed as outcome parameters.Conclusion: Simultaneous resection is safe and exhibits advantages in the long-time survival of patients. However, the incidence of complications and mortality are higher in simultaneous resection than in staged resection.
Introduction:The role of liver resection in secondary liver tumors are growing along with the consequences of Post Hepatectomy Liver Failure (PHLF). Systematic Extended Right Posterior Sectionectomy (SERPS) is offered as an alternative to resect secondary liver tumors in segment 6-7 with vascular invasion towards right hepatic vein (RHV) compared to the right hepatectomy procedure in the past. The goal of SERPS procedure itself is maintaining appropriate oncological border, while minimizing the risk of PHLF. Methods: We aim to describe two patients with liver metastases in segment 6-7 with RHV vascular invasion, due to GIST and colorectal cancer metastases, which undergone USG guided SERPS in 2020. We reported the patients' primary tumor characteristics, adjuvant chemotherapy, surgical outcomes, PHLF incidence measured with ISGLS criteria, and liver metastases recurrencies in 3 months post-operative. Results: No tumor recurrencies and mortalities due to primary tumors or complications were detected in 3 months post-operative follow-ups. No PHLF incidence were detected. Conclusions: SERPS is a safe and promising alternative for secondary liver tumors at segment 6-7 and RHV vascular invasion. Thus, minimizing the risk of PHLF by saving larger volume of future liver remnant.
Latar belakang: Adhesi peritoneal sering terjadi setelah operasi abdomen, dimana adhesi kemudian menjadi sumber morbiditas. Adanya perlekatan menimbulkan keluhan seperti nyeri perut, mempersulit pembedahan berikutnya, sampai terjadinya obstruksi usus. Pemakaian obat-obatan farmakologik sebagai ajuvan telah banyak dilakukan untuk pencegahan adhesi paska operasi. Pada penelitian ini diteliti perbandingan efektivitas antara penggunaan Virgin Coconut Oil (VCO) dan Triamcinolone Acetonide (TCA) dalam mencegah terbentuknya adhesi intraperitoneal paska laparatomi Metode: Penelitian eksperimen dengan pengukuran perbandingan derajat adhesi secara makroskopik dan mikroskopik pada 30 tikus jantan Rattus norvegicus strain Wistar. Subjek dibagi dalam tiga kelompok. Satu kelompok diberikan VCO pada caecum yang telah diabrasi, satu kelompok diberikan TCA, dan kelompok yang lain menjadi kontrol. Hasil: Tampak bahwa sebagian hewan-hewan tersebut (n = 14, atau 47%) tidak menunjukkan adanya adhesi secara makroskopik dan mikroskopik. Pada 16 tikus dengan fibrosis pun, semuanya berkategori ringan dan tipis (tingkat 1) menurut klasifikasi Yilmaz. Dalam pembagian gambaran makroskopik Zuhlke, tiga perempat (n = 12) dari tikus-tikus dengan adhesi tergolong tingkat 1 ataupun 2. Diskusi: Penggunaan preparat TCA dan VCO terbukti membantu mengurangi angka kejadian adhesi intraperitoneal sesuai kepustakaan dan penelitian sebelumnya, yang mengungkapkan bahwa TCA dan VCO mengandung zat-zat yang secara langsung berfungsi mencegah adhesi baik secara lokal maupun sistemik karena kinerjanya dalam proses inflamasi. Simpulan: Penggunaan TCA dan VCO memiliki efektivitas yang bermakna dalam pencegahan adhesi intraperitoneal dibandingkan dengan kelompok kontrol, namun dalam perbandingan antara kedua preparat yaitu TCA dan VCO, tidak ditemukan perbedaan efektivitas yang bermakna.
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