Tesis

Hasil jangka pendek dan kesintasan lima tahun pembedahan laparoskopi pada kanker kolorektal divisi bedah digestif FKUI–RSCM 2010–2015 = Short Term Clinical Outcome and Five Years Survival of Laparoscopy Colorectal Cancer Resection 2010 – 2015.

Latar belakang. Pembedahan konvensional atau pembedahan terbuka pada kanker kolorektal dihubungkan dengan morbiditas yang tinggi. Sejak diperkenalkannya pembedahan laparoskopi kolorektal pada tahun 1991, morbiditas akibat pembedahan kanker kolorektal menurun. Metode. Diambil total sampel subjek kanker kolorektal yang menjalani pembedahan laparoskopi dari registrasi kanker kolorektal di Jakarta dari 2010 hingga 2015. Data ditabulasi dan dianalsis dengan SPSS 22.0 untuk mendapatkan data jangka pendek seperti durasi pembedahan, kehilangan darah intra bedah, lama rawat pascabedah, nyeri pascabedah, mulai diet pascabedah dan mobilisasi pascabedah. Uji kesintasan Kaplan-Meier juga dilakukan untuk mendapatkan angka kesintasan lima tahun. Hasil. Didapatkan 65 data subjek yang dianalisis. Terdapat 21 kasus kolon (32,3%) dan 44 kasus rektum (67,7%), 34 pria (52,3%) 31 wanita (47,7%), rata– rata usia 57,17 tahun (SD 13.380). Pada kelompok kolon didapatkan rata–rata durasi bedah 216,75 menit (SD 65,94) dan kehilangan darah 159,75 mL (SD 125,47). Median VAS, diet, mobilisasi pascabedah adalah empat, dua hari, empat hari dan lama rawat pascabedah tujuh hari. Kesintasan lima tahun pasien didapatkan 83%. Tidak ada komplikasi pascabedah, pembedahan ulang dan infeksi luka operasi (ILO) pada kelompok ini. Pada kelompok rektum didapatkan rata–rata durasi bedah 305,97 min (SD 94,23) dan perdarahan intra operasi 150 mL (SD 50). Median VAS pascabedah tiga, diet dan mobilisasi pascabedah dua hari dan empat hari. Lama rawat pascabedah delapan hari. Kesintasan lima tahun adalah 58,5%. Kesimpulan. Morbiditas pascabedah pada penelitian ini lebih rendah dengan pembedahan laparoskopi dengan hasil kesintasan keseluruhan yang tidak berbeda dengan kesintasan pasien kanker kolorektal yang ditangani sebelumnya.
Kata kunci. Laparoskopi kolorektal, kesintasan, kanker kolon, kanker rektum, hasil jangka pendek, morbiditas pascabedah.


Background: Conventional or open resection of colorectal cancer is linked to post operative morbidity. Laparoscopic resection decreases these morbidities with similar survival rate to conventional resection. Method: Retrospective data of patients with colorectal cancer treated with laparoscopic resection, in regard to inclusion and exclusion criteria, were collected from three hospitals in Jakarta between 2010 and 2015. Data was tabulated and analyzed to get short term outcomes such as length of operation, intra operative blood loss, length of hospital stay, pain, and return of Gastro- Intestinal function post operatively. Kaplan-Meier survival analysis was done to get three and five year survival rate. Result: There were 65 data collected; 21 cases were colon cancer (32,3%) and 44 cases were rectal cancer (67,7%). There were more male patients (n=34, 52.3%) than female patients (n=31, 47.7%) with mean age of 57,17±13.38 years. Results for colon cases were duration of operation lasted 216.75±65.94 minutes, intra operative blood loss 159.75±12.47 cc, Visual Analog Score (VAS) was 4 (2-5), post operative diet 2 (1-3) days, post operative mobilization 4 (2-7) days and length of stay 7 (4-12) days. The 30 days survival of all stages was 100%, oneyear survival was 95%, there and five years was 83% for each. Colon cancer group had duration of operation at 305,97±94,23 minutes and intra operative blood loss 150±50 cc. Post operative VAS, diet, mobilization and length of stay were 3 (2-5), 2 (1-4) days, 4 (2-22) days and 8 (5-36) days respectively. The 30 days, one, three and five years survival rate for all stages were 93.8%, 90.6%, 82.4% and 58.5% respectively. Conclusion: Post operative morbidities in colorectal cancer decreases with laparoscopic resection with satisfactory overall survival rate.
Keywords: Laparoscopic colorectal surgery, colorectal cancer, colon cancer, rectal cancer, short-term outcome, overall survival.