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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%).

Abstrak :
ABSTRAK
Latar belakangFistel enterokutan FEK adalah salah satu komplikasi paling ditakuti pada pembedahan abdomen, baik bagi ahli bedah maupun tim kesehatan lainnya. Komplikasi ini menyebabkan morbiditas yang signifikan, hingga kemungkinan kematian. Dengan kemajuan teknologi pada teknik perawatan operatif dan non operatif pun, komplikasi-komplikasi yang disebabkan oleh FEK masih sulit dihindari. Negative pressure wound therapy NPWT telah lama digunakan untuk merawat luka kronis, dengan tujuan mengurangi oedema jaringan, memperbaiki sirkulasi, membantu pembentukan jaringan granulasi sehat, dan menghambat lokalisasi kuman. Pada karya tulis ilmiah ini, dilaporkan seorang pasien laki-laki berusia 29 tahun dengan FEK dan komplikasi-komplikasinya yang berhasil dirawat menggunakan NPWT. Ini adalah kasus pertama perawatan FEK menggunakan NPWT di RSUPN dr. Cipto Mangunkusumo. MetodeSebuah laporan kasus berbasis bukti. SimpulanHasil penelitian ini menyimpulkan bahwa penggunakan NPWT aman dan efektif untuk merawat FEK, baik sebagai terapi definitif maupun terapi jembatan sebelum pembedahan definitif.

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ABSTRACT
IntroductionEnterocutaneous fistula ECF is one of the most challenging abdominal complications, for surgeons and other healthcare members, which involves significant morbidity and potentially mortality. Despite advancements in both operative and non operative therapy, fistula related complications are still unavoidable. Negative pressure wound therapy NPWT had been used years to treat chronic wound, to decrease tissue oedema, improve circulation, promote healthy granulation tissue, and inhibit bacterial growth. We report the first use of NPWT to successfully treat ECF patient in our hospital. Case PresentationA 29 year old male was admitted to Cipto Mangunkusumo Hospital with septic shock and generalized peritonitis due to bowel perforation. Following resuscitation and laparotomy, the patient developed laparotomy wound dehiscence and multiple high output fistulas. The pathologic examination revealed intestinal tuberculosis infection. During the course of treatment, the patient developed cellulitis, dermatitis, hipoproteinemia, and severe malnutrition. After unsatisfactory results using conservative dressings for one month, NPWT was applied. Improvements were observed immediately after three days. Spillage contaminations were controlled, and the number of active fistulas decreased. One month following the end of NPWT, keystone flap was performed to facilitate closure. No complications occurred.ConclusionThe results in suggest that NPWT is a safe and effective alternative to treat ECF, whether to achieve fistula closure or as a bridge to definitive surgery.

Abstrak :
ABSTRAK
Fistel enterokutan (FEK) mengakibatkan sepsis, malnutrisi, ketidakseimbangan cairan dan elektrolit. Tujuan penelitian ini supaya diketahuinya faktor risiko yang mempengaruhi penyembuhan FEK. Penelitian ini dirancang secara potong lhe purpose of this study be discovered the risk factors that affect ECF healing. The study was designed as a cross-sectional retrospective analytic, by recording medical records for the period January 2007 - December 2011 at Cipto Mangunkusumo Public Hospital. Obtained 69 cases, the appropriate inclusion criteria 57 cases, aged 17-76 years, the highest in the group 31-45 years, male 37 cases, 54 cases of post-operative, 3 cases of spontaneous. Factors that affect healing is albumin levels> 3.0 mg / dl 3.8 times, low output fistula 2.9 times, colon fistula site 2.9 times, Subjective Global Assessment A and B 1.6 times. Factors that affect healing is good nutrition, low output fistula, colon fistula site.intang retrospektif analitik, dengan mencatat rekam medis penderita pada periode Januari 2007 - Desember 2011 di RSUPN Cipto Mangunkusumo. Didapatkan 69 kasus, yang sesuai kriteria inklusi 57 kasus, usia 17–76 tahun, terbanyak pada kelompok 31–45 tahun, laki-laki 37 kasus, 54 kasus pasca operatif, 3 kasus spontan. Faktor yang memengaruhi penyembuhan adalah kadar albumin >3,0 mg/dl 3,8 kali, fistel low output 2,9 kali, lokasi fistel kolon 2,9 kali, Subjective Global Assessment A dan B 1,6 kali. Faktor yang memengaruhi penyembuhan adalah nutrisi baik, fistel low output, lokasi fistel kolon.

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ABSTRACT
Enterocutaneous fistula (ECF) resulting in sepsis, malnutrition, fluid and electrolyte imbalance. The purpose of this study be discovered the risk factors that affect ECF healing. The study was designed as a cross-sectional retrospective analytic, by recording medical records for the period January 2007 - December 2011 at Cipto Mangunkusumo Public Hospital. Obtained 69 cases, the appropriate inclusion criteria 57 cases, aged 17-76 years, the highest in the group 31-45 years, male 37 cases, 54 cases of post-operative, 3 cases of spontaneous. Factors that affect healing is albumin levels> 3.0 mg / dl 3.8 times, low output fistula 2.9 times, colon fistula site 2.9 times, Subjective Global Assessment A and B 1.6 times. Factors that affect healing is good nutrition, low output fistula, colon fistula site.