Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
ABSTRAK
Latar Belakang: Kebocoran anastomosis adalah komplikasi yang dapat terjadi pasca dilakukannya reduksi manual, reseksi dan anastomosis end-to-end pada kasus intususepsi. Faktor-faktor yang mempengaruhi kebocoran anastomosis antara lain teknik operator, kondisi lokal usus, kondisi umum pasien dan grading kolagen yang terbentuk pada proses penyembuhan luka. Tujuan: Mengetahui pengaruh perubahan grading kolagen usus pasca reseksi anastomosis terhadap kebocoran pada kasus intususepsi. Metode: Dua puluh satu tikus Sprague-dawley dilakukan laparatomi untuk dibuat model intususepsi (IN). Setelah 45 menit dilakukan destrangulasi selama 10 menit, dinilai adanya nekrosis dan dilanjutkan reseksi anastomosis. Tikus dibagi menjadi 3 kelompok, kelompok A : reseksi anastomosis pada batas usus yang nekrosis, kelompok B : reseksi anastomosis pada batas usus yang mengalami trombosis pembuluh darah mesenteriumnya, dan kelompok C : reseksi anastomosis pada batas usus yang sehat. Sampel usus yang direseksi diperiksa secara Histopatologi untuk menilai grading kolagen. Setelah 5 hari dilakukan laparatomi ulang, dinilai secara subjektif ada tidaknya kebocoran anastomosis, lalu diambil sampel segmen anastomosis usus untuk dinilai kembali grading kolagennya. Diharapkan jika terjadi kenaikan grading kolagen, anastomosis akan paten, sebaliknya jika terjadi penurunan akan terjadi perforasi. Hasil: Kelompok A: grading kolagen menurun dengan perforasi 6 (85,7%), grading kolagen tetap tanpa perforasi 1 (14,2%). Kelompok B: grading kolagen menurun dengan perforasi 2 (28,6%), tetap dengan perforasi 1 (14,3%), meningkat tanpa perforasi 4 (42,9%). Kelompok C: grading kolagen meningkat tanpa perforasi 5 (71,4%), menetap tanpa perforasi 2 (28,6%). Kesimpulan: Terdapat perubahan grading kolagen pasca reseksi anastomosis usus yang mempengaruhi tingkat kebocoran anastomosis pada kasus intususepsi

---

ABSTRACT
Background: Anastomosis leakage is a common complication following manual reduction, resection and end-to-end anastomosis in treating intussusceptions. Factors influencing the anastomosis leakage such as surgeon?s technique, local bowel condition, systemic condition of patients and the concentration of collagen in the bowel tissue during the anastomosis healing. Aim: To study the effect of collagen concentration changes after resection and anastomosis procedure, in relation to the anastomosis leakages in intussusceptions case. Methods: 21 Sprague-dawley rats were performed laparotomy to create the intussusception model (IN). The IN models were applied for 45 minute, after the bowel considered necrotic, destrangulation were performed for 10 minutes continued with resection and anastomosis on 3 group of resection margin: A on necrotic margin of bowel, B: on the thrombotic mesenterium vessel margin, C: on normal bowel margin. Resected bowels were sent for histopathology examination of collagen concentrations. After 5 days, another laparotomy was performed and the anastomosis leakages were subjectively assessed. The anastomosed segments were sampled for collagen concentration and grade. Results: In study group A the collagen grading were found to be decreased with 6 leakages occurred (85.7%) and 1 subject (14.2%) with stable collagen grading and no leakages. From group B, subjects with decreased collagen and leakages were 2 (28.6%), and 1 subjects (14.3%) were stable in grading with leakages, and 4 subjects (42.9%) with increased collagen without leakages. In Group C, 5 rats (71.4%) had increased collagens without leakages, and 2 rats were at stable collagen grade without leakages. Conclusion: There were collagen grade changes in bowel anastomosis that affect the extent of leakages in intussusceptions case

Abstrak :
Komplikasi kebocoran anastomosis dan panjangnya reseksi usus non vital pada kasus intususepsi masih menjadi permasalahan.Tujuan: Mengetahui pengaruh NaCl 0.9 dan papaverin terhadap derajat kolagen serta kejadian komplikasi kebocoran anastomosis usus yang mengalami intususepsi pada model tikus putih.Metode: Dilakukan laparotomi pada 21 tikus Sprague-dawley untuk membuat model intususepsi. Setelah 45 menit, dilakukan relaparotomi dan reduksi manual intususepsi. Tikus dibagi 3 kelompok secara random: kelompok A tanpa perlakuan, kelompok B aplikasi NaCl 0,9 hangat, kelompok C aplikasi papaverin di daerah usus yang mengalami strangulasi. Kemudian dilakukan reseksi dan anastomosis pada zona usus yang votalitasnya meragukan. Setelah hari ke-5 dilakukan laparatomi ulang, dinilai secara subjektif ada tidaknya kebocoran anastomosis, dan diambil sampel untuk dinilai grade kolagennya secara mikroskopik dengan parameter Philips.Hasil: Kadar kolagen tertinggi pada kelompok C dan tidak ada kebocoran anastomosis pada kelompok ini. Lima ekor tikus dengan kolagen terendah pada kelompok A dan B, seluruhnya mengalami perforasi. Tikus dengan kolagen grade 3 dan 4 tidak ada yang mengalami perforasi. Perlakuan aplikasi NaCl 0.9 dan papaverin tidak bermakna secara statistik terhadap kejadian perforasi namun bermakna terhadap kadar kolagen. ......Background In operative management of intussusception case, the most common complication is anastomosis leakage. Many factors influenced the anastomosis leakage and we concern the collagen factor which important in anastomosis wound healing process. We performed experimental study using topical 0.9 warm saline and papaverine at the released intussusceptum bowel.Aim To study the effect of topical saline and papaverin application in collagen grading and anastomosis leakage incident in rats intussusception model.Methods laparotomy was performed in 21 Sprague dawley rats to create the intussusception model. After the bowel considered ischemic, destrangulation with retrograde milking technique were performed. Rats were randomly divided in 3 groups A, control group B, saline group and C, papaverine group. We gave topical saline or papaverine at the mesenterium of the released intussusceptum bowel then resected and anastomosed the questionable vitality of bowel. After 5 days, the anastomosis leakage were subjectively assessed. The anastomose segment were sampled for measuring the collagen grading Phillips .Results Collagen grade of the group C was the highest among other groups and no anastomosis leakage in this group. There were 5 rats with collagen grade 1 and 2 in group A and B, and all 5 anastomosis site were perforated. There is no statistically relation between saline or papaverine application and the leakage events, but the application were significantly effect the collagen grading.Conclusion Findings suggest that saline and papaverine increase the collagen grading and the grading decrease the anastomosis leakage incidents.Key words intussusception, collagen, anastomosis leakage, normal saline, papaverine.