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Abstrak :
PURPOSE: To clarify the risk factors for complications after diverting ileostomy closure in patients who have undergone rectal cancer surgery.

METHODS: The study group comprised 240 patients who underwent a diverting ileostomy at the time of lower anterior resection or internal anal sphincter resection, in our department, between 2004 and 2015. Univariate and multivariate analyses of 18 variables were performed to establish which of these are risk factors for postoperative complications.

RESULTS: The most common complications were intestinal obstruction and wound infection. Univariate analysis showed that an age of 72 years or older (p = 0.0028), an interval between surgery and closure of 6 months or longer (p = 0.0049), and an operation time of 145 min or longer (p = 0.0293) were significant risk factors for postoperative complications. Multivariate analysis showed that age (odds ratio, 3.4236; p = 0.0025), the interval between surgery and closure (odds ratio, 3.4780; p = 0.0039), and operation time (odds 2.5179; p = 0.0260) were independent risk factors.

CONCLUSIONS: Age, interval between surgery and closure, and operation time were independent risk factors for postoperative complications after diverting ileostomy closure. Thus, temporary ileostomy closure should be performed within 6 months after surgery for rectal cancer.

Abstrak :
Latar belakang : Sekuel Tuberkulosis (TB) adalah deformitas permanen sebagai gejala sisa pada pasien yang telah menjalani pengobatan TB lengkap atau sudah dinayatakan sembuh. Pembedahan merupakan tata laksana efektif sekuel TB, meski tidak terbebas dari komplikasi. Penelitian ini ditujukan melakukan evaluasi peran pemberian OAT terhadap komplikasi pascabedah, dan menilai pengaruh riwayat Diabetes mellitus (DM), merokok dan status gizi kurang terhadap kejadian komplikasi pascabedah kasus sekuel TB. Metode : Dilakukan suatu studi kohort retrospektif pada pasien pasien yang menjalani operasi sekuel TB di Rumah Sakit Umum Pusat Persahabatan dalam periode 1 Januari 2016 hingga 31 Desember 2019. Faktor pemberian OAT, riwayat DM, kebiasaan merokok dan status gizi kurang serta pengaruhnya pada komplikasi pascabedah merupakan variabel penelitian. Dilakukan uji statistik dengan kemaknaan p<0,05. Hasil : Sebanyak 58 subjek dilibatkan sebagai sampel penelitian. Komplikasi pascabedah terjadi pada 36 (62,1%) subjek. OAT diberikan pada 26 (44,8%) subjek. Pemberian OAT menurunkan odds kejadian komplikasi yang bermakna secara statistik rasio odds 0,06 (0,01-0,24); p < 0,001 Simpulan : Pemberian OAT pascabedah menurunkan kejadian komplikasi pascabedah secara bermakna. Komplikasi pascabedah lebih banyak terjadi pada pasien yang tidak menerima OAT pascabedah ......Introduction: Tuberculosis (TB) sequelae are permanent deformities identified as residual signs after completion of TB treatment or cured TB cases. Surgery has been demonstrated to be an effective treatment of TB sequelae albeit with possible post-surgical complications. This study aimed to assess the role of antituberculosis chemotherapy in postoperative complications and to evaluate the impact of diabetes mellitus (DM), smoking and nutritional status on the incidence of postoperative complications. Method: A retrospective cohort trial was conducted on patients who underwent surgery of TB sequelae at the Rumah Sakit Umum Pusat Persahabatan from January 1, 2016 to December 31, 2019. Administration of antituberculosis chemotherapy, diabetes mellitus (DM), smoking habits, nutritional status and their effects on postoperative complications were evaluated. Statistical analysis concluded to be significant if p<0.05. Results: A total of 58 subjects were included in the study. Postoperative complications were observed in 36 (62.1%) subjects. Antituberculosis chemotherapy was administered to 26 (44.8%) subjects. Post-surgical administration of antituberculosis drug reduced the likelihood of complications [OR 0.06, 95% CI 0.01-0.24, p <0.001). Conclusion: Antituberculosis chemotherapy significantly reduced the occurence of postoperative complications. Patient who encountered postoperative complication tend not to receive antituberculous chemotherapy