Circumcision in subject with hemophilia: the Yogyakarta Method.
Background Circumcision is one of the most common surgical procedures in boys in Indonesia. In cases patient with hemophilia (PWH), doctors tend to avoid this procedure due to increased bleeding tendency. In 2007, we developed a protocol for clotting factor concentrate (CFC) administration for circu...
| Publicado en: | Paediatrica Indonesiana Vol. 64; no. 3; pp. 244 - 250 |
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| Autores principales: | , , , , , , |
| Formato: | clinical trial pictorial protocol research tables/charts Journal Article |
| Publicado: |
Indonesian Pediatric Society
May2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=178328869&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 178328869 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00309311 LPSA jtl: Paediatrica Indonesiana issn: 00309311 maglogo: N pubinfo: dt: May2024 vid: 64 iid: 3 pid: 50274 pub: Indonesian Pediatric Society artinfo: ui: 178328869 178328869 178328869 10.14238/pi64.3.2024.244-9 178328869 ppf: 244 ppct: 6 formats: tig: atl: Circumcision in subject with hemophilia: the Yogyakarta Method. aug: au: Widjajanto, Pudjo Hagung Wibowo, Agus Saputro, Ivan Onggo Budiono, Nur Hadi, Nurul Tusino, Agus Sutowo, David Wijaya affil: Division of Pediatric Hematology & Oncology, Dr. Sardjito Hospital/Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada sug: subj: Hemophilia Complications Hemorrhage Drug Therapy Circumcision Adverse Effects Hemostasis, Surgical Methods Blood Coagulation Factors Therapeutic Use Blood Coagulation Factors Administration and Dosage Treatment Outcomes Human Male Child, Preschool Child Adolescence Young Adult Descriptive Research Medical Records Record Review Indonesia Hospitalization Preoperative Care Wound Healing Age Factors Severity of Illness Indices Hemophilia Classification Tranexamic Acid Administration and Dosage Blood Loss, Surgical Prevention and Control Clinical Trials Child, Preschool: 2-5 years Child: 6-12 years Adolescent: 13-18 years Male ab: Background Circumcision is one of the most common surgical procedures in boys in Indonesia. In cases patient with hemophilia (PWH), doctors tend to avoid this procedure due to increased bleeding tendency. In 2007, we developed a protocol for clotting factor concentrate (CFC) administration for circumcision in PWH, namely, the "Yogyakarta Method." Objective To evaluate the outcomes of the Yogyakarta Method for circumcising PWH. Methods This descriptive study was based on medical records of PWH who underwent circumcision at Dr. Sardjito Hospital (DSH), Yogyakarta and 3 surrounding hospitals under DSH supervision from 2008-2017 and 2018-2022. Diagnoses of hemophilia were based on clinical findings and factor assays. Subjects with hemophilia A received factor VIII (25 IU/kg/dose) and those with hemophilia B received factor IX (50 IU/kg/dose) before, during and after the procedure. In addition, patients received tranexamic acid (15 mg/kg/dose). Circumcision was performed by a pediatric surgeon or urologist. Results From 2008-2017, 28 PWH underwent circumcision, 14/28 of whom were in DSH. Twenty-six patients had hemophilia A and 2 had hemophilia B. Their severities were mild (12 subjects), moderate (10 subjects), and severe (6 subjects). Subjects' median age was 10.5 (5-19) years and their median CFC use was 8 (range 7-10) doses in hemophilia A and 4 (range 4-5) doses in hemophilia B patients. Three of 28 PWH had bleeding episodes after the procedure. Following the encouraging results from the initial 2008-2017 study period, most of PWH circumcised in 2018-2022 underwent the procedure in the same 3 district hospitals rather than at DSH (21/28 subjects), and had similar CFC consumption. Only 1 bleeding episode occurred after the procedure during the second study period. Conclusion The Yogyakarta method is safe and sufficient to control bleeding in circumcision of PWH. This method is also suitable in a district hospital setting. pubtype: Academic Journal doctype: clinical trial pictorial protocol research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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