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Ditemukan 8 dokumen yang sesuai dengan query
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Rynaldy
Obstruksi Akut pada Keganasan Kolo-Rektal
Fakultas Kedokteran Universitas Indonesia, 1994
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UI - Tesis Membership  Universitas Indonesia Library
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Sihotang, Ely Sakti Panangian
Uji Prognostik Nilai Carcinoembrionic Antigen Terhadap Insiden Metastasis Hepar Pada Kasus Kanker Kolorektal Usia Dewasa Muda Di RSUPN Dr Cipto Mangunkusumo Jakarta = Prognostic value of Serum Carcinoembryonic Antigen Level in Predicting Liver Metastases of Colorectal Cancer Among Young Adult Patient in Cipto Mangunkusumo Hospital Jakarta
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.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2021
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UI - Tesis Membership  Universitas Indonesia Library
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Simanjuntak, Bonauli
Hubungan antara microsatellite instability (MSI) terhadap kesintasan tiga tahun pada pasien kanker kolorektal = Correlation between microsatellite instability (MSI) and five years survival rate in colorectal cancer
Abstrak :
ABSTRAK
Latar Belakang: Prognosis dan tatalaksana kanker kolorektal sangat dipengaruhi olehstadiumnya. Pada tahun 2012, the European Society for Medical Oncology mempublikasikan pedoman yang menyarankan evaluasi terhadap microsatellite instability MSI untuk menentukan perjalanan penyakit kanker kolorektal. Penelitian ini bertujuan untuk menginvestigasi faktor prognostik MSI-H pada kadar kesintasan 3 tahun. Metode: Penelitian ini menggunakan data sekunder dari penelitian sebelumnya oleh Setyaningsih, dkk. yang berjudul ldquo;Penelitian Microsattelite Instability Melalui Ekspresi PMS2 dan MSH6 serta Tumor-Infiltrating Lymphocyte pada Kanker Kolorektal Kiri dan Kanan rdquo;. Kami memasukkan total 90 pasien yang didiagnosis sebagai kanker kolorektal yang menjalani bedah reseksi dari tahun 2008 hingga 2013 di RSUPN Cipto Mangunkusumo. Kami menganalisa status MSI sebagai faktor prognosis untuk menentukan kadar kesintasan 3 tahun yang disesuaikan dengan ukuran dan tipe tumor, metastasis, dan umur pasien. Hasil: Dari 90 pasien, 47 orang dapat dilakukan follow up. Mayoritas pasien didiagnosis dengan kanker kolorektal stadium III n=29; 61,7 , 8 pasien didiagnosis sebagai stadium IV, 9 pasien didiagnsosis sebagai stadium II, dan 1 pasien didiagnosis dengan stadidum I. Kesintasan tiga tahun untuk pasien MSI-H adalah 33,3 , 22,2 , dan 20 untuk stadium II, III, dan IV; dibandingkan dengan kesintasan tiga tahun untuk pasien MSI-L yaitu 0 , 5 , dan 0 p = 0,003 . Selain itu, berdasarkan analisis multivariate, kami menemukan bahwa MSI-L memiliki hazard ratio 2,421 1,991-2,851 dibandingkan dengan MSI-H p = 0,004 . Kesimpulan: MSI-H adalah faktor prognosis yang penting untuk menentukan kesintasan tiga tahun pada pasien kanker kolorektal. Kami menemukan bahwa pasien dengan MSI-H memiliki prognosis yang lebih baik dibandingkan dengan pasien MSI-L. Temuan ini sejalan dengan pedoman dan penelitian sebelumnya yang menyarankan penggunaan MSI untuk menentukan perjalanan penyakit dan pilihan terapi pada pasien kanker kolorektal.
ABSTRACT Background The prognosis and treatment of colorectal cancer is based on its stadium. Due to its features, the prognosis stage II colorectal cancer is still considered inexact with the survival rates ranging from 87,5 in stage IIA to 58.4 in stage IIC.The European Society for Medical Oncology published a guideline in 2012 which suggests that microsatellite instability MSI should be evaluated to determine the course of the colorectal cancer. This study is aimed to investigate prognostic factor of MSI ndash H for 3 years survival rates. Method This study used secondary data from a previous study performed by Setyaningsih, et al. titled ldquo Penelitian Microsattelite Instability Melalui Ekspresi PMS2 dan MSH6 serta Tumor Infiltrating Lymphocyte pada Kanker Kolorektal Kiri dan Kanan rdquo . We included a total of 90 patients diagnosed with colorectal cancer who underwent resection surgery from 2008 to 2013 in RSUPN Cipto Mangunkusumo. We analyzed the MSI status as a prognosticfactor to determine 3 years survival rate, adjusted with the size and types of the tumor, metastasis, and age. Results Among 90 patients, 47 have been followed up. The median age was 47 years. The majority of the patients was diagnosed with stage III colorectal cancer n 29 61.7 , 8 patients were diagnosed with stage IV, 9 patients were diagnosed with stage II colorectal cancer, and 1 patient was diagnosed with stage I colorectal cancer. Three years survival rates for patients with MSI H are 33.3 , 22.2 , and 20 for stage II, III, and IV respectively, compared to 5 years survical rates for MSI L patients which are 0 , 5 , and 0 p 0.003 . Futhermore, with multivariate analysis, we found that MSI L has 2.421 1.991 2.851 hazard ratio compared to MSI H p 0.004 . Conclusions MSI H is an important prognostic factor to determine 3 years survival rate in colorectal cancer patients.We found that patient with MSI H have more favourable prognosis compared to MSI L patients This findings complements previous guidelines and studies which suggested the use of MSI to determine the disease course and treatment options in colorectal cancer.
2017
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UI - Tugas Akhir  Universitas Indonesia Library
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Harris Putra Reza
Pengaruh Komponen Anestesi pada Protokol ERAS RSCM terhadap Mobilisasi Dini Pasien yang Menjalani Operasi Kolorektal = Effect of Anesthesia Component of RSCM ERAS Protokol on Early Mobilization in Colorectal Surgery Patients
Abstrak :
Latar Belakang: Mobilisasi dini merupakan faktor penting dalam meningkatkan luaran pascaoperasi kolorektal. Terdapat empat komponen dalam protokol ERAS untuk operasi kolorektal di Rumah Sakit Cipto Mangunkusumo (RSCM) yang dipegang penuh Anestesi yang diharapkan menunjang keberhasilan mobilisasi dini, yaitu pemberian profilaks Post Operative Nausea and Vomiting (PONV), multimodal analgesia intraoperasi, manajemen cairan intraoperasi dan manajemen nyeri pascaoperasi tanpa opioid. Meskipun keberhasilan mobilisasi dini dipengaruhi oleh nyeri, mual muntah, dan manajemen cairan intraoperasi, namun hingga saat ini belum jelas seberapa besar bobot setiap komponen anestesi ini terhadap keberhasilan mobilisasi dini. Metode: Penelitian ini merupakan penelitian kohort retrospekstif dengan pengambilan data sekunder pasien yang menjalani operasi kolorektal elektif di RSCM dari Januari 2020 hingga Desember 2022. Luaran yang dinilai adalah angka mobilisasi dini pascaoperasi dan faktor-faktor yang memengaruhinya (profilaksis PONV, multimodal analgesia, manajemen cairan, dan manajemen nyeri pascaoperasi tanpa opioid). Hasil: Total pasien yang terjadwal menjalani operasi kolorektal elektif di RSCM antara tahun 2020 hingga 2022 adalah 595 pasien dengan pasien yang memenuhi kriteria inklusi dan eksklusi sebanyak 343 pasien. Keberhasilan mobilisasi dini sebesar 39.7%. Manajemen cairan intraoperasi [RR 12.353, (95% CI 3.131-46.745), p < 0,001] dan manajemen nyeri pascaoperasi tanpa opioid [RR 3.647, (95% CI 1.444-108.764), p 0.029] merupakan faktor independen dalam keberhasilan mobilisasi dini. Simpulan: Faktor-faktor yang memengaruhi mobilisasi dini pascaoperasi kolorektal adalah manajemen cairan intraoperasi dan manajemen nyeri pascaoperasi tanpa opioid. Pemberian profilaksis PONV dan multimodal analgesia intraoperasi tidak memiliki hubungan yang signifikan terhadap mobilisasi dini. ......Background: Early mobilization is an important factor in increasing colorectal postoperative outcome. There are four components held by anesthesiologist in ERAS protokol for colorectal surgery in Cipto Mangunkusumo Hospital (RSCM) those are PONV prophylaxis, intraoperative fluid management, intraoperative analgesia multimodal, and opioid free postoperative pain management. Although early mobilization affected by postoperative pain, vomiting and nausea, and fluid balance therapy, nonetheless there is no clear evidence of how much each of these components will affect early mobilization. Methods: This study is a retrospective cohort study by collecting secondary data from patients underwent elective colorectal surgery at RSCM from January 2020 to December 2022. The outcomes assessed were early mobilization rate and factors affecting it (PONV prophylaxis, intraoperative fluid management, intraoperative analgesia multimodal, and opioid free postoperative pain management). Results: The total number of patients underwent elective colorectal surgery at RSCM during 2020 to 2022 was 595 patients and 343 patients fulfilled inclusion and exclusion criteria of this study. Early mobilization rate is 39.7%. Intraoperative fluid management [RR 12.353, (95% CI 3.131-46.745), p < 0,001] and opioid free postoperative pain management [RR 3.647, (95% CI 1.444-108.764), p 0.029] are independent factors affecting early mobilization. Conclusion: Factors affecting colorectal postoperative early mobilization are intraoperative fluid management and opioid free postoperative pain management. PONV prophylaxis and intraoperative analgesia multimodal do not have significant effect on early mobilization
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Tugas Akhir  Universitas Indonesia Library
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Manual of fast track recovery for colorectal surgery
Abstrak :
Manual of fast track recovery for colorectal surgery provides a broad overview on enhanced recovery, with expert opinions from leaders in the field regarding elements of enhanced recovery care that are generic and specific to colorectal surgery. This book covers the patient journey through such a programme, commencing with optimisation of the patient’s condition, patient education and conditioning of their expectations. Manual of fast track recovery for colorectal surgery investigates the metabolic response to surgery, anaesthetic contributions and optimal fluid management, after surgery. It also details examples of enhanced recovery pathways and practical tips on post-operative pain control, feeding, mobilisation and criteria for discharge.
London : Springer, 2012
e20426202
eBooks  Universitas Indonesia Library
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Il fuoco dentro : le malattie infiammatorie croniche dell'intestino : colloquio con Silvio Danese e Marco Greco / Daniela Minerva
Abstrak :
Colpiscono circa 170 mila italiani, con un trend in forte ascesa. Si chiamano Malattia di Crohn e colite ulcerosa: malattie autoimmuni, ovvero causate da un errore del sistema immunitario che si scatena contro se stesso. Perché? Come fermare questa furia distruttiva? Sono stati fatti grandi passi avanti ma molto resta ancora da scoprire e molte sono le questioni controverse: dalle cause della malattia ai metodi di diagnosi più tempestiva, alle terapie. Le malattie autoimmuni dell'intestino colpiscono in giovane età, tra i 15 e i 45 anni, hanno un impatto molto negativo sulla qualità della vita di chi si ammala e pongono questioni di primissimo piano: come si convive con una diagnosi di questo tipo, qual è il migliore accesso alle cure, quali le disposizioni di legge che facilitano la vita dei malati. Questo libro vuole raccontare la vita e la battaglia quotidiana delle persone colpite da queste malattie, le scelte che devono fare e gli ostacoli che si trovano ad affrontare, dal punto di vista di uno dei massimi esperti mondiali della materia, Silvio Danese, e da quello di un giovane paziente, Marco Greco, che ha trasformato la sua lotta quotidiana in una battaglia condotta a nome di tutti i malati. Gettando luce su uno dei più straordinari misteri della medicina moderna, le malattie autoimmuni, questo volume affronta senza omissioni il grande tema sanitario dell’Italia di oggi, la cronicità, la condizione sociale e medica di milioni di persone costrette a convivere con la malattia per decenni.
Milan: Springer, 2011
e20426722
eBooks  Universitas Indonesia Library
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Contemporary coloproctology
Abstrak :
Contemporary coloproctology covers colorectal surgery, as practiced today, in an easily accessible format with emphasis on bringing key facts rapidly into focus. It is ideal reading both for the medical trainee and the practicing colorectal surgeon. As well as a succinct presentation of the current colorectal knowledge base, each chapter contains practical advice and pearls of wisdom from established practicing clinicians. A unique feature of the format is the identification of key references and questions and scenarios that present real life decisions in colorectal surgery.
London : Springer, 2012
e20425882
eBooks  Universitas Indonesia Library
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Intersphincteric resection for low rectal tumors
Abstrak :
The work describes a new method of sphincter salvage in surgery of rectal cancer. Low tumors of the rectum are traditionally treated with amputation of the rectum. However, this operation is not well-received by patients, since it results in a permanent colostomy. By contrast, intersphincteric resection allows sphincter salvage even in low tumors and is now widely accepted among experts in the field of colorectal surgery. The book will describe the basics (pathology,physiology, radiology) as well as the surgical technique and its different modifications.
Wien: Springer, 2012
e20426486
eBooks  Universitas Indonesia Library