WEEKLY REPORT

GENERAL SURGERY RESIDENT

29 March – 04 April 2019
ISA NIC HIS DIM
CER MAN DIL
DIT
 EMERGENCY OPERATION
DIVISI 29 30 31 1 2 3 4 Total
GENERAL
SURGERY
UROLOGY
ORTHOPEDIC
ONKOLOGY
NEURO SURGERY 1
PAEDIATRIC
SURGERY
THORACIC
1
CARDIOVASKULER
PLASTIC 2
TOTAL

2
 Tgl 29 - 3 -2019
Jam Jam
No ID DIAGNOSA TINDAKAN Op
Datang Op

3
 Tgl 30 - 3 -2019
Jam Jam
No ID DIAGNOSA TINDAKAN Op
Datang Op

1 M, 55 yo Burn injury gr IIAB 65% ec Debridemen Ward 11.50 MAN/FU

flame injury (T31.6) Combustio (86.28) N
2 M, 25 yo Burn injury gr IIAB 5% ec Debridemen 13.40 18.00 ISA/FUN
flame injury (T31.1) Combustio (86.28)
3. M, 14 yo Mild Brain Injury GCS 15 + Craniotomy EDH 21.10 23.30 DIM/FU
EDH at left evacuation (01.24) R
temporoparietoccipital region
(S02.0+S06.4)
4. M, 64 yo Blunt chest trauma + left Left tube 00.00 01.30 ISA/IJ
hematothorax (S20.2+S27.1) thoracostomy (34.04)

4
 Tgl 31 - 3 -2019
Jam
No ID DIAGNOSA TINDAKAN Jam Op Op
Datang

5
 Tgl 1 - 4 -2019
Jam Jam
No ID DIAGNOSA TINDAKAN Op
Datang Op

6
 Tgl 2 - 4 -2019
Jam Jam
No ID DIAGNOSA TINDAKAN Op
Datang Op

7
 Tgl 3 - 4 -2019
Jam Jam
No ID DIAGNOSA TINDAKAN Op
Datang Op

8
 Tgl 4- 4 -2019
Jam Jam
No ID DIAGNOSA TINDAKAN Op
Datang Op

9
ELECTIVE OPERATION
22 23 24 25 26 27 28 Total
UROLOGY 2 - - 3 3 6 5 19
ORTHOPEDIC 5 - - 4 4 4 7 24
ONKOLOGY 1 - - 2 2 2 2 9
NEURO SURGERY 1 - - 1 3 2 2 9
PAEDIATRIC
- - - - 1 2 1 4
SURGERY
THORACIC 3 - - 2 2 3 3 13
CARDIOVASKULER
PLASTIC 3 - - 2 3 3 2 13
DIGESTIVE 1 - - 2 2 3 1 9
HEAD & NECK - - - 2 - - 2 4
Total 16 0 0 18 20 25 25 104
 Digestive
No ID Diagnosis Procedure OP
1 F, 43 yo Cholelithiasis (K80.8) Laparoscopy cholecystectomy NIC / BS
(51.23)
2 F, 54 yo Achalasia (K22.0) Laparoscopy Heller Myotomy + BS
Fundoplication (42.7)
3 M, 36 yo Perianal fistule (K60.3) LIFT Procedure (49.1) ISA/BS
4 F, 63 yo Malignant neoplasm of sigmoid Laparotomy sigmoid resection + NIC / BS
(Adenocarcinoma) (C18.7) anastomosis end to end (45.2)
5 F, 47 yo Cholelithiasis (K80.8) Laparoscopy cholecystectomy MO
(51.23)
6 M, 56 yo Choledocholithiasis + IHBD Laparotomy CBD exploration + BS
foreign body (K80.5) foreign body + CBD stone
(Basket ERCP) extraction
7 M, 37 yo Post right hemicolectomy + Ileostomy closure (46.5) ISA / NIC
ileostomy due to malignant / BS
neoplasm of right colon (Z90.49)
8 F, 47 yo rectovaginal fistula due to Diversion colostomy (46.1) ISA / NIC
residive malignant neoplasm of / BS
cervix (N82.3)
9 M, 46 yo Malignant neoplasm of upper Laparoscopic low anterior BS
third rectum (C21.8) resection (48.62)
 Urology
No ID Diagnosis Procedure OP

1 F, 39 yo Both renal calculi (N20.0) Left PCNL + Left DJ Stent RAO

insertion (55.04 + 59.8)
2 F, 63 yo Right DJ Stent + Malignant neoplasm of Right DJ Stent removal (97.60) RAO
Cervix (Z46.6 + C53.9)
3 M, 43 yo Left upper urether calculi + severe Left URS (53.1) POP
left hydronephrosis + CKD stage V
(N20.1 + N13.3 + N18.5)
4 M, 56 yo Anuria + both lower urether calculi Both URS (53.1) RAO
+ both renal calculi (N20.1
+N20.0)
5 M, 55 yo Right upper urether calculi + left Both URS (53.1) POP
renal calculi + severe both
hydronephrosis + CKD st V (N20.1
+ N20.0 + N13.3 + N18.5)
6 F, 16 yo Bladder calculi (N21.0) Vesicolithotomy (57.0) MIH
7 F, 71 yo Right renal tumor (C64.9) Right radical nephrectomy (55) MIH
8 M, 57 yo Both renal calculi +both DJ stent Both DJ Stent removal (97.60) RAO
(N20.0 + Z46.6)
 Urology
No ID Diagnosis Procedure OP

9 M, 44 yo Both renal calculi + Left DJ stent Left DJ Stent removal + RIRS RAO
(N20.0) (97.60 + 59.9)
10 M, 1 yo Hypospadia penoscrotal type (Q54.2) Chordectomy + urethroplasty BOY
(64.0)
11 M, 44 yo Bladder calculi (N21.0) Vesicolithotripsy (58.22) MIH
12 M, 60 yo Suspect malignant neoplasm of Prostate biopsy (60.1) MIH
prostate (C61)
13 M, 51 yo Both urether calculi (N20.1) Both URS (53.1) BOY
14 F, 38 yo Right DJ Stent + Malignant neoplasm of Right DJ Stent removal (97.60) RAO
Cervix (Z46.6 + C53.9)
15 M, 36 yo Bladder calculi (N21.0) Vesicolithotripsy (58.22) POP
16 M, 61 yo Benign Prostate Hyperplasia (N40) Transurethral Prostatectomy MIH
(60.29)
17 M, 62 yo Benign Prostate Hyperplasia (N40) Transurethral Prostatectomy MIH
(60.29)
18 M, 45 yo Penile cicatrix (N48) Penile reconstruction (64.0) BOY
19 F, 63 yo Right pyelum calculi + left urether Left URS + Right PCNL (53.1 + POP
calculi (N20.0 + N20.1) 55.04)
 Thorax Cardiovascular

No ID Diagnosis Procedure Operator

1 F, 64 yo Aspergilloma of right lower lobe Right thoracotomy lobectomy DIT / AP

lung (B44.0) (32.4)
2 M, 60 yo CKD St V + Stenosis AV Fistula PTA (00.61) IJ
(N18.5)
3 F, 53 yo CKD St V + Stenosis AV Fistula PTA (00.61) IJ
(N18.5)
4 F, 54 yo Right diabetic foot wagner gr IV Below knee amputation (84.1) DIT / AP
(E11.621)
5 M, 56 yo CAD 3VD (I25.10) CABG (36.1) IJ

6 M, 56 yo CKD St V (N18.5) AV Shunt (39.2) IJ

7 M, 47 yo Blunt thoracic injury + fracture Clipping costae (78.51) AP

of the Left 4-6 Costae (S20 +
S22.4)
8 F, 46 yo Thymoma Non Myasthenia Thymectomy (07.8) IJ
Gravis (C37)
9 M, 56 yo Varicose vein of left lower limb EVLA (37.33) AP
CEAP grade 3(I83.813)
 Thorax Cardiovascular

No ID Diagnosis Procedure Operator

10 M, 36 yo Blunt thoracic injury + Fracture Clipping costae (78.51) AP

of right ribs 5-6 (S20 + S22)
11 M, 54 yo Abscess at right lower lobe of VATS AP
the lung (J85.1)
12 F, 56 yo Varicose Vein of the left lower EVLA (37.33) AP
limb CEAP gr III (I83.813)
13 F, 55 yo CKD St V(N18.5) AV Shunt (39.2) IJ
Neuro Surgery
No ID Diagnosis Procedure OP

1 M, 18 Skull defect at right Cranioplasty (02.0) GS

yo temporoparietal region (M95.2)
2 M, 24 Post EVD due to VP Shunt (02.34) GS
yo communicating hydrocephalus
(G91.0)
3 M, 18 Skull defect at left Cranioplasty (02.0) GS
yo temporoparietal region (M95.2)
4 M, 2 mo Communicating hydrocephalus VP Shunt (02.34) FUR
(G91.0)
5 M, 3 mo Non communicating VP Shunt (02.34) GS
hydrocephalus (G91.0)
6 M, 12 Cerebral palsy + communicating VP Shunt (02.34) GS
yo hydrocephalus (G91.0)
7 M, 31 yo Skull defect at left Cranioplasty (02.0) FUR
temporoparietal region (M95.2)
8 F, 3 mo Post EVD due to communicatiing VP Shunt (02.34) FUR
hydrocephalus (G91.0)
9 F, 63 yo Post EVD due to spontaneous VP Shunt (02.34) FUR
IVH
Pediatric surgery
No ID Diagnosis Procedure OP

1 F, 1 yo Nephroblastoma (C64.9) Laparotomy nephrectomy DIL/

(54.9) STR
2 M, 6 yo Left undecensus testis + phimosis Orchidopexy + circumcision Dil /
(Q53.2 + N47.1) (62.5 + 64.0) STR
3 M, 7 yo Wound infected + hypospadia post Debridement (86.22) STR
urethroplasty (Q54.9)
4 F, 1 yo Hisrchsprung disease (Q43.1) Levelling colostomy STR
Oncology
> ID Diagnosis Procedure OP

1 F, 50 yo Malignant neoplasm of left breast Left modified radical mastectomy RT

(cT4aN2M0) (C50) (85.43)
2 F, 67 yo Malignant neoplasm of left breast Incision biopsy (86.0) ED
(cT4cN3bM0) (C50)

3 F, 58 yo Malignant neoplasm of left breast Incision biopsy (86.0) RT

(cT4cN2M0) (C50)

4 F, 64 yo Lymphadenopathy of neck (R59.0) Excision (85.2) CER / ED

5 F, 45 yo Benign neoplasm of right axilla region Wide excision (83.3) CER / ZA

(D21.3)
6 F, 36 yo Schwannoma of right tonsil region + SNNT Mandibulectomy + disection of ED
(D10.4 + E04.9) tonsil region + right
isthmolobectomy (06.2)
7 F, 40 yo Multiple benign neoplasm at right and left Wide excision (83.3) ZA
forearm, right thigh, and suprapubic (D21)
8 F, 55 yo Right phyloides tumor (D48.6) Right simple mastectomy (85.4) CER / RT

9 F, 66 yo Malignant neoplasm of right breast Right modified radical ZA

(cT2N2M0) (C50) mastectomy (85.43)
Plastic
No ID Diagnosis Procedure OP
1 M, 1 yo CLP/____l (Q37.5) Cheilorraphy (27.5) MAN/ YDY

2 F, 1 yo CLP/__hShal post cheiloraphy (Q37.5) Palatorraphy (27.5) DNA

3 F, 2 yo Post meningoencephalocele excision + Suture removal (97.38) MAN/ YDY

canthopexy

4 M, 24 yo Left zygomaticomaxillary complex fracture + Open reconstruction zygoma- MAN/ DNA

segmental mandibulary fracture (S02.40) maxilla-mandibula with plate
and screw
5 M, 9 yo Burn injury gr IIAB with RS 16% due to flame Debridement (86.22) MAN/ YDY
injury (T31.1)
6 F, 40 yo Multiple keloid of right thigh (L91.0) Triamcinolone injection MAN/ DNA
(99.2)

7 M, 24 yo Post forehead flap at left nasomaxilla region Flap thinning (86.7) MAN/ DNA
(T86.821)
8 M, 78 yo Pressure ulcer grade III-IV at sacrum Debridement (86.22) MAN/ DNA
(L89.159)
Plastic
No ID Diagnosis Procedure OP
9 M, 47 yo Penile parafinoma (T83.1XS) Penile reconstruction DNA
(Scrotal buried flap (64.0)

10 M, 23 yo Fistule of oromaxilla post ORIF maxilla + post Fistule repair DNA

reconstruction of lower lips with radial
forearm free flaps
11 F, 27 yo Post STSG chronic wound of right arm Graft evaluation DNA

12 F, 3 yo Multiple keloid of labia mayora and right Triamcinolone injection DNA

thigh (L91.0) (99.2)

13 M, 16 yo Both microtia + CLP post cheilopalatoraphy Left ear reconstruction MAN / FUN
(Q1.2 + Q37.5) (18.09) / DNA
Orthopedic
No ID Diagnosis Procedure Op

1 M, 40 yo Osteoarthritis at right knee (M17.11) PRP Injection (99.2) GT

2 F, 45 yo Osteoarthritis + Meniscus tear at left knee Arthroscopy (80.26) FA

(M17.10)
3 F, 42 yo Open fracture at regio left middle clavicle ORIF (79.3) AF
(S42.00)
4 F, 56 yo Neglected closed fracture at regio third ORIF (79.3) AF
lower of left thigh (S72.9)
5 M, 62 yo Cervical spondylitis/spondylosis PLF YR
myelopathy (M47.12)
6 F, 24 yo Neglected closed fracture at right tibia ORIF (79.3) FA
plateau (S82.201A)
7 F, 27 yo Closed fracture at third middle of right ORIF (79.3) FA
thigh (S72.91)
8 F, 54 yo Closed fracture of left acromion ORIF (79.3) FA
(S42.122A)
9 M, 26 yo Closed fracture at third lower of right arm ORIF (79.3) FA
(S42.20)
Orthopedic
No ID Diagnosis Procedure Op

10 M, 73 yo Union closed fracture at third middle of Implant removal (78.6) FA

left forearm (S52.92)
11 M, 22 yo Post ORIF at right ankle (S82.91) Implant removal (78.6) FA

12 M, 37 yo Open fracture at right ankle (S82.91) ORIF (79.3) FA

13 F, 33 yo Implant failure post ORIF at left ulnar ORIF (79.3) FA

14 F, 52 yo Osteoarthritis at left knee (M17.12) PRP Injection (99.2) GT

15 M, 48 yo Closed fracture at left calcaneus Close reduction + short leg cast YR

(S92.002A) (79.0)
16 M, 42 yo Closed fracture third middle of radius ulna ORIF (79.3) FA
+ closed fracture at left lower third
humerus + closed fracture at left thigh +
DM type II (S25.5 + S42.20 + S72.3 +
E11)
17 F, 48 yo Tendon rupture of right achilles (S86.0) Achilles tendon repair (83.8) AF

18 M, 56 yo Union fracture at left lower radius Implant removal (78.6) AF

(S52.501A)
19 M, 17 yo Union fracture upper phalanx at ring finger Implant removal (78.6) AF
Orthopedic
No ID Diagnosis Procedure Op

21 F, 20 yo Closed fracture middle third at left thigh ORIF (79.3) FA

(S72.9)
22 M, 24 yo Closed fracture middle third of right ORIF (79.3) FA
clavicle (S42.00)
23 F, 8 yo Malunion fracture of right supracondylar ORIF (79.3) GT
humerus (S42..411)
24 M, 55 yo Avascular necrosis of left femoral head PRP Injection (99.2) GT
(M87.059)
Head & Neck
No ID Diagnosis Procedure OP

1 F, 23 yo Benign neoplasm of thyroid (D34) Isthmolobectomy (06.2) HIS/IL

2 M, 16 yo Neck tumor susp NHL (C76) Incisional biopsy (86.9) HIS/IL

3 M, 59 yo Soft tissue tumor at nuchae region Excision (85.2) MO

(M79.9)
4 M, 38 yo Soft tissue tumorr at frontal region (M79.9) Excision (85.2) MO
 POLYCLINIC
4 22 23 24 25 26 27 28 Total
PB PL PB PL - - PB PL PB PL PB PL PB PL PB PL
GS 12 44 - - - - 5 28 0 23 2 8 3 18 22 121
UROLOGY 7 42 - - - - 7 30 10 59 10 41 5 37 39 209
ORTHOPEDIC 8 23 - - - - 7 17 7 35 8 23 3 22 33 120
ONKOLOGY 2 60 - - - - - 64 - - 1 36 - - 3 160
NEURO
SURGERY
- - - - - - - - 3 5 - - 4 9 7 14
PEDIATRIC
0 5 - - - - 2 4 - - 0 4 - - 2 13
SURGERY
TCV 5 11 - - - - 5 10 4 14 3 7 4 12 21 54
PLASTIC 1 4 - - - - 5 1 - 7 3 1 - 1 9 14
TOTAL 35 189 - - - - 31 154 24 143 27 120 19 99 136 705
WARD
Total Pre op Post op Non op
DIGESTIVE 20 7 7 6
UROLOGY 28 9 14 5
ORTHOPEDIC 39 8 28 3

ONKOLOGY 12 2 4 6
NEURO
20 1 17 2
SURGERY
PAEDIATRIC
12 0 8 4
SURGERY
PLASTIC 9 5 4 0
HEAD & NECK 3 0 3 0
THORACIC
16 5 11 0
CARDIOVASKULER
Total 159 37 96 26
 MORBIDITY& MORTALITY
NO RESIDEN TANGGAL MORBIDITAS MORTALITAS
 DEATH CASE
NO NAMA/ TGL MRS/ DIAGNOSA Tanggal Sebab
USIA/ HARI MOS kematian
RUANGAN/ PERAWATAN
DPJP

2
 THANK YOU

29