Tesis

Kedalaman Kerusakan Jaringan Serviks Normal Pasca Aplikasi Topikal Dosis Tunggal TCA 85 Persen = Depth of Normal Cervical Tissue Destrucion Post Topical Application of Single Dose TCA 85 Percent.

Tesis ini bertujuan mengukur kedalaman kerusakan jaringan serviks normal pasca aplikasi topikal dosis tunggal Trichlor-Acetic Acid (TCA) 85 persen. Desain penelitian adalah intervensi dengan mengoleskan ±5 mL larutan TCA 85% pada serviks 40 orang subjek yang terjadwal menjalani prosedur histerektomi total atas indikasi selain patologi serviks 24 jam sebelum operasi. Kedalaman kerusakan jaringan diukur secara mikroskopis pada foto preparat histologi spesimen serviks. Hasil penelitian ini didapatkan dari total 39 subjek. Gambaran mikroskopis ditemukan area nekrosis lapisan superfisial disertai erosi seluruh ketebalan epitel skuamosa. Ditemukan juga area fibrotik mirip jaringan luka bakar pada stroma. Rata-rata kedalaman kerusakan jaringan serviks di bibir anterior adalah 1,16 ± 0,49 mm dan posterior 1,01 ± 0,35 milimeter. Tidak terdapat perbedaan signifikan antara kedalaman di bibir anterior dan posterio (p0,05). Sebagai kesimpulan, aplikasi topikal dosis tunggal larutan TCA 85% mampu menimbulkan kerusakan jaringan serviks normal dengan kedalaman yang lebih dalam daripada rata-rata kedalaman lesi NIS III di epitel skuamosa serviks.
Kata Kunci: TCA, NIS, epitel skuamosa serviks, kerusakan jaringan, terapi topikal


This study aims to measure the depth of destruction to normal cervical tissue after topical application of a single dose of 85 percent Trichlor-Acetic Acid (TCA). The study design was interventional by applying ±5 mL of 85% TCA solution to the cervix of 40 subjects who were scheduled to undergo a total hysterectomy procedure for indications other than cervical pathology 24 hours before surgery. The depth of tissue destruction was measured microscopically on histological photographs of cervical specimens. The results of this study were obtained from a total of 39 subjects. The microscopic picture found areas of superficial layer necrosis accompanied by full thickness erosion of the squamous epithelium. There were also fibrotic areas resembling burnt tissue in the stroma. The mean depth of cervical tissue destruction in the anterior lip was 1.16 ± 0.49 mm and the posterior 1.01 ± 0.35 mm. There was no significant difference between the depth in the anterior and posterior lips (p0.05). In conclusion, topical application of a single dose of 85% TCA solution was able to cause destruction to normal cervical tissue with a deeper depth than the average CIN III depth in cervical squamous epithelium.
Keywords: TCA, CIN, cervical squamous epithelium, tissue destruction, topical therapy