Tesis

Kualitas Hidup Pasien Pituitari Adenoma Paska Endoscopic Endonasal Transsphenoidal Surgery /Eets Dan Faktor Yang Memengaruhinya = Pituitary Adenoma Patient’s Quality of Life After Endoscopic Endonasal Transsphenoidal Surgery/EETS and Its Accociated Factors.

Latar Belakang: Adenoma pituitari merupakan tumor jinak hipofisis yang dapat menimbulkan gejala akibat efek massa dan defisiensi hormon. Endoscopic Endonasal Transsphenoidal Surgery (EETS) menjadi terapi utama dengan keberhasilan anatomis dan fungsional tinggi, namun kualitas hidup (QoL) pascaoperasi dapat tetap terganggu. Defisiensi hormon, komplikasi pascaoperatif, serta keterbatasan akses terapi adjuvan dan pemeriksaan hormonal, terutama di negara berkembang seperti Indonesia, dapat memperburuk kondisi ini. Hingga kini, belum ada data nasional yang secara spesifik mengevaluasi QoL pasien pascaEETS. Tujuan: Menilai kualitas hidup pasien adenoma pituitari pada dengan kuesioner SF-36 dan mengidentifikasi faktor-faktor yang memengaruhinya pasca-EETS. Metode: Studi potong lintang dilakukan di Poli Pituitari RS Pusat Otak Nasional, Jakarta. Data primer diperoleh melalui wawancara kuesioner SF-36, data sekunder dari rekam medis dan registri. Analisis dilakukan dengan SPSS 24.0 secara univariat, bivariat, dan multivariat (regresi linier metode backward), dengan pelaporan koefisien β, nilai p ( < 0,05), CI 95%, dan R². Hasil: Sebanyak 90 pasien (45 laki-laki, 45 perempuan) diikutsertakan. Mayoritas mengalami gangguan visual (85,6%), defisiensi hormon (93,3%), dan makroadenoma (95,6%). Terapi kombinasi EETS dan medikamentosa dilakukan pada 62,2% pasien. Skor Physical Component Summary (PCS) lebih tinggi dibandingkan Mental Component Summary (MCS), dengan nilai tertinggi pada fungsi fisik dan peran emosional, serta terendah pada vitalitas dan kesehatan mental. Jenis kelamin berhubungan dengan keterbatasan fisik, vitalitas, fungsi emosional, dan kesehatan mental; defisiensi hormon memengaruhi fungsi emosional. Multivariat menunjukkan jenis kelamin dan defisiensi hormon signifikan terhadap kesehatan mental dan MCS (R² = 74%); tidak ada faktor signifikan untuk PCS. Kesimpulan: Kualitas hidup pasien pasca-EETS umumnya baik, terutama aspek fisik. Aspek mental, khususnya vitalitas dan kesehatan mental, memerlukan perhatian lebih. Jenis kelamin dan defisiensi hormon menjadi determinan utama.
Kata kunci: adenoma pituitari, kualitas hidup, EETS, Defisiensi hormon kuesioner SF-36


Background: Pituitary adenoma is a benign pituitary tumour that can cause symptoms due to mass effect and hormonal deficiency. Endoscopic Endonasal Transsphenoidal Surgery (EETS) is the mainstay treatment, offering high anatomical and functional success. However, postoperative quality of life (QoL) may remain impaired. Hormonal deficiency, postoperative complications, and limited access to adjuvant therapy and hormonal assessm ent especially in developing countries such as Indonesia can exacerbate these outcomes. National data specifically evaluating QoL after EETS are lacking. Objective : To assess the QoL of pituitary adenoma patients across eight SF-36 domains and identify factors influencing QoL after EETS. Methods: This cross-sectional study was conducted at the Pituitary Clinic of the National Brain Center Hospital, Jakarta. Primary data were obtained through SF-36 interviews; secondary data came from medical records and registry. Data analysis using SPSS 24.0 included univariate, bivariate, and multivariate linear regression (backward method). Associations were expressed with β-coefficients, p-values ( < 0.05), 95% CI, and R² values. Results: Ninety patients (45 males, 45 females) were included. Most had visual disturbances (85.6%), hormonal deficiencies (93.3%), and macroadenomas (95.6%). Combined EETS and medical therapy was performed in 62.2%. Physical Component Summary (PCS) scores exceeded Mental Component Summary (MCS) scores, with the highest scores in physical functioning and emotional role, and the lowest in vitality and mental health. Bivariate analysis showed sex was associated with physical role, vitality, emotional function, and mental health, while hormonal deficiency affected emotional function. Multivariate analysis found sex and hormonal deficiency significantly influenced mental health and MCS (R² = 74%); no significant predictors were found for PCS. Conclusion: Post-EETS QoL is generally good, particularly in physical aspects. Mental components especially vitality and mental health require greater attention. Sex and hormonal deficiency are key determinants of mental QoL.
Keywords: pituitary adenoma, quality of life, EETS, hormone deficiency, SF-36