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"[ABSTRAKGaster merupakan organ pencernaan yang salah satu fungsinya sebagai penampungmakanan. Keganasan dapat terjadi di sepanjang saluran pencernaan termasuk gaster.Operasi merupakan salah satu modalitas terapi yang dipakai sebagai terapi keganasangaster. Penderita keganasan gaster akan mengalami perubahan status gizi. Data mengenaigambaran status gizi pasien yang menjalani operasi keganasan gaster belum ada diRSCM.Jenis penelitian ini adalah deskriptif retrospektif dengan mengumpulkan data rekammedis pada pasien dengan diagnosis keganasan gaster yang menjalani operasi di RumahSakit dr Cipto Mangunkusumo selama periode tahun 2009 sampai dengan 2012.HASILDari 30 pasien yang didiagnosis keganasan gaster , didapatkan data yang lengkap 19(63,3 %). Penderita laki laki, usia tua dan jenis keganasan dominan pada penelitian inisesuai dengan penelitian Leonard A Laisang tahun 2008 dan kepustakaan.5,19Terdapat peningkatan jumlah operasi pada kegansan gaster dari tahun 2009 sampaidengan 2011 namun terjadi penurunan pada tahun 2012. Rerata waktu tunggu operasicukup lama sampai 14,15 hari sedangkan rerata lama rawat 28 hari. Kebanyakan pasienberdomisili di jabodetabek dan sepertiganya dari luar jawa. Jenis operasi kebanyakanadalah parsial gastrektomi baik dengan bypass atau tidak. Perbandingan rerata albumindan IMT saat masuk rumah sakit, sebelum operasi dan setelah operasi mengalamipenurunan. Sedangkan perbandingan rerata Total Limfosit Count saat masuk rumahsakit dan sebelum operasi mengalami penurunan dan meningkat kembali setelah operasi.Pada penelitian ini terdapat dua kali lipat pasien menderita malnutrisi dibandingkanpenelitian oeh Rofi dan Kalis.15,16Kelengkapan data mengenai status nutrisi pada status rekam medis sangat diperlukan.Hasil penelitian bersesuaian dengan kepustakaan dan penelitian sebelumnya.5,19 Lamanyamenunggu operasi dan lama rawat memerlukan perhatian khusus untuk menguranginya.

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ABSTRACTGaster is a digestive organ that is one of its functions as a container for food. Malignancymay occur along the digestive tract, including the stomach. Operation is one that is usedas a therapeutic modality therapy of gastric malignancy. Patients with gastric malignancywill change the nutritional status. Data on the picture of the nutritional status of patientswho underwent surgery for gastric malignancy not yet available at RSCM.METHODThis research is a descriptive retrospective medical record by collecting data on patientswith a diagnosis of gastric malignancy who underwent surgery at the Hospital Dr. CiptoMangunkusumo during the period from 2009 to 2012.THE RESULTOf the 30 patients diagnosed with gastric malignancy, obtained complete data 19(63.3%). Patients men, old age and type of malignancy dominant in this study isconsistent with research Leonard A Laisang 2008 and literature. 5.19There are an increasing number of operations on gastric malignancy from 2009 to 2011but decreased in 2012. The mean waiting time operation long enough to 14.15 days, whilethe average length of 28 days. Most patients live in Jabodetabek and a third from outsideJava. This type of surgery is mostly partial gastrectomy with bypass or not. A comparisonof the albumin and BMI at admission, before surgery and after surgery decreased.Meanwhile, the average ratio of Total Lymphocyte Count on admission and beforesurgery decreased and increased again after the operation. In this study, there are two-foldcompared to patients suffering from malnutrition research by Rofi and Kalis.15,16CONCLUSIONCompleteness of data on nutritional status on the status of medical records is needed.Results consistent with the literature study and research previously.5,19 The waiting list ofsurgery and length of stay require special attention to reduce it.;BACKGROUNDGaster is a digestive organ that is one of its functions as a container for food. Malignancymay occur along the digestive tract, including the stomach. Operation is one that is usedas a therapeutic modality therapy of gastric malignancy. Patients with gastric malignancywill change the nutritional status. Data on the picture of the nutritional status of patientswho underwent surgery for gastric malignancy not yet available at RSCM.METHODThis research is a descriptive retrospective medical record by collecting data on patientswith a diagnosis of gastric malignancy who underwent surgery at the Hospital Dr. CiptoMangunkusumo during the period from 2009 to 2012.THE RESULTOf the 30 patients diagnosed with gastric malignancy, obtained complete data 19(63.3%). Patients men, old age and type of malignancy dominant in this study isconsistent with research Leonard A Laisang 2008 and literature. 5.19There are an increasing number of operations on gastric malignancy from 2009 to 2011but decreased in 2012. The mean waiting time operation long enough to 14.15 days, whilethe average length of 28 days. Most patients live in Jabodetabek and a third from outsideJava. This type of surgery is mostly partial gastrectomy with bypass or not. A comparisonof the albumin and BMI at admission, before surgery and after surgery decreased.Meanwhile, the average ratio of Total Lymphocyte Count on admission and beforesurgery decreased and increased again after the operation. In this study, there are two-foldcompared to patients suffering from malnutrition research by Rofi and Kalis.15,16CONCLUSIONCompleteness of data on nutritional status on the status of medical records is needed.Results consistent with the literature study and research previously.5,19 The waiting list ofsurgery and length of stay require special attention to reduce it., BACKGROUNDGaster is a digestive organ that is one of its functions as a container for food. Malignancymay occur along the digestive tract, including the stomach. Operation is one that is usedas a therapeutic modality therapy of gastric malignancy. Patients with gastric malignancywill change the nutritional status. Data on the picture of the nutritional status of patientswho underwent surgery for gastric malignancy not yet available at RSCM.METHODThis research is a descriptive retrospective medical record by collecting data on patientswith a diagnosis of gastric malignancy who underwent surgery at the Hospital Dr. CiptoMangunkusumo during the period from 2009 to 2012.THE RESULTOf the 30 patients diagnosed with gastric malignancy, obtained complete data 19(63.3%). Patients men, old age and type of malignancy dominant in this study isconsistent with research Leonard A Laisang 2008 and literature. 5.19There are an increasing number of operations on gastric malignancy from 2009 to 2011but decreased in 2012. The mean waiting time operation long enough to 14.15 days, whilethe average length of 28 days. Most patients live in Jabodetabek and a third from outsideJava. This type of surgery is mostly partial gastrectomy with bypass or not. A comparisonof the albumin and BMI at admission, before surgery and after surgery decreased.Meanwhile, the average ratio of Total Lymphocyte Count on admission and beforesurgery decreased and increased again after the operation. In this study, there are two-foldcompared to patients suffering from malnutrition research by Rofi and Kalis.15,16CONCLUSIONCompleteness of data on nutritional status on the status of medical records is needed.Results consistent with the literature study and research previously.5,19 The waiting list ofsurgery and length of stay require special attention to reduce it.]"

"ABSTRAK Penatalaksanaan Fistel Enterokutan masih sangat beragam dan sulit dengan tingkat kekambuhan dan kematian pasca pembedahan yang masih tinggi. Tujuan dari penatalaksanaan pasien dengan fistel enterokutan adalah koreksi defisit metabolik dan nutrisi, penutupan fistel dan mengembalikan kesinambungan saluran cerna. Tujuan dari penelitian ini adalah untuk melakukan evaluasi penatalaksanaan bedah pada fistel enterokutan yang dirawat di RSUPN Cipto Mangunkusumo selama tahun 2014-2015. Penelitian ini dirancang secara retrospektif analitik dengan mengambil data rekam medik penderita di RSUPN Cipto Mangunkusumo pada periode 2014-2015. Ditemukan 27 kasus fistel enterokutan, dimana 21 kasus yang di evaluasi, rentang umur 27-65 tahun, terbanyak pada kelompok 40-60 tahun (52,38%), letak fistel terbanyak di ileum (57,14%), high output (71,43%), gizi buruk (52,38%), dilakukan tindakan operatif (85,71%), lama rawat <20 hari (66,67%), rekurensi fistel (19,05%) dan angka kematian (14,29%).ABSTRACT Management of enterocutaneous fistula still varies and frustrating with high recurrence and mortality rate. The goal of management for patient with enterocutaneous fistula are correct metabolic and nutritional deficits, close the fistula and reestablish continuity of the gastrointestinal tract. The purpose of this study was to evaluate the surgical management of the enterocutaneous fistula treated at Cipto Mangunkusumo Hospital during 2014-2015. This study designed analytic retrospectively by taking the patient medical record data at Cipto Mangunkusumo Hospital ini the period 2014-2015. Found 27 cases of enterocutaneous fistula which 21 cases were evaluated, age range 40-60 years (52,38%), the location of the fistula largest in the ileum (57,14%), high output (71,43%), malnutrition (52,38%), operative management (85,71%), length of stay in hospital <20 days (66,67%), fistula recurrence (19,05%) and mortality rate (14,29%).;Management of enterocutaneous fistula still varies and frustrating with high recurrence and mortality rate. The goal of management for patient with enterocutaneous fistula are correct metabolic and nutritional deficits, close the fistula and reestablish continuity of the gastrointestinal tract. The purpose of this study was to evaluate the surgical management of the enterocutaneous fistula treated at Cipto Mangunkusumo Hospital during 2014-2015. This study designed analytic retrospectively by taking the patient medical record data at Cipto Mangunkusumo Hospital ini the period 2014-2015. Found 27 cases of enterocutaneous fistula which 21 cases were evaluated, age range 40-60 years (52,38%), the location of the fistula largest in the ileum (57,14%), high output (71,43%), malnutrition (52,38%), operative management (85,71%), length of stay in hospital <20 days (66,67%), fistula recurrence (19,05%) and mortality rate (14,29%).;Management of enterocutaneous fistula still varies and frustrating with high recurrence and mortality rate. The goal of management for patient with enterocutaneous fistula are correct metabolic and nutritional deficits, close the fistula and reestablish continuity of the gastrointestinal tract. The purpose of this study was to evaluate the surgical management of the enterocutaneous fistula treated at Cipto Mangunkusumo Hospital during 2014-2015. This study designed analytic retrospectively by taking the patient medical record data at Cipto Mangunkusumo Hospital ini the period 2014-2015. Found 27 cases of enterocutaneous fistula which 21 cases were evaluated, age range 40-60 years (52,38%), the location of the fistula largest in the ileum (57,14%), high output (71,43%), malnutrition (52,38%), operative management (85,71%), length of stay in hospital <20 days (66,67%), fistula recurrence (19,05%) and mortality rate (14,29%)."

"ABSTRAK Fistula perianal merupakan salah satu penyakit yang cukup banyak di divisi bedah digestif RSCM Namun sampai saat ini belum tersedia karakteristik pasien sehingga penatalaksanaan sampai saat ini fistel perianal tidak banyak berubah dalam dua dekade terakhir Dilakukan penelitian deskriptif retrospektif menggunakan data rekam medis pasien fistula perianal yang dilakukan pembedahan periode Januari 2009 sampai Desember 2012 di RSCM JakartaTerdapat 26 orang laki laki 74 3 dan 9 orang perempuan 25 7 penderita fistula perianal dengan usia rerata 37 03 tahun rentang 10 61 tahun median 35 tahun Pasien dirawat di bangsal bedah pasca operasi rerata 9 17 hari rentang 2 26 hari Tindakan tersering dilakukan adalah fistulektomi 60 pasien dengan dengan letak tersering pada fistula di arah jam 6 29 3 pasien yang kembali dilakukan operasi karena rekurensi 8 6 dengan waktu kembali pasca operasi pertama rerata 3 bulan pasca operasi pertama Fistula perianal merupakan salah satu penyakit tersering di divisi bedah digestif Karakteristik pasien perianal fistula terbanyak adalah laki laki dengan tindakan yang tersering dilakukannya fistulektomi Penatalaksanaan pasien dengan fistel perianal bertujuan menghilangkan fistel dengan mempertahankan fungsi dari sfingter Perlunya data yang lengkap dan terperinci didalam status dan laporan operasi dapat membantu terbentuknya penelitian yang lengkap Kata kunci fistula perianal fistulektomi karakteristik pasien lama rawat usia penatalaksanaan.ABSTRACT Perianal fistula is one of the most frequently disease in RSCM digestive surgery Nevertheless until now there is no data about the patient so there is no different treatment of this disease for the last two decade Have been done the retrospective descriptive research in Ciptomangunkusumo Hospital by using medical record of patient with diagnosis perianal fistula from January 2009 till December 2012 There is 26 male 74 3 and 9 female 25 7 patient with perianal fistula and with the average age was 37 03 years old range from 10 61years median 35 years old Patient was admitted in the ward with length of stay average 9 17 days range 2 26 days Fistulektomy 60 is the most frequently treatment with the location of fistula at 6 o rsquo clock 29 There is 3 patient with recurrent fistula perianal 8 6 with average time the patient was came after 3 months after the first surgeryThe treatment it self is to remove the fistula and preserve the function of sphincter The key to help the good research is to collect and write the good medical recordKey word perianal fistula fistulektomy patient characteristic length of stay age treatment."

"Tesis ini menggambarkan pola kuman pada kasus infeksi intra abdomen yang disebabkan perforasi saluran cerna atas dan bawah beserta kepekaan antibiotiknya di Rumah Sakit dr Cipto Mangunkusumo. Penelitian ini adalah penelitian cross sectional dengan desain deskriptif analitik. Kuman yang terdapat pada infeksi intra abdomen di tahun 2013 adalah E.coli, Stapylococcus sp dan Enterococcus, sama dengan studi sebelumnya. Sedangkan angka kepekaan kuman terhadap antibiotik terutama golongan aminoglikosida lebih rendah dari data yang sudah ada sebelumnya. Usulan penggunaan antibiotik Amikacin masih dapat diberikan untuk terapi empiris infeksi intra abdomen bersama dengan Metronidazol.

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Intra Abdominal Infection (IAI) is the second most commonly identified cause of severe sepsis. This study wants to identify pattern of bacteria in intra abdominal infections due to upper and lower gastro intestinal tract perforation. This is cross sectional study with analytic descriptive. Result of this study shows that mostly bacteria in intra abdominal infections are E.coli, Stapylococcus and Enterococcus. This is similar with the previous study but with antibiotic susceptibility rate are lower especially aminoglicoside, compare to prior data. Amikacin is still recommended for empiric therapy in intra abdominal infection but combine with Metronidazole."

"ABSTRAKLatar Belakang: Mortalitas pasien perforasi tukak peptik (PTP) masih stabil padaangka 20-50% dimana penyebab terbanyak adalah sepsis. Tantangan ini memicu paraahli bedah untuk meneliti faktor-faktor yang berhubungan dengan mortalitas danmorbiditas penyakit ini. Selain pembedahan untuk kontrol infeksi, antibiotikapreoperatif diketahui menurunkan angka mortalitas. Penelitian ini bertujuanmengetahui hubungan kesesuaian antibiotika empiris dengan hasil kultur sensitifitasantibiotika terhadap ketahanan hidup 30 hari pasien perforasi tukak peptik di RSUPNDr Cipto Mangunkusumo (RSCM) Jakarta. Metode: Studi kohort terhadap pasienPTP sejak Januari 2012 hingga Agustus 2015 di Departemen Bedah FKUI/RSCMJakarta, dimana PTP akibat keganasan dan trauma tembus dieksklusikan. Pola kumandan antibiotika pada pasien PTP disajikan sebagai studi pendahuluan. Hasil: dari 45pasien yang didapat, angka mortalitas pasien PTP di RSCM sebesar 31,1% danketahanan hidup sebesar 68,9%. Pola kuman pada pasien PTP adalah Escherichia colisebagai kuman Gram negatif terbanyak (35,85%) dan Streptococcus alfahemolyticsebagai kuman Gram positif terbanyak (15,09%). Antibiotika lini kedua yang sesuaiuntuk pasien PTP adalah Sulbactam/Ampicillin.Tidak terdapat hubungan antara skor Boey dan ketahan hidup, namun syok preoperatif memengaruhi ketahanan hidup(nilai OR 14,67). Begitu juga dengan komorbiditas memengaruhi ketahanan hidupsebesar 10,54 kali. Lama persiapan operasi tidak bermakna terhadap ketahanan hidup,sedangkan durasi operasi memengaruhi ketahanan hidup sebesar 7,5 kali. Antibiotikaempiris yang sesuai dengan hasil kultur memengaruhi ketahanan hidup sebesar 12,57kali. Kesimpulan: Pemberian antibiotika empiris yang tepat terbukti berhubungandengan ketahanan hidup pasien perforasi tukak peptik.;

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ABSTRACT

Background: Mortality of patients with peptic ulcer perforation (PUP) was stable at

20-50%, which is the most common cause is sepsis. This challenge prompted the

surgeon to examine the factors associated with mortality and morbidity of this

disease. In addition to surgery to control infection, preoperative antibiotics are

known to reduce mortality. This study aims to determine the suitability of empiric

antibiotics relationship with antibiotic sensitivity culture results to the 30 days

survival of perforated peptic ulcer patients in Dr Cipto Mangunkusumo General

Hospital (RSCM) in Jakarta. Methods: A cohort study of patients PUP since January

2012 to August 2015 at Department of Surgery Faculty of medicine/RSCM Jakarta,

where PUP due to malignancy and penetrating trauma were excluded. Patterns of

bacteria and antibiotics in PUP patients presented as a preliminary study. Results:

45 patients were obtained, the mortality rate of patients in RSCM PUP by 31.1% and

amounted to 68.9% survival. Patterns of bacteria in a patient PUP is Escherichia

coli as most Gram-negative bacteria (35.85%) and Streptococcus alfahemolytic as

most Gram-positive bacteria (15.09%). The second line antibiotics are appropriate

for the PUP patients is sulbactam/ampicillin. There was no relationship between

Boey?s score and survivability, but the preoperative shock affect survival (OR 14.67).

Likewise with comorbidities affecting the survival of 10.54 times. Time to surgery on

survival was not significant, while the duration of surgery affecting the survival of 7.5

times. Empiric antibiotics in accordance with the culture results affects survival of

12.57 times. Conclusion: The provision of appropriate empiric antibiotic shown to be

associated with survival in patients with peptic ulcer perforation. ;Background: Mortality of patients with peptic ulcer perforation (PUP) was stable at20-50%, which is the most common cause is sepsis. This challenge prompted thesurgeon to examine the factors associated with mortality and morbidity of thisdisease. In addition to surgery to control infection, preoperative antibiotics areknown to reduce mortality. This study aims to determine the suitability of empiricantibiotics relationship with antibiotic sensitivity culture results to the 30 dayssurvival of perforated peptic ulcer patients in Dr Cipto Mangunkusumo GeneralHospital (RSCM) in Jakarta. Methods: A cohort study of patients PUP since January2012 to August 2015 at Department of Surgery Faculty of medicine/RSCM Jakarta,where PUP due to malignancy and penetrating trauma were excluded. Patterns ofbacteria and antibiotics in PUP patients presented as a preliminary study. Results:45 patients were obtained, the mortality rate of patients in RSCM PUP by 31.1% andamounted to 68.9% survival. Patterns of bacteria in a patient PUP is Escherichiacoli as most Gram-negative bacteria (35.85%) and Streptococcus alfahemolytic asmost Gram-positive bacteria (15.09%). The second line antibiotics are appropriatefor the PUP patients is sulbactam/ampicillin. There was no relationship betweenBoey?s score and survivability, but the preoperative shock affect survival (OR 14.67).Likewise with comorbidities affecting the survival of 10.54 times. Time to surgery onsurvival was not significant, while the duration of surgery affecting the survival of 7.5times. Empiric antibiotics in accordance with the culture results affects survival of12.57 times. Conclusion: The provision of appropriate empiric antibiotic shown to beassociated with survival in patients with peptic ulcer perforation.;Background: Mortality of patients with peptic ulcer perforation (PUP) was stable at20-50%, which is the most common cause is sepsis. This challenge prompted thesurgeon to examine the factors associated with mortality and morbidity of thisdisease. In addition to surgery to control infection, preoperative antibiotics areknown to reduce mortality. This study aims to determine the suitability of empiricantibiotics relationship with antibiotic sensitivity culture results to the 30 dayssurvival of perforated peptic ulcer patients in Dr Cipto Mangunkusumo GeneralHospital (RSCM) in Jakarta. Methods: A cohort study of patients PUP since January2012 to August 2015 at Department of Surgery Faculty of medicine/RSCM Jakarta,where PUP due to malignancy and penetrating trauma were excluded. Patterns ofbacteria and antibiotics in PUP patients presented as a preliminary study. Results:45 patients were obtained, the mortality rate of patients in RSCM PUP by 31.1% andamounted to 68.9% survival. Patterns of bacteria in a patient PUP is Escherichiacoli as most Gram-negative bacteria (35.85%) and Streptococcus alfahemolytic asmost Gram-positive bacteria (15.09%). The second line antibiotics are appropriatefor the PUP patients is sulbactam/ampicillin. There was no relationship betweenBoey?s score and survivability, but the preoperative shock affect survival (OR 14.67).Likewise with comorbidities affecting the survival of 10.54 times. Time to surgery onsurvival was not significant, while the duration of surgery affecting the survival of 7.5times. Empiric antibiotics in accordance with the culture results affects survival of12.57 times. Conclusion: The provision of appropriate empiric antibiotic shown to beassociated with survival in patients with peptic ulcer perforation."

"ABSTRAKLatar Belakang: Dalam beberapa dekade terakhir telah dikembangkan terapi paliatif yang bertujuan untuk mengeliminasi metastasis. Kemoterapi paliatif banyak dipilih menjadi terapi standar pada tatalaksana kanker kolorektal stadium lanjut. Pemberian 5-fluorouracil 5-FU intravena ditambah dengan leucovorin LV dan targeted therapy bevacizumab telah menjadi terapi paliatif standar dalam beberapa tahun terakhir. Di Indonesia, belum ada penelitian yang membandingkan efektifitas pemberian regimen kemoterapi Bevacizumab mFOLFOX6 dan Bevacizumab XELOX. Metode: Penelitian ini menggunakan desain potong lintang pada 15 pasien karsinoma kolorektal dengan metastasis hati dengan 11 pasien menjalani protokol Bevacizumab mFOLFOX6 dan 4 pasien menjalani protokol Bevacizumab XELOX. Efektifitas respons dilihat dengan menggunakan kadar CEA dan hasil CT scan. Hasil: Dengan menggunakan protokol kemoterapi Bevacizumab mFOLFOX6 81,8 subjek memberikan respons stable disease dan 54,5 subjek memberikan respons progressive disease. Sementara itu, dengan menggunakan protokol kemoterapi Bevacizumab XELOX 75,0 subjek memberikan respons stable disease dan 50,0 subjek memberikan respons partial response. Efektivitas kemoterapi tidak memiliki hubungan yang bermakna dengan regimen/protokol kemoterapi yang digunakan Bevacizumab mFOLFOX6 dan Bevacizumab XELOX, baik berdasarkan respon CT Scan p = 0,993 maupun kadar CEA 0,774 . Tidak terdapat pula hubungan antara variabel faktor dengan efektivitas kemoterapi. Kesimpulan: Efektivitas kemoterapi tidak memiliki hubungan yang bermakna dengan regimen/protokol kemoterapi yang digunakan. Selain itu, variabel usia, jenis kelamin, IMT, SGA, skor Karnofsky, lokasi tumor primer, jenis operasi, waktu kemoterapi dan tipe histopatologi tidak memiliki hubungan yang bermakna dengan efektivitas kemoterapi.

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ABSTRACTBackground In the last few decades, palliative therapy has been developed to eliminate metastasis. Palliative chemotherapy has become a standard therapy in the treatment of late stage colorectal cancer. Treatment with 5 fluorouracil 5 FU plus leucovorin intravenous LV and targeted therapies bevacizumab has become a standard palliative therapy in recent years. In Indonesia, there were no study comparing the effectiveness of Bevacizumab mFOLFOX6 and Bevacizumab XELOX chemotherapy regimens. Method This study used a cross sectional design in 15 patients with liver metastatic colorectal carcinoma which 11 patients were treated with Bevacizumab mFOLFOX6 protocol and 4 patients were treated with Bevacizumab XELOX protocol. The effectiveness of the response were measured using CEA concentration and CT scan result. Results With the Bevacizumab mFOLFOX6 protocol 81.8 of the subjects responded as stable disease and 54.5 responded as progressive disease. Meanwhile, with the Bevacizumab XELOX protocols 75.0 of the subjects responded as stable disease and 50.0 responded as partial response. Effectiveness of chemotherapy did not have a relationship with the chemotherapy protocols used Bevacizumab mFOLFOX6 and XELOX , based on CT scans p 0.993 and CEA levels 0.774 . In addition, there is no relationship between variable factors and the effectiveness of chemotherapy. Conclusions Effectiveness of chemotherapy did not have a relationship with the chemotherapy protocols used. In addition, the variables of age, sex, BMI, SGA, score Karnofsky, primary tumor site, type of surgery, chemotherapy and histopathology type of time did not have a relationship with the effectiveness of chemotherapy. "

"Latar Belakang. Pemberian kemoterapi oxaliplatin sebagai salah satu modalitas terapi kanker kolorektal telah terbukti memperbaiki angka kesembuhan, ketahanan hidup maupun masa bebas penyakit dan kualitas hidup penderita. Namun, juga memberikan berbagai efek samping toksisitas hematologi anemia, leukopenia, dan trombositopenia yang paling sering ditemukan. Metode. Penelitian ini merupakan penelitian observasional dengan menggunakan rancangan hysterikal kohort. Penelitian dilakukan di Departemen Bedah Fakultas Kedokteran Universitas Indonesia Divisi Bedah Digestif RSCM, periode Januari 2016 - Desember 2016. Populasi sasaran adalah 65 pasien kanker kolorektal yang mendapat kemoterapi oxaliplatin adjuvan. Hasil. Usia pasien kanker kolorekta berkisar antara 18 tahun sampai dengan 73 tahun rata-rata 50,8 tahun, perbandingan pria 32 49,2 dan wanita33 50,8. dari 65 pasien kanker kolorektal distribusi lokasi tumor terbanyak pada rektum 39 60, sigmoid 11 16,9, kolon desenden 7 10,8, kolon tranversum 5 7,7, kolon asenden 2 3,1, dan pada caecum 1 1,5. Stadium terbanyak adalah stadium II dan tindakan pembedahan berupa Low Anterior Resction atau Anterior Perineal Resection. Terdapat penurunan rerata kadar hemoglobin yang bermakna dengan p

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Background. The administration of oxaliplatin chemotherapy as one of the therapeutic modalities of colorectal cancer has been shown to improve the rate of cure, survival and disease free and quality of life of patients. However, it also provides the most common side effects of hematologic toxicity anemia, leukopenia, and thrombocytopenia.

Methods. This research is an observational using hysterical cohort design. It was conducted in Department of Surgery Faculty of Medicine, University of Indonesia Division of Digestive Surgery RSCM, periode January 2016 December 2016. The target population is 65 patients of colorectal cancer receiving adjuvant oxaliplatin chemotherapy.

Results The age of colorectal cancer patients ranged from 18 to 73 years mean 50.8 years, male 32 49.2 and female 33 50.8. 65 patients of colorectal cancer distributed the most tumor sites in the rectum 39 60, sigmoid 11 16.9, descending colon 7 10.8, tranversum colon 5 7.7, ascending colon 2 3.1, and at caecum 1 1.5. Most stages are stage II and the operate type of Low Anterior Resction or Anterior Perineal Resection. There was a significant decrease in mean hemoglobin level with p "

"Pendahuluan: Hal yang penting untuk transplantasi hati donor hidup (LDLT) yaitu risiko morbiditas dan mortalitas minimal terhadap donor hidup yang sehat. Tujuan dari penelitian ini yaitu untuk menganalisis seluruh komplikasi pascadonor dengan derajat beratnya komplikasi dikelompokkan berdasarkan klasifikasi Clavien-Dindo yang dikombinasikan dengan Comprehensive Complication Index (CCI) dan untuk menganalisis faktor-daktor yang berhubungan dengan komplikasi pascaoperasi.Metode: Penelitian ini menggunakan desain potong lintang. Terdapat 53 pasien dengan rekam medis lengkap dan menjalani LDLT di RSUPN Cipto Mangunkusumo, Jakarta, pada Desember 2010 dan Januari 2019. Seluruh subjek penelitian dianalisis secara retrospektif. Penelitian ini telah lolos kaji etik dengan nomor surat No 93/UN2.F1/ETIK/2019.Hasil: Dari 53 pasien yang menjalani LDLT di RSCM, terdapat 7 pasien yang menjalani prosedur transplan hati adult-to-adult dan 46 pasien menjalani prosedur transplan hati adult-to-child. Pada kelompok pasien transplan adult-to-child, sebanyak 43 pasien merupakan donor lobus kiri lateral, 4 pasien donor lobus kiri, 2 pasien donor lobus kiri total, dan 4 pasien donor lobus kanan total. Komplikasi pascaoperasi dilaporkan pada 18 donor (33%). Terdapat 3 (5,6%) pasien dengan klasifikasi Clavien-Dindo derajat IIIa atau lebih berat dengan skor CCI keseluruhan yaitu 10,45 (8,7-55,8). Terdapat 1 dari 53 donor (1,8%) dengan komplikasi bilier derajat III yang membutuhkan ERCP dan ditata laksana dengan stenting bilier dan sfingterektomi. Reoperasi terkati hepatektomi donor dilakukan pada 1 donor akibat infeksi daerah operasi dalam. Tidak ada insidensi gagal hati pascahepatektomi dan mortalitas perioperatif sejak awal prosedur transplantasi hati dilakukan.Kesimpulan: Morbiditas pasca-LDLT berhubungan dengan pengalaman pelaksana. Sistem klasifikasi Clavien-Dindo yang dikombinasikan dengan CCI bermanfaat dalam memperkirakan hasil prosedur.

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Introduction: The crucial prerequisite for living donor liver transplantation (LDLT) is minimal morbidity and mortality risk to the healthy living donor. The purposes of this study were to analyze all post donor complications according to severity using Clavien-Dindo Classification (CDC) integrated with Comprehensive Complication Index (CCI) and to identify factors related to post-operative complications.

Methods: The cross-sectional design was used. A total of 53 patients, with complete medical records, who underwent LDLT in Cipto Mangunkusumo Hospital Jakarta (RSCM) between Desember 2010 and January 2019 were retrospectively analyzed. Ethical approval No 93/UN2.F1/ETIK/2019.

Results: Of 53 patients underwent LDLT at RSCM, 7 patients underwent adult-to-adult liver transplant and 46 patients underwent adult-to-child liver transplant. Of these, 43 were donors of the left-lateral lobe, 4 were of the left lobe, 2 were full-left lobes, and 4 were of the full-right lobe. Postoperative complications were reported in 18 (33%) donors. There were 3 (5.6%) patients in CDC grade IIIa or greater and the overall CCI was 10.45 (8.7-55.8). Only 1 out of the 53 donors (1.8%) had a grade III biliary complication requiring ERCP and managed with biliary stenting and sphincterotomy. Re-operation related to donor hepatectomy was done in 1 donor due to deep incisional surgical site infection. No incidence of post hepatectomy liver failure and perioperative mortality were recorded since inception of the liver transplantation program.

Conclusions: Morbidity after LDLT strongly correlates to center experience. The CDC grading system integrates with CCI is useful to comprise surgical outcomes."

"ABSTRAKLatar belakang: Tuberkulosis TB adalah penyakit yang masih merupakan masalah global dan dapat melibatkan seluruh organ, termasuk organ-organ gastrointestinal. Insidensi dan angka kesakitan dari TB abdomen terus meningkat pada dekade terakhir, namun penegakkan diagnosa TB abdominal seringkali menemui kendala.Metode: Penelitian ini merupakan suatu penelitian deskriptif potong lintang dengan menggunakkan rekam medis penderita dengan diagnosa TB abdomen yang dirawat inap di Rumah Sakit Umum Pusat Nasional RSUPN Cipto Mangunkusumo, Rumah Sakit Umum Pusat RSUP Fatmawati periode Januari 2011 hingga Desember 2013.Hasil: Ada 48 pasien, dengan kisaran umur 1-85 tahun, dengan pasien perempuan lebih banyak rasio laki-laki banding perempuan= 1:1,4 . Mayoritas pasien berkisar antar usia 25-44 tahun 47,9 , dengan keluhan utama tersering adalah nyeri abdomen. Hanya 15 penderita 31,25 yang memiliki gambaran rontgen TB paru. Sedangkan hasil pemeriksaan laboratorium menunjukkan hasil yang cukup beragam. Kesimpulan: Mendiagnosis TB abdominal masih sering terkendala karena tidak adanya keluhan dan gejala yang khas serta tidak ada pemeriksaan penunjang yang memiliki nilai diagnostik yang tinggi. Sehingga, kombinasi dari anamnesis, pemeriksaan fisis, serta pemeriksaan penunjang diperlukan untuk dapat menegakkan diagnosa TB abdomen.Kata kunci: TB abdomen, gambaran klinis

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ABSTRACTIntroduction Abdominal Tuberculosis TB is a global burden and can infect many organs, including gastrointestinal organs. There has been an increase in the incidence and morbidity rate of abdominal TB. However, there are still some hurdles in diagnosis abdominal TB.Methods This study is a descriptive cross sectional study using medical records of patients diagnosed with abdominal TB that are hospitalized in RSUPN Cipto Mangunkusumo and RSUP Fatmawati from January 2011 to December 2013.Results There was a total of 48 patients included in this study whose age ranges from 1 85 years old, and predominantly were female male to female ratio 1 1,4 . Majority of the patients were in 25 44 years old 47,9 with the most common chief complaint was abdominal pain. Only 15 patients 31,25 had radiographical findings suggestive of pulmonary TB. Laboratory tests results were varied.Conclusion Diagnosing abdominal TB is often difficult due to the wide array of signs and symptoms, and also the unavailability of auxillary examinations with high diagnostic value. Therefore, a combination of anamnesis, physical examination, and supporting examinations are needed to diagnose abdominal TB.Keywords Abdominal TB, clinical presentation"

"Latar belakang. Adenokarsinoma kolorektal AKR merupakan keganasan gastrointestinal yang sering ditemukan dan mempengaruhi lebih dari satu juta individu di seluruh dunia. Identifikasi histologis invasi limfovaskular telah dikenali sebagai indikasi potensial untuk metastasis KGB dan indikasi prognostik dan prediktor dari luaran pasien.Metode.Penelitian ini adalah penelitian retrospektif dengan regresi logistik multivariat.Hasil. Hasil penelitian didapatkan faktor usia, diferensisasi tumor, pT, dan jenis kelamin tidak mempengaruhi kejadian invasi limfovaskular. AKR diferensiasi sedang dan jenis kelamin laki-laki didapatkan kejadian invasi limfovaskular yang lebih besar dibanding diferensiasi lain dan jenis kelamin perempuan.Kesimpulan. Faktor-faktor yang mepengaruhi invasi limfovaskular yaitu diferensiasi tumor, usia, jenis kelamin, lokasi tumor dan derajat patologis T tidak bermakna secara statistik. Invasi limfovaskular merupakan prediktor terjadinya metastasis KGB.

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Background. Adenocarcinoma colon and rectum are the most common gastrointestinal malignancy and afflict more than one million individual worlds wide. Histologic finding of limphovascular invasion has known as potensial indication for lymphatic metastatic and prognostic indication and predictor of patient outcome.Methods. This studi was retrospective, logistic regression test was used for multivariate analysis.Result. Result of this study ara gender, age, tumor differentiation and pT not significantly related to lymphovascular invasion. Mild differentiation and male gender recorded had bigger risk to had lymphovascular invasion descriptively.Conclusion. Factors affecting lymphovascular invasion ie tumor differentiation, age, sex, tumor location and pathologic T degree were not statistically significant. Lymphovascular invasion is a predictor of limph nodes metastasis."