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EVIDENCE BASED MEDICINE (EBM)

BLOK METODE BELAJAR

Disusun Oleh :
Nusicha Siti Andriana
NPM : 1102015173
FK-B

FAKULTAS KEDOKTERAN UNIVERSITAS YARSI


PROGRAM STUDI KEDOKTERAN UMUM
JL. LET. JEND. SUPRAPTO,
CEMPAKA PUTIH
2015

1. SKENARIO :
Ratri, 46 tahun, datang ke spesialis bedah dengan keluhan susah buang air besar, rasa
panas, gatal dan tidak nyaman pada rektum saat duduk, rasa sakit saat buang air besar,
dan ada benjolan yang besar di rektum. Setelah dilakukan pemeriksaan fisik dan
protoskopi, dokter mendiagnosa Ratri terkena penyakit hemorrhoids stadium IV. Sang
dokter menyarankan Ratri untuk melakukan operasi Laser atau operasi bedah terbuka
untuk pengangkatan hemorrhoids.

2. PERTANYAAN KLINIS (FOREGROUND QUESTION) :


Manakah pengobatan yang lebih efektif dan durasi operasinya lebih cepat diantara
menggunakan operasi Laser atau operasi bedah terbuka untuk membuang
hemorrhoids yang diderita pasien ?

3. KOMPONEN PICO :
Patient (P) : Pasien penderita hemorrhoids
Intervention (I) : Operasi laser hemorrhoids
Comparison (C) : Operasi bedah terbuka hemorrhoids
Outcome (O) : Lebih cepat sembuh

4. KEYWORD :
Hemorrhoids AND Laser AND Open Surgery

5. TYPE OF QUESTION AND STUDY:


a. Theraphy
b. Systematic review / Meta-Analysis of RCT
Randomized Controlled Trial (RTC)

6. SOURCE / DATABASE :
http://www.ncbi.nlm.nih.gov/pubmed/25684841
http://www.ncbi.nlm.nih.gov/pubmed/?
term=hemorrhoid+AND+laser+AND+open+surgery

7. LIMITATION :
Last year, Free PMC article
Received: 21 September 2014, Accepted: 25 November 2014, Published online:
19/12/2014

8. RESULT: 7 Articles
Maloku H, Gashi Z, Lazovic R, et al. Laser hemorrhoidoplasty procedure vs open
surgical hemorrhoidectomy: a Trial comparing 2 treatments for hemorrhoids of third
and fourth degree. Acta Inform Med. 2014 Dec ; 22(6) : 365-7.

Plapler H, Hage R, Duarte J, et al. A new method for hemorrhoid surgery:


intrahemorrhoidal diode laser, does it work ?. Photomed Laser surg. 2009 Oct ;
27(5) : 819-23.

Gupta PJ. Radio-ablation of advanced grades of hemorrhoids with radiofrequency.


Curr Surg. 2003 Jul-Aug ; 60(4) :452-8.

Cheetham MJ. and Philips RK. Evidence-based practice in haemorrhoidectomy.


Colorectal Dies. 2001 Mar ; 3(2) : 126-34.

Armstrong DN, Ambroze WL, et al. Harmonic scalpel vs electrocautery


hemorrhoidectomy: a prospective evaluation. Dis Colon Rectum. 2001 Apr ; 44(4) :
558-64.

Hodgson WJ. and Morgan J. Ambulatory hemorrhoidectomy with CO2 laser. Dis
Colon Rectum. 1995 Des ; 38(12) :1265-9.
Sankar MY. and Joffe SN. Laser surgery in colonic and anorectal lesions. Surg Clin
North Am. 1988 Dec ; 68(6) : 1447-69.

9. SELECTED ARTICLE :
Maloku H, Gashi Z, Lazovic R, et al. Laser hemorrhoidoplasty procedure vs open
surgical hemorrhoidectomy: a Trial comparing 2 treatments for hemorrhoids of third
and fourth degree. Acta Inform Med. 2014 Dec ; 22(6) : 365-7.

10. LAMPIRAN ARTICLE :