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"Kanker lambung adalah penyebab paling umum kedua kematian terkait kanker secara global. kejadian global diprediksi naik sebagai akibat dari pertumbuhan penduduk, ditandai dengan variasi geografis dalam kejadian kanker lambung. Penelitian ini bertujuan untuk mengetahui pemberian nutrisi melalui drip atau continous feeding untuk menghindari gejala gastro-oesophageal reflux dapat diterapkan pada pasien gastrektomi untuk mengatasi kekurangan nutrisi pada pasien. Metode studi kasus dengan pendekatan evidenced based practice yaitu menggunakan penelitian sebagai dasar dalam praktik asuhan keperawatan pada klien dengan gastrektomi dapat mengurangi gejala gastro-oesophageal reflux yaitu mual dan muntah sehingga evidence based practice tersebut bisa diterapkan pada pemberian nutrisi enteral pada klien gastrektomi sehingga ketidakseimbangan nutrisi kurang dari kebutuhan tubuh b.d mual dan muntah dapat teratasi.

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Gastric cancer is the second most common cause of cancer-related deaths globally. Global incidence is predicted to increase as a result of population growth, characterized by geographical variation in the incidence of gastric cancer. This study aims to determine the provision of nutrition or continuous drip feeding through to avoid the symptoms of gastro-oesophageal reflux in patients with gastrectomy can be applied to address nutritional deficiencies in patients.

The case study method with evidenced based practice approach is to use research as a basis for the practice of nursing care to clients with gastrectomy may reduce symptoms of gastro-oesophageal reflux are nausea and vomiting so that evidence-based practice can be applied to enteral nutrition on the client so that the imbalance nutrition less gastrectomy than body requirements; nausea and vomiting can be resolved."

"Kanker merupakan salah satu masalah kesehatan yang terjadi pada masyarakat perkotaan. Karsinoma gaster adalah jenis kanker yang terjadi pada saluran cerna yang menjadi penyebab terbesar kedua penyebab kematian karena kanker di dunia. Pada umumnya karsinoma gaster pada stadium lanjut dapat menginvasi area sekitarnya seperti obstruksi usus yang terjadi karena infiltrasi dari neoplasma, sehingga dilakukan tindakan pembedahan laparatomi. Tujuan penulisan ini untuk melakukan analisis evidence based mengenai protokol tahapan pemberian mobilisasi dini untuk meningkatkan penyembuhan luka post operasi laparatomi. Hasil dari penulisan ini menyatakan bahwa mobilisasi dini dapat meningkatkan penyembuhan luka postoperasi. Rekomendasi penulisan ini ialah agar perawat perlu melakukan pendidikan kesehatan mengenai pentingnya mobilisasi post operasi pada pasien yang telah menjalani pembedahan.

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Cancer is one of the health problems that occur in urban communities. Gastric carcinoma is a type of cancer that occurs in the gastrointestinal tract that cause the second largest cause of cancer death in the world. In general, at an advanced stage gastric carcinoma can invade the surrounding areas such as bowel obstruction that occurs due to infiltration of the neoplasm, so do laparotomy surgery. The purpose of this paper to analyze evidence based on the stage of granting early mobilization protocol to improve postoperative wound healing laparotomy. The results of this paper states that early mobilization may increase postoperative wound healing. Recommendation of this paper is that nurses need to do health education on the importance of postoperative mobilization in patients who have undergone surgery."

"Latar belakang: Kanker lambung bertanggung jawab atas lebih dari 1.000.000 kasus kanker baru pada tahun 2020 dan diperkirakan 769.000 kematian atau sama dengan satu dari setiap 13 kematian secara global. Deteksi dini menjadi kunci penurunan angka kematian dan perbaikan prognosis, dengan baku emas berupa avaluasi histopatologi dari hasil biopsi endoskopi. Tetapi subjektivitas pemeriksan tersebut berpotensi menimbulkan kesalahan diagnosis terutama akibat kesalahan interpretasi ahli patologi. Untuk itu, diperlukan metode diagnostik kuantitatif yang dapat menilai secara objektif lesi prekanker atau inflamasi pada dinding lambung. Metode autofluoresensi sebelumnya sudah digunakan dalam upaya diagnostik kanker lambung. Namun, saat ini belum ada studi terkait penggunaan spektrofotometri autofluoresensi sebagai metode diagnostik kuantitatif dan objektif untuk kanker lambung. Tujuan: Studi ini dilakukan untuk mengetahui kemampuan spektrofotometri autofluoresensi dalam mengidentifikasi jaringan lambung normal, inflamasi dan prekanker berdasarkan intensitas fluoresensi jaringan.Metode: Studi ini menggunakan sediaan blok parafin jaringan lambung mencit (Mus musculus) normal, inflamasi dan prekanker. Intensitas fluoresensi jaringan diukur pada 640 panjang gelombang menggunakan spektrofotometer autofluoresensi sederhana dengan sumber cahaya ultraviolet. Analisis data dilakukan dengan SPSS untuk uji normalitas, homogenitas dan hipotesis. Dilanjutkan dengan pengelompokkan data secara kualitatif dengan Principal Component Analysis (PCA) dan secara kuantitatif dengan machine learning dengan 3-fold cross validation. Hasil analisis dengan PCA dinilai dengan scatter plot. Hasil pengolahan data secara kuantitatif dinilai dengan Area under the Curve (AUC),Classification Accuracy (CA), precision, recall, F1-score, sensitivitas dan spesifisitas. Hasil: Ditemukan dua panjang gelombang dengan intensitas fluoresensi bermakna untuk tiga kelompok jaringan dan 554 panjang gelombang yang bermakna untuk dua kelompok jaringan. Dalam pengelompokkan tiga variabel, ditemukan nilai AUC 0,900, CA 0,833, Skor F1 0,831, Precision 0,802, dan Recall 0,800. Dalam pengelompokkan dua variabel, ditemukan sensitivitas dan spesifisitas 100% untuk membedakan jaringan prekanker dengan normal. Sensitivitas 100% dan spesifisitas 80% untuk jaringan prekanker dengan inflamasi. Serta sensitivitas 80% dan spesifisitas 90% untuk jaringan inflamasi dengan normal. Kesimpulan: Spektrofotometeri autofluoresensi dapat membedakan jaringan lambung normal, inflamasi dan prekanker mencit Mus musculus dengan sensitivitas dan spesifisitas yang baik.

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Introduction: Gastric cancer was responsible for more than 1,000,000 new cancer cases in 2020 and an estimated 769,000 deaths or equal to one in every 13 deaths globally. Early detection is the key to reducing mortality and improving prognosis, with histopathological evaluation of endoscopic biopsy results as gold standard. However, the subjectivity of the examination has the potential to cause misdiagnosis, mainly due to the pathologist's misinterpretation. For this reason, quantitative diagnostic methods are needed that can objectively assess precancerous or inflammatory lesions in the gastric wall. The autofluorescence method has previously been used in the diagnostic effort of gastric cancer. However, there are currently no studies related to the use of autofluorescence spectrophotometry as a quantitative and objective diagnostic method for gastric cancer Objective: This study was conducted to determine the ability of autofluorescence spectrophotometry to identify normal, inflammatory and precancerous gastric tissue based on the intensity of tissue fluorescence.Method: This study used a paraffin block preparation of normal, inflammatory and precancerous mice (Mus musculus) gastric tissue. The intensity of tissue autofluorescence was measured at 640 wavelengths using simple autofluorescence spectrophotometer with ultraviolet light source. Data analysis was performed using SPSS to test for normality, homogeneity and hypotheses. Followed by grouping the data qualitatively with Principal Component Analysis (PCA) and quantitatively with machine learning with 3-fold cross validation. The results of the PCA analysis were assessed using a scatter plot. The results of quantitative data processing were assessed by Area under the Curve (AUC), Classification Accuracy (CA), precision, recall, F1-score, sensitivity and specificity. Result: Two wavelengths with significant fluorescence intensity were found for three tissue groups and 554 significant wavelengths for two tissue groups. In grouping the three variables, the AUC value was 0.900, CA 0.833, F1 score 0.831, Precision 0.802, and Recall 0.800. In grouping the two variables, 100% sensitivity and specificity were found to differentiate between precancerous and normal tissues. 100% sensitivity and 80% specificity for precancerous tissue with inflammation. As well as 80% sensitivity and 90% specificity for normal inflammatory tissue. Conclusion: Autofluorescence spectrophotometry can differentiate normal, inflammatory and precancerous gastric tissue in mice Mus musculus with good sensitivity and specificity."

"Latar Belakang: Karsinoma gaster merupakan tumor ganas yang paling sering di daerah gastrointestinal atas. Menurut data epidemiologi adenokarsinoma gaster menunjukkan perkembangan kanker tipe intestinal dan kanker tipe difus melalui jalur kausa yang berbeda dan juga akhir-akhir ini pengobatan terapi target untuk adenokarsinoma telah diketahui dan dikembangkan. Penelitian ini bertujuan untuk mengetahui hubungan antara ekspresi HER2 dengan tipe histopatologik menurut klasifikasi Lauren dan derajat diferensiasi pada adenokarsinoma gaster.Bahan dan cara kerja: Penelitian dilakukan di Departemen Patologi Anatomik FKUI RSCM Jakarta, dengan melakukan analisis ekspresi HER2 untuk melihat hubungannya dengan tipe histopatologik dan derajat diferensiasi adenokarsinoma gaster yang diperoleh secara reseksi dan biopsi sejak tahun 2007-2011. Penilaian tipe histopatologik dengan menggunakan pulasan Hematoxillin Eosin dan penilaian ekspresi HER2 dengan menggunakan pulasan imunohistokimia HER2.Hasil: Dari tahun 2007-2011 diperoleh 55 kasus (76,4% laki-laki dan 23,6% wanita). Rata-rata umur penderita 50,55 tahun (rentang umur 29-73 tahun). Ekspresi HER2 3+, 2+, dan 1+ didapatkan pada 14,5%, 34,5%, dan 25,5% sampel. Sebanyak 25,5% sampel tidak menunjukkan ekspresi HER2. Ekspresi berlebih HER2 (3+) didapatkan pada 8 kasus (14,5%) adenokarsinoma gaster, yang seluruhnya adalah tipe intestinal .Kesimpulan: Terdapat hubungan yang bermakna antara ekspresi HER2 dengan tipe histopatologik (p= 0,021). Tidak terdapat hubungan yang bermakna antara ekspresi HER2 dengan derajat diferensiasi tumor (p=0,253).

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Background: Gastric carcinoma is the most common malignant tumor in upper gastrointestinal. According to epidemiologic data, gastric adenocarcinoma intestinal type and diffuse type showed different carcinogenesis. Recently, targeting therapy for adenocarcinoma has established. The aim of the study to know the relationship between HER2 expression and histopathologic type according to Lauren's classification and grading of gastric adenocarcinoma.Patient and method: This study has done in Anatomical Pathology department of medicine University Indonesia/ Cipto Mangunkusumo National Hospital, Jakarta. HER2 expression is analyzed to see the relationship with histopathologic type and differentiation of gastric adenocarcinoma. The specimens were from resection and biopsy (2007-2011). Histopathologic type evaluated with Hematoxylin Meyer's staining. HER2 expression evaluated with immunostaining with HER2 antibody.Results: We found 55 cases from 2007 until 2011 (76,4% men and 23,6% women). The mean age is 50,55 years (the range of age 29-73 years). HER2 expression 3+,2+ and 1+ are 14,5%, 34,5%, and 25,5% sampling. 25% sample did not show HER2 expression. We found overexpression HER2 (3+) in 8 cases (14,5%) of adenocarcinoma gastric intestinal type.Conclusion: There is a significant relation between HER2 expression with histopathologic type (p=0,021). There is no significant relation between HER2 with grading (p=0,253)."

"ABSTRAKAnalisis Praktik Residensi Keperawatan Medikal Bedah pada Kanker Lambung dengan Pendekatan Model Adaptasi Roy di Rumah Sakit Kanker Dharmais dan Cipto Mangunkusumo Jakarta Karya ilmiah ini bertujuan memberikan gambaran analisis praktik residensi Keperawatan Medikal Bedah selama 2 semester tentang penerapan teori model keperawatan dalam studi kasus, dan analisis hasil penerapan tindakan mandiri keperawatan berbasis pembuktian ilmiah (evidence based nursing practice), serta analisis hasil inovasi kelompok terhadap fenomena yang ditemui selama praktik residensi. Penerapan peran perawat profesional dalam proses asuhan keperawatan dengan menggunakan teori adaptasi Roy dilakukan pada kasus karsinoma nasofaring dan berbagai kasus keganasan lainnya terbukti bermanfaat membantu dan meningkatkan kemampuan adaptasi pasien terhadap stimulus internal dan esternal yang dialami. Kegiatan aplikasi tindakan mandiri keperawatan berdasarkan pembuktian ilmiah pelaksanaan guided imagery dan progressive muscle relaxation bukti bermanfaat untuk mengurangi nyeri dan meningkatkan kualitas hidup pasien. Pada proyek inovasi manajemen nyeri pada pasien kanker yang menjalani kemoterapi di ruang rawat inap dengan memfasilitasi pembuatan multi media video guided imagery dan progressive muscle relaxation perawat dalam manajemen nyeri. Peran perawat profesional dapat dijalankan dalam setiap tahap kegiatan praktik residensi keperawatan medikal bedah peminatan onkologi secara holistik dan komprehensif meliputi upaya promotif, reventif, kuratif, dan rehabilitatif. Kata kunci: Adaptasi Roy, kanker, guided imagery dan progressive muscle relaxation, Manajemen nyeri.

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ABSTRACTractice Analysis of Medical Surgical Nursing Surgery on Stomach Cancer with Roy's Adaptation Model Approach at Dharmais Cancer Hospital and Cipto Mangunkusumo Jakarta This paper aims to provide an overview of residency medical Surgical Nursing residency analysis for 2 semesters on the application of nursing model theory in case study, and analysis of the results of the implementation of scientifically based nursing based action (evidence based nursing practice), and analysis of group innovation results on the phenomenon encountered during residency practice. The application of the role of professional nurses in the nursing care process using Roy's adaptation theory was done in cases of nasopharyngeal carcinoma and other malignant cases proved helpful in improving the patient's adaptability to internal and esternal stimuli. The activities of self-directed nursing action based on scientific proof of guided imagery and progressive muscle relaxation are useful to reduce pain and improve patient's quality of life. In the pain management innovation project in cancer patients undergoing chemotherapy in the inpatient room by facilitating the creation of multi media video guided imagery and progressive muscle relaxation nurses in pain management. The role of professional nurse can be carried out in every stage of medical residency practice of medical surgical treatment of oncology specialization holistically and comprehensively covering promotive, reventif, curative and rehabilitative efforts. Keywords: Roy's adaptation, cancer, guided imagery and progressive muscle relaxation, pain management"

"Latar Belakang: Data GLOCOBAN tahun 2018 menunjukkan bahwa kanker lambung merupakan penyebab kematian akibat kanker nomor tiga di dunia. Hingga saat ini, belum terdapat deteksi dini untuk kanker lambung. Kanker lambung sering ditemukan dalam kondisi yang sudah berat, karena 25,8% kasus tidak terdiagnosis ketika dilakukan upper endoscopy. Sejumlah penelitian menunjukkan bahwa spektrofotometri dapat digunakan dalam mendeteksi jaringan kanker, antara lain spektroskopi Raman dan optik. Hingga saat ini belum ada penelitian yang mendeteksi jaringan kanker lambung berdasarkan spektrofotometri sederhana.Tujuan: Studi ini dilakukan untuk mengetahui ambang batas perbedaan panjang gelombang reflektansi pada jaringan kanker normal dengan jaringan pra-kanker dan jaringan kanker lambung serta menganalisis akurasi spektrofotometer dalam klasifikasi jaringan..Metode: Reflektansi jaringan mencit Mus musculus diukur menggunakan spektrofotometer konvensional pada panjang gelombang 431.5-705.2 mm. Hasil reflektansi kemudian digunakan dalam model machine learning untuk menentukan klasifikasi berdasarkan reflektansi.Hasil: Machine learning Tree menggunakan panjang gelombang 431,5, 494,2, dan 502.5 nm. Analisis Principal Component Analysis menunjukkan adanya penumpukkan antara jaringan prekanker dengan jaringan kanker. Metode Random Forest (CA: 0.857, precision: 0.872, recall: 0.857) lebih baik dalam mengklasifikasikan jaringan kanker lambung dibandingkan metode Tree (CA;0,607, precision:0,619, dan recall:0,607) dan logistic regression (CA:0,750, precision: 0,739, dan recall:0,750). Spektrofotometri reflektans sederhana memiliki sensitivitas sebesar 68.42%-89.47% dan spesifisitas sebesar 44-88.89% dalam mendeteksi jaringan pra-kanker dan jaringan kanker.Kesimpulan: Dengan rentang panjang gelombang 431,5, 494,2, dan 502.5 nm, spektrofotometri sederhana tidak dapat membedakan jaringan pra-kanker dan kanker karena terdapat penumpukan protein seperti miglobin, dan juga tingkat sensitivitas dan spesifisitas yang baik dalam membedakan jaringan normal dan tidak normal.

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Background: GLOCOBAN in 2018 shows that gastric cancer is the third leading cause of death for cancer-related disease. Until now, there’s no early detection for gastric cancer. This causes gastric cancer to be diagnosed at a later stage, because 25,8% gastric cancer cases are undiagnosed even with upper endoscopy 3 years before diagnosis.A number of study has shows that spectrophotometry can be used for detecting gastric cancer, such as Raman spectroscopy and optical. Until now, there is no research that detect gastric cancer using conventional spectrophotometer.

Objectives This study aims to understand the difference between wavelength of the reflectance from the normal gastric tissue, precancerous gastric tissue, and gastric cancer tissue and analyze the accuracy of conventional spectrophotometer to classify the tissues.

Methods The reflectance of the tissue of Mus musculus is evaluated using conventional spectrophotometer at the wavelength of 431.5-705.2 mm. The resulting data will then be used in a machine learning model to help classify the tissue based on the reflectance

Result: Wavelengths used by Tree is 431,5, 494,2, dan 502.5 nm. Analysis using Principal Component Analysis shows a grouping formed by the gastric precancer tissue and gastric cancer tissue. Random Forest (CA: 0.857, precision: 0.872, recall: 0.857) is proven to be better for classifying the tissue based on the reflectance compared to Tree (CA;0,607, precision:0,619, and recall:0,607) and Logistic regression (CA:0,750, precision: 0,739, and recall:0,750). Conventional reflectance spectrophotometry yielded a 68.42%-89.47% sensitivity and 44-88,89% specificity in differentiating normal gastric tissue with abnormal gastric tissue.

Conclusion: Within the wavelength of 431,5, 494,2, dan 502.5 nm, conventional spectrophotometer cannot differentiate precancerous lesion with gastric cancer tissue due to the abundance of protein such as myoglobin, and having a good sensitivity and specificity in differentiating normal and abnormal tissue."

"The first laparoscopy-assisted gastrectomy for gastric cancer was performed in Japan in 1991. In the ensuing 20 years, at first through a process of trial and error, then through the sharing of master surgeons’ accumulated experience, the procedure has been honed and refined to its current high level. From the beginning, it soon became evident that this much less invasive form of gastrectomy, in comparison with traditional open surgery, led to improved quality of life for postsurgical patients, and use of the procedure spread rapidly among gastric surgeons. Early on, however, there were calls for the establishment of standard techniques and procedures to be followed, with a recognized need to improve the level of safety and the quality of lymph node dissection for local control in cancer treatment. Toward that end, the Laparoscopy-Assisted Gastrectomy Club was formed in 1999. In the following year, because both Japan and Korea experience a high rate of gastric cancer, specialists from those two nations came together to form the Japan–Korea Laparoscopic gastrectomy joint seminar, to facilitate and encourage the exchange of vital information. The result has been to achieve an evolving consensus among specialists in the field of endoscopic surgery in Japan and Korea with expertise that can be shared worldwide. A compilation of the current state-of-the-art is now presented in this volume, with accompanying DVD, which will be of great value to all endoscopic surgeons who perform laparoscopic gastrectomy."