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Curriculum Vitae

Nama

: dr. Marshal Sp B, Sp BTKV

Tempat, tanggal
lahir

Pekerjaan

: kuta cane, 16 Maret 1961


: kepala divisi bedah thorax dan kardiak
vaskular / departemen ilmu bedah FK
USU /

Riwayat pendidikan :

RSUP H. Adam Malik

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

Duration of
Surgery and
Post
Operative
Complication:

General Considerations
Complicatio
n following
surgery
depenson
Preoperati
ve
Evaluatio
n

Meticulous
Technique(Dur
ing 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

Lengthen
the
Duration
Of
Surgery
O
t
h
e
r
i
n
t

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


(chi- square 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 contribut to


our
of
independent
e
understanding
relative to
the
across a broad
infection
rangerisk operative
procedures in a veryduratio
multicenter contemporary
of patient
large, population. Strategies
n
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

havin similar
of surgery
Despite
differences
g
duration
the
between the three
in
postoperative
groups suggest
complication
that
duration of surgery alone sis not a
major determinant
of postoperative
morbidity, and that the type of surgery
performed
and
the
pa tien t s
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
conciuosnes
s

CPB Duration and


time to recovery of
conciousness

Conclusion
Patients with older age, higher BUN, and longer
CPB
tended
time to recover consciousness
Thes nding
slowly.
e
s
providedsurgery
cardiac
valuable
forclinician
information
andonassist
care followin
patient their anesthetic
anesthesiologists
adjust
to
management based on g
condition.
patients

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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