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Abstrak :
Latar Belakang: Infeksi daerah operasi (IDO) meliputi 20% dari kejadian hospital acquired infection pada pembedahan yang dilatari berbagai macam faktor, termasuk faktor internal (usia, jenis kelamin, penyakit bawaan) maupun faktor eksternal (pola makan, merokok, pengobatan yang dijalani). Selain itu, pembedahan sendiri juga membawa faktor-faktor risiko yang bisa menyebabkan IDO, seperti jenis pembedahan, lama pembedahan, dan sebagainya. Diperlukan sebuah analisis yang dilihat dari faktor-faktor tersebut dan bagaimana hubungannya terhadap kejadian IDO. Metode: Penelitian ini menggunakan desain kohort retrospektif dengan data rekam medis pasien Divisi Bedah Digestif, Departemen Bedah RSCM tahun 2012 hingga 2016. Kriteria inklusi, yakni semua pasien RSCM yang ditangani staf divisi Bedah Digestif FKUI RSCM selama periode 2012-2016 dengan rekam medik yang tercatat baik, lengkap, dan datanya tersedia dengan ekslusi, jika data rekam medis yang dibutuhkan tidak lengkap. Sampel diambil dengan cara random sampling meliputi semua pasien yang memenuhi kriteria inklusi dan tidak mengenai kriteria eksklusi, didapatkan sampel minimal 58 per kelompok. Data diambil dan dimasukkan ke dalam tabel Microsoft Excel dan kemudian dianalisis secara univariat, bivariat, dan multivariat. Hasil: Pada uji bivariat dan multivariat, didapatkan bahwa “Derajat Kontaminasi” adalah faktor yang berpengaruh secara signifikan terhadap kejadian IDO. Kesimpulan: Terdapat hubungan yang kuat antara faktor risiko intrabedah dengan IDO di RSCM. Derajat kontaminasi adalah faktor risiko yang signifikan terhadap IDO. Penelitian selanjutnya sebaiknya memakai metode kohort prospektif, dengan sampel pasien yang diikuti sejak admisi, tidak ada masalah nutrisi untuk pasien lanjut usia, dengan lama rawat pra-bedah di bawah 7 hari, dan ada perluasan jangkauan faktor risiko yang dianalisa. ......Background: Surgical site infection (SSI) after gastrointestinal surgery can affect mortality and morbidity of the patients. Risk factors are needed to prevent and decrease number of SSI. This study investigated the pre-operative and intra-operative risk factors of gastrointestinal surgeries and incidence of SSI. Methods: A retrospective audit analysis of age, nutritional status, pre-operative length of stay, length of surgery, type of surgery, degree of contamination in adult gastrointestinal surgery patients at Cipto Mangunkusumo General Hospital was conducted from the medical records from 2012 to 2016. Outcomes consisted of incidence and potential univariate risk factors were determined to investigate the independent associated factors using multivariate logistic regression. Results: The incidence of SSI in four years is 3.4% among 4,357 gastrointestinal surgeries with 86.4% of surgical site infection appears in contaminated wound operations. Our study included 116 subjects. From univariate analysis between SSI as dependent factors and the the risks factors, age (p=0,2), pre operative length of stay (p=0,06), length of surgery (p=0,1), and degree of contamination (p=0,003) have correlative association with SSI. The risk factor with surgical site infection is surgical wound contamination (OR=1.233, p=0.011) and independent from other risk factors. Conclusions: From pre operative and intra operative risk factors there are four factors which have correlation with SSI, there are age, pre operative length of stay, length of surgery, and degree of contamination. Degree of contamination is the significant risk factors for SSI.

Abstrak :
The gastrointestinal track provides one of the distinct systems where multiple malignancies, including adenocarcinoma of the pancreas, esophagus and colon are each associated with obesity. The focus on possible dietary contribution as well as the role of exercise in prevention and therapy is presented in both animal model and patient based studies. Special focus is provided also on the role of genetic mutations and inflammatory pathways as drivers of these obesity related gastrointestinal malignancies.

Abstrak :
Although there has been a slow but steady decrease in incidence, gastric cancer remains the second leading cause of cancer death worldwide. Several aspects of the oncological and surgical management are still controversial and so gastric cancer represents a challenge for the surgeon. This book aims to delineate the state of the art in the surgical and oncological treatment of gastric cancer, describing the new TNM staging system, the extent of visceral resection and lymphadenectomy focusing on the different open and minimally invasive surgical techniques and discussing intraoperative chemohyperthermia and neoadjuvant and adjuvant treatment. Operative endoscopy and endoscopic ultrasonography are also discussed, as these now have an important role in both diagnostic work-up and palliative care of gastric cancer patients. Only a multidisciplinary approach involving the surgeon, gastroenterologist, and oncologist can produce the comprehensive and integrated overview that today constitutes a winning strategy for the optimization of results.What we hope we have achieved is a flexible, up-to-date, exhaustive publication, rich in illustrations and consistent with evidence-based medicine.

Abstrak :
This recent results in cancer research volume contains the majority of the invited expert contributions from the First St. Gallen EORTC Gastrointestinal Cancer Conference, held on 22-24 March 2012 in St. Gallen, Switzerland. Written by some of the world?s leading experts in the field, the volume constitutes a comprehensive update on recent developments in the imaging, molecular biology, pathology, and multidisciplinary management of early cancer of the gastrointestinal tract. The latest recommendations regarding diagnosis and treatment are provided, and areas of consensus and controversy, identified. While the principal focus is on esophageal and gastric cancer, advances in the treatment of colorectal and pancreatic cancer are also discussed in some detail.