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Abstrak :
Tujuan. Penelitian ini bertujuan untuk mengetahui nila diagnostic kadar CEA serum sebagai indikator terjadinya metastasis hepar dari kanker kolorektal (KKR) pada usia dewasa muda Metode. Studi potong lintang dilakukan dengan menggunakan data sekunder berupa catatan pasien dalam rekam medis. Pasien berusia <50 tahun yang terdiagnosis kanker kolorektal primer secara histopatologis di Cipto Mangunkusumo Hospital direkrut dalam penelitian ini. Kami mengeksklusi pasien dengan riwayat keganasan lain, telah menjalani tatalaksana operatif untuk kanker kolorektal, dan memiliki komorbiditas penyakit hati. Luaran akhir dari penelitian ini adalah cut off nilai CEA yang didapat dengan kurva ROC, sensitivitas, dan spesifisitas nilai CEA dalam memprediksi metastasis hepar KKR. Hasil. Kami merekrut 181 pasien dengan proporsi 43.6% perempuan. 59 pasien (32.6%) diketahui memiliki metastasis hepar pada saat intraoperatif. Kadar CEA pasien metastasis ditemukan sebesar 208.1 (2.1–12503.2) ng/mL, angka ini jauh lebih tinggi dibandingkan pasien non-metastasis 6.27 (0.8–1099.4) ng/mL (p<0.001). Nilai AUC tercatat sebesar 0,904, dan cut off optimal didapat pada kadar CEA ≥38,765 ng/mL (Indeks Youden = 1,718). Peneliti mencatat sensitivitas dan spesifisitas niali CEA serum ≥38,765 ng/mL, secara berturut-turut, sebesar 91,53% (IK 95%, 81,32%–97,19%) dan 80,3% (72,16%–86,97%). Rasio odds pasien kanker kolorektal usia muda untuk mengalami metastasis hepar adalah sebesar 44,10 (IK 95%, 15,92–122,20) bila nilai CEA serum pasien sebesar ≥38,765 ng/mL. Simpulan. Kadar CEA ≥38,765 ng/mL memiliki sensitivitas dan spesifisitas yang baik, sehingga cukup efektif untuk digunakan sebagai prediktor metastasis hepar pada penderita KKR. ...... Introduction. This study aims to determine the diagnostic value of serum CEA levels as the liver metastases predictor of colorectal cancer (CRC) in young adults.. Method. A cross-sectional study was conducted using secondary data (patient medical records) from 2015–2021. Patients aged <50 years who were diagnosed histopathologically with primary colorectal cancer at Cipto Mangunkusumo General Hospital were recruited in this study. We excluded patients with a history of other malignancies, who had undergone operative management for colorectal cancer, and preexisting liver disease. The outcome of this study is the cut-off of the CEA value obtained by the ROC curve, the sensitivity and specificity of the CEA value in predicting CR liver metastases. Results. We recruited 181 patients with a proportion of 43.6% women. Fifty-nine patients (32.6%) had liver metastases. The CEA level of metastatic patients was 208.1 (2.1–12503.2) ng/mL; this was much higher than the non-metastatic group, which was recorded at 6.27 (0.8–1099.4) ng/mL (p<0.001). The AUC value was recorded at 0.904, and the optimal cut-off was obtained at CEA levels 38.765 ng/mL (Youden's Index = 1.718). We noted the sensitivity and specificity of serum CEA values 38.765 ng/mL, respectively, of 91.53% (91.5 CI, 81.32%–97.19%) and 80.3% (72.16%– 86.97%). The odds ratio of young colorectal cancer patients to have liver metastases was 44.10 (95% CI, 15.92–122.20) if the patient's serum CEA value was 38.765 ng/mL. Conclusion. CEA level ≥38,765 ng/mL has good sensitivity and specificity in predicting liver metastases among young adults with CRC.

Abstrak :
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%).