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Manginstar, Christian
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Nursing Public Health

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Penilaian Jaringan Parut Paska Insisi Kulit Menggunakan Patient and Observer Scar Assessment Scales (POSAS): Perbandingan Hasil Penggunaan Monopolar Electrosurgery dan Pisau Bedah Barends, David; Hatibie, Mendy; Manginstar, Christian; Rawung, Rangga; Langi, Fima FL
Medical Scope Journal Vol 2, No 2 (2021): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.2.2.2021.32731

Abstract

Abstract: Scalpel was once considered as the gold standard in surgical incisions. Electrosurgery has been used as a substitute for scalpels but has not been accepted as standard due to burns and injuries. Patient and observer scar assessment scale (POSAS) is a subjective scar assessment of the patient as well as the observer. This study was aimed to compare post-skin-incision scarring of monopolar electrosurgery and scalpel, and evaluate the appropriateness of scar assessments of the observer and the patient by using POSAS. This was a self-controlled trial design. Post-incision scar tissue assessment was carried out simultaneously by the observer and the patient in the third month after the operation was completed. The paired t test or Wilcoxon rank sum test showed that the differences of assessments of either patient or observer or both were not significant (p=0.05). The correlation test between the total POSAS scores of the patient and observer assessments showed a moderate linear relationship (r=0.51; p<0.001). In conclusion, the use of monopolar electrosurgery and scalpel in performing skin incisions resulted in the formation of equally good scar tissues. The POSAS assessments of patient and observer showed a moderate degree of similarity.Keywords: electrocautery, scar tissue, surgery scalpel, patient and observer scar assessment scale (POSAS)  Abstrak: Pisau bedah dahulu dianggap sebagai standar emas dalam insisi pembedahan. Electrosurgery telah digunakan sebagai pengganti pisau bedah namun belum diterima sebagai standar karena luka bakar dan cedera. Patient and observer scar assessment scale (POSAS) merupakan instrumen penilaian jaringan parut yang bersifat subyektif baik dari pasien maupun observer. Penelitian ini bertujuan untuk membandingkan jaringan parut pasca insisi kulit antara monopolar electrosurgery dan pisau bedah serta mengevaluasi kesesuaian penilaian jaringan parut hasil insisi kulit dari dokter pengamat dan pasien saat keduanya meng-gunakan POSAS. Desain penelitian ialah self-controlled trial. Setiap subjek mendapat dua macam perlakuan secara bersamaan: operasi dengan monopolar electrosurgery dan pisau bedah. Penilaian jaringan parut pasca insisi dilakukan bersamaan oleh observer dan pasien pada bulan ketiga setelah operasi selesai. Hasil paired t test atau Wilcoxon rank sum test terhadap penilaian dalam bentuk skor baik dari pasien atau observer ataupun keduanya terhadap perbedaan jaringan parut oleh penggunaan kedua modalitas tidak bermakna (p>0,05). Uji korelasi antara skor total POSAS dari pasien dan observer menunjukkan adanya hubungan linear sedang (r=0,51; p<0,001). Simpulan penelitian ini ialah penggunaan monopolar electrosurgery mau-pun pisau bedah untuk insisi kulit menghasilkan pembentukan jaringan parut yang sama baik. Penggunaan POSAS dalam penilaian jaringan parut memperlihatkan tingkat kesamaan sedang antara pasien dan observer.Kata kunci: electrocautery, jaringan parut, pisah bedah, patient and observer scar assessment scale (POSAS)
Analisis Hubungan Ca 15-3 dan Respon Kemoterapi Neoadjuvan pada Pasien Kanker Payudara Stadium Lanjut Lokal Rusli, Lie V.; Merung, Marselus; Pontoh†, Victor; Manginstar, Christian; Hatibie, Mendy J.; Langi, F. L. Fredrik G.
e-CliniC Vol 9, No 2 (2021): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v9i2.34659

Abstract

Abstract: Neoadjuvant chemotherapy is one of the therapeutic modalities used in the management of locally advanced breast cancer. Therapeutic response can be objectively assessed with RECIST and Ca 15-3 could be used to monitor response to breast cancer (BC) treatment. This study was aimed to prove the relationship between Ca 15-3 and response to neoadjuvant chemotherapy in locally advanced BC. The study was carried out at the Departement of Surgery Prof. Dr. R. D. Kandou Hospital Manado using a single-arm pre-post trial. Each patient would be performed Ca 15-3 test and clinical assessment (RECIST) pre and post chemotherapy for two sessions. There were 11 BC patients with invasive ductal carcinoma.  The average age was 60 years old and the majority had anemia and lymphocytopenia. There was a decrease in Ca 15-3 in each patient by a baseline of 21.8 U/mL pre-treatment and a decrease in the lesion size by 30.3 mm using RECIST. The results showed that changes in RECIST and Ca 15-3 level were correlated with each unit change in RECIST was associated with a decrease in Ca 15-3 level by 0.03 units (p=0.019). In conclusion, there was a decrease in Ca 15-3 level in response to chemotherapy, followed by a decrease in RECIST. There was a relationship between Ca 15-3 level and chemotherapy response assessed with RECIST after the second chemotherapy.Keywords: Ca 15-3, chemotherapy response, neoadjuvant chemotherapy, RECIST, breast cancer  Abstrak: Kemoterapi neoadjuvan masih merupakan pilihan utama terapi untuk kanker payudara (KPD) stadium lanjut local. Respon suatu kemoterapi dapat dinilai secara objektif dengan RECIST dan Ca 15-3 dapat digunakan untuk memantau respon terhadap pengobatan KPD. Penelitian ini bertujuan untuk membuktikan hubungan antara Ca 15-3 dengan respon kemoterapi neoadjuvan RECIST pada pasien KPD stadium lanjut lokal. Penelitian dilaksanakan di Bagian Bedah RSUP Prof. Dr. R. D. Kandou, Manado dengan menggunakan single-arm pre-post trial. Setiap individu yang terlibat akan diperiksa kadar Ca 15-3, serta penilaian RECIST sebelum dan sesudah mereka menerima kemoterapi selama dua sesi. Hasil penelitian mendapatkan 11 pasien KPD dengan karsinoma duktal invasif. Rerata usia 60 tahun, umumnya dengan anemia dan limfositopenia. Terdapat penurunan Ca 15-3 pada tiap pasien sebesar awal 21,8 U/mL pra pengobatan dan penurunan lesi 30,3 mm saat dinilai menurut RECIST. Didapatkan bahwa perubahan RECIST dan Ca 15-3 memiliki keterkaitan dengan setiap unit perubahan RECIST berhubungan dengan penurunan kadar Ca 15-3 sebesar 0,03 unit (p=0,019). Simpulan penelitian ini ialah terdapat hubungan antara kadar Ca 15-3 dengan respon kemoterapi setelah kemoterapi siklus ke dua.Kata kunci: Ca 15-3; respon kemoterapi; neoadjuvan kemoterapi; RECIST; kanker payudara
Co-Authors Barends, David Hatibie, Mendy J. Marselus Merung, Marselus Mendy Hatibie Pontoh†, Victor Rawung, Rangga Rusli, Lie V.