Journal Reading

Assalamualaikum.

IDENTITAS JURNAL
Point 1 Point 2 Point 3 Point 4

PENDAHULUAN
Hemorrhoids are one of the most common colorectal diseases. Hemorrhoidectomy is still the treatment of choice for patients with symptomatic grade 3, 4 and combined hemorrhoids. Unfortunately, it may be accompanied by significant postoperative complications including pain or bleeding. Many studies have compared closed with open hemorrhoidectomy, the results show no differences between postoperative pain and complications. In the present study, hemorrhoidectomy using Ligasure was compared with closed hemorrhoidectomy (Fanslers technique)

Material & Method

Study was conducted in a prospectively randomized controlled fashion. 47 patients with grade 3 or 4 hemorrhoids plus external component or skin tag were operated on by either hemorrhoidectomy with Ligasure (24 patients) or closed hemorrhoidectomy (23 patients).

The operative time, postoperative verbal numeric pain score, analgesi crequirement, bleeding, and wound dehiscence between the two groups were compared

Unpaired t-tests,Mann-Whitney U tests, or Fishers Exact tests were used where appropriate.

Result

Conclusion
Ligasure hemorrhoidectomy is an easy-to learn technique that takes less operative time than the closed technique, with no different in the complication rate (urinary retention, bleeding and wound dehiscence).

Critical Appraisal

Judul

Closed vs Ligasure Hemorrhoidectomy: A Prospective,Randomized Clinical Trial

Sudah sesuai dengan isi penelitian

Penulisan judul < 12 kata Tidak mencantumkan variabel bebas maupun terikatnya secara jelas.

Abstrak
Abstrak ditulis tidak dalam satu paragraph tetapi secara terstruktur

Komponen: Objective, material & methode, Result, conclusion

Kurang dari 250 kata

Analisa PICO
Populasi

47 patients with symptomatic grade 3 or 4 hemorrhoids with external component were recruitedto the trial from March to December 2004 in King Chulalongkorn MemorialHospital.

Ligasure hemorroidektomy and close hemorroidektomy

Interfens

Comparasion

To compare the operative time, postoperative complications, and analgesic requirement between closed hemorrhoidectomy and Ligasure hemorrhoidectomy. Ligasure hemorrhoidectomy takes less operative time than the closed technique, with no different in the complication rate (urinary retention, bleeding and wound dehiscence).

Outcome

Analisa VIA..

Valid

Important

Acceptable

Bukti Valid..
Pertanyaan Apakah alokasi pasien pada penelitian Ya ini dilakukan secara acak? Apakah pengamatan pasien dilakukan secara cukup panjang dan lengkap? Apakah semua pasien dalam kelompok yang diacak, dianalisis? Apakah pasien dan dokter tetap blind dalam melakukan terapi, selain dari terapi yang diuji? Apakah kelompok terapi dan kontrol sama? Ya

Ya

Ya

Ya, kelompok terapi dan kontrol memiliki karakteristik yang sama.

Number needed to Harm (NNH)

Urinary Retension
+ Ligasi hemoroidectomy
Close hemoroidektomy

_ 22

20

EER=1/23=0.04 CER=2/22=0.09 ARR=0,09-0,04=0,05 NNT=1/0.05=20

Wound Dehiscence
+ Ligasi hemoroidectomy Close hemoroidectomy 5 4 18 18 _

EER = 5/23=0,22 CER = 4/22=0,18 ARR= 0,18-0,22 = -0,04 NNT = 1/0.,04=-25

Bukti Penting dan Bisa Diterapkan

Penting Seberapa besarkah pengaruh terapi tersebut terhadap komplikasi ? (berdasarkan NNT) Dapat Diterapkan Apakah pada pasien kita terdapat perbedaan bila dibandingkan dengan yang terdapat pada penelitian sblmnya sehingga hasil tsb tdk dpt diterapkan pada pasien kita? Apakah terapi tersebut mungin dapat diterapkan pada pasien kita? Apakah pasien memiliki potensi yang menguntungan atau merugikan bila terapi tsb diterapkan? Tidak terdapat perbedaan Urine retension (NNT=20) dan , wound dehiscence (NNT=25)

Tidak Tidak

Wassalamualaikum