Tesis

Tingkat kesintasan pasien unresectable tumor periampula pascaoperasi paliatif double-bypass di RSUPN dr. Cipto Mangunkusumo tahun 2010 – 2015 = Survival rate of unresectable periampullary tumor post palliative double bypass surgery in Cipto Mangunkusumo Teaching Hospital on January 2010 - August 2015.

Latar belakang: Tumor periampula merupakan jenis kanker dengan tingkat mortalitas yang tinggi dan sebagian besar dating dengan stadium lanjut. Terdapat terapi operasi paliatif double-bypass untuk pasien tumor periampula unresectable untuk memperbaiki kualitas hidup. Metode: Studi kohort retrospektif dengan data diambil melalui rekam medis pada pasien periampula yang dilakukan tindakan double-bypass dari periode Januari 2010 – Agustus 2015. Tingkat kesintasan dinilai menggunakan metode KaplanMeier dan kualitas hidup pada pasien yang masih hidup dinilai menggunakan kuisioner EORTC QLQ-C30. Hasil: 31 pasien tumor periampuladan diketahui 25 kasus (80%) diantaranya unresectable sehingga dilakukan operasi paliatif double-bypass, jenis tumor periampula pada subjek penelitian yaitu tumor kaput pancreas 68%, ampula vater 16%, duodenum 12%, dan kolangiokarsinoma 4%. Median waktu kesintasan sebesar 3 bulan (95%CI 2,13 – 3,87). Kualitas hidup subjek secara keseluruhan baik, dengan skor status kesehatan umum 60, rerata skor skala fungsional 82,36 (SB 4,9), dan rerata skor gejala yang mempengaruhi kualitas hidup 18,36 (SB 7,48). Kesimpulan: Operasi paliatif double-bypass dapat menjadi pilihan dalam meningkatkan kualitas hidup pasien.
Kata kunci: tumor periampula, operasi double-bypass, tingkat kesintasan, kualitas hidup



Background: Periampullary tumor is a type of cancer with high mortality rate and most patients present in advanced stage. There is palliative double bypass surgery for patients with unresectable periampullary tumors to improve the quality of life. Method: This study aims to determine the survival rate of patients with unresectable periampullary tumors who underwent palliative double bypass surgery. The survival rate is assessed using Kaplan- Meier method and quality of live in patients whom survive were assessed using EORTC QLQ-C30 questionnaire. Results: In January 2010 - August 2015, we retrospectively analyzed 31 patients with tumors known periampullary and 25 cases (80%) of whom are unresectable so palliative double bypass surgery. Types of periampullary tumors on the subject of this study are pancreatic head tumors (68%), papilla Vater (12%), duodenum (12%), ampulla Vater (4%), and cholangiocarcinoma (4%). Median survival time was 3 months (95% CI 2.13 to 3.87). Quality of life of the subjects are good, with general health status scores’ are 60, mean functional scale scores are 82.36 (SB 4.90), and mean scores of symptoms that affect quality of life are 18,36 (SB 7.48). Conclusion: Palliative double bypass surgery may be an option to improve quality of life of patients with unresectable periampullary tumors.
Keywords: periampullary tumors, double bypass surgery, survival rates, quality of life