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Curriculum Vitae

Nama

: dr. Marshal Sp B, Sp BTKV

Tempat, tanggal lahir

: kuta cane, 16 Maret 1961

Pekerjaan

: kepala divisi bedah thorax dan kardiak


vaskular / departemen ilmu bedah FK USU /
RSUP H. Adam Malik

Riwayat pendidikan :

Pendidikan dokter FK USU 1986

Pendidikan dokter spesialis bedah FK USU 1996

Pendidikan dokter spesialis bedah thorak kardiovaskular FK UI 2002

Riwayat pekerjaan

Kepala puskesmas kecamatan Sukajaya, Sabang 1986-1990

Dokter umum RSU Sabang 1986-1990

Dokter spesialis bedah RSU Langsa, Aceh Timur 1996-2000

Staf departemen ilmu bedah FK USU / RSUP H Adam Malik 2000 - sekarang

Duration of
Surgery and Post
Operative
Complication:
Any Correlation

General Considerations
Complication
following
surgery
depens on
Preoperative
Evaluation

Meticulous
Technique(During
surgery)

Post Operative Carefull


Monitoring

In the surgery factor


surgery
Meticulous
technique is
not the factor
determining
outcome post
operative
during

Obstacle during
surgery
Unexpected
Bleeding

Other intrasurgery
complication

Lengthen
the
Duration
Of Surgery

Do the duration of
surgery increase post
surgery complication?

Study Analysis

There are several studies in different setting and


patients focus on post operative complications
following long standing surgery

In 299,359 operation
in 173 hospitals

Prospective study
with length of follow
up 30 days after
surgery

Patients clasified by
less than 1 hour
surgery and 6 hours
length of surgery

Infection rates doubled in 1 to 1 12 hours and continued to increase (chisquare test for linear trend, p 0.001). In these same select patients, adjusted
OR for infection at 1 to 1 12 hours versus half an hour or less operative
duration was 2.07 (95% CI, 1.13 to 3.78; p 0.018)

Conclusion

Our data contribute to our understanding of the


independent infection risk relative to operative duration
across a broad range of procedures in a very large,
multicenter contemporary patient population. Strategies to
reduce operative duration can reduce ICs and LOS.

Operative duration is independently associated with


increased ICs (infectious Complications) and LOS (Length of
Stay) after adjustment for procedure and patient risk
factors. (J Am Coll Surg 2010;210:6065. 2010 by the
American College of Surgeons)

In 1,432,855 operations from all surgeries in


315 hospitals 2005-2011

Prospective study with length of follow up 30


days after surgery

Subgroup Analysis in Surgical Speciality

Cardiothoracic and neurologic surgical procedures had


the greatest incidence of VTE (1.44%and 3.49%, and 1.04%
and 2.86%, respectively.

Conclusion

Among patients undergoing surgery, an increase


in surgical duration was directly associated with
an increase in the risk for VTE. These findings may
help inform preoperative and postoperative
decision making related to surgery.

A total of 62 patients were studied and they were


grouped into three categories: head and
neck surgery (n = 23), breast reconstruction (n = 18)
and upper and lower limb surgery (n = 21)

From September 1996 to September 1997, we


prospectively assessed those patients undergoing
reconstructive surgery
lasting 6 h or moreective study with length of follow
up 12 months

Sub group Description

Conclusion

Despite having similar duration of surgery the


differences
in
postoperative
complications
between the three groups suggest that duration
of surgery alone is not a major determinant of
postoperative morbidity, and that the type of
surgery performed and the patients general
health are more important predictors of outcome.

A total of 253 patients were recruited, aged


between 20 years and 90 years, without
conscious disturbance and receiving
general anesthesia for elective cardiac
surgery

From January 2009 to April 2010, we


retrospectively assessed those patients
undergoing thoracic surgery, ROC time was
dened as the duration from the
completion of the surgery to the time the
patient recovered clear consciousness.

CPB Duration
and time to
recovery of
conciuosness

CPB Duration and time to


recovery of conciousness

Conclusion

Patients with older age, higher BUN, and longer CPB time
tended to recover consciousness slowly. These ndings
provided valuable information on patient care following
cardiac surgery for clinician and assist anesthesiologists to
adjust their anesthetic management based on patients
condition.

Final Statements

Clinically, this relationship between operative time


and the incidence of complication post surgery
suggests an important role of surgical duration in the
postoperative assessment and assessing the risk of
complication.
Risk assessment factor should in the length of surgery
more thoroughly.
Given effective prophylactic measures, the possible
complications of long surgery can be minimised and
we feel that the type of surgery performed, rather
than the duration of the procedure, appears to be
more relevant to morbidity.
The development of strict criteria for risk stratification
based on surgical duration is difficult given the
inherent differences across procedures.

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