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ABSTRAK
Latar belakang Tindakan ablasi endovenous untuk varises tungkai di Indonesia mulai dikerjakan tahun 2010 EVLT dikerjakan di RSCM tahun 2013 dan MOCA dikerjakan di RSUP Fatmawati tahun 2014 Belum ada evaluasi terhadap rekanalisasi pasca tindakan MOCA dan EVLT di Indonesia Metode Studi ini merupakan penelitian deskriptif analitik dengan desain cross sectional Subjek pasca MOCA atau EVLT dengan rentang waktu 3 18 bulan pasca tindakan diwawancara dan dilakukan pemeriksaan USG vaskular pada tungkai yang dioperasi untuk menilai rekanalisasi Data sekunder praoperasi diambil dari rekam medis Dicari karakteristik klinis subjek membandingkan kecenderungan rekanalisasi pasca tindakan MOCA dan EVLT dicari hubungan antara karakteristik klinis subjek dengan kejadian rekanalisasi Data diolah dengan SPSS ver 20 0 Hasil Didapatkan 43 sampel tungkai terdiri dari 24 tungkai pasca MOCA dan 19 tungkai pasca EVLT Karakteristik subjek MOCA terbanyak usia 7 mm 13 19 tungkai Pada MOCA rekanalisasi total didapatkan 2 24 dan partial 8 24 tungkai sedangkan pada EVLT rekanalisasi total 1 19 dan partial 3 19 tungkai Hubungan antara karakteristik klinis subjek dengan kejadian rekanalisasi p 0 05 Kesimpulan Kecenderungan rekanalisasi MOCA lebih tinggi dibandingkan EVLT Tidak ada hubungan bermakna antara karakteristik klinis subjek dengan kejadian rekanalisasi secara statistik namun diameter terbesar VSM 7 mm sebelum operasi secara proporsional lebih tinggi MOCA 3 4 tungkai dibandingkan EVLT 3 13 tungkai ABSTRACT
Background Endovenous ablation for varicose vein of the limb in Indonesia has been done since 2010 EVLT has been done in RSCM since 2013 and MOCA in RSUP Fatmawati in 2014 There has not any evaluation been done for recanalization post MOCA and EVLT procedure in Indonesia Method This study was descriptive analytic with cross sectional design Subjects post MOCA or EVLT with time span 3 18 months post procedure are interviewed and USG vascular examination is done on operated limb in order to evaluate the recanalization Secondary data pre surgery are taken from medical records Clinical characteristics of the subjects are seek comparing possibility of recanalization post MOCA and EVLT procedure in order to see the correlation between clinical characteristics of subjects and recanalization Data is treated using SPSS ver 20 0Results Forty three samples were collected consists of 24 extremities post MOCA samples and 19 extremities post EVLT samples Most subjects on MOCA group were 7mm were 13 19 extremities On MOCA group total recanalization were 2 24 extremities and partial were 8 24 extremities EVLT group total recanalization were 1 19 extremities and partial were 3 19 extremities Relationship between subjects clinical characteristics with recanalization event p 0 05 Conclusion Recanalization tendency in MOCA is higher compared to EVLT There is no statistically significant assosiation between clinical characteristic of the subjects and recanalization but the highest diameter VSM 7 mm pre surgery proportionally is higher in MOCA 3 4 extremities compared to EVLT 3 13 extremities ;Background Endovenous ablation for varicose vein of the limb in Indonesia has been done since 2010 EVLT has been done in RSCM since 2013 and MOCA in RSUP Fatmawati in 2014 There has not any evaluation been done for recanalization post MOCA and EVLT procedure in Indonesia Method This study was descriptive analytic with cross sectional design Subjects post MOCA or EVLT with time span 3 18 months post procedure are interviewed and USG vascular examination is done on operated limb in order to evaluate the recanalization Secondary data pre surgery are taken from medical records Clinical characteristics of the subjects are seek comparing possibility of recanalization post MOCA and EVLT procedure in order to see the correlation between clinical characteristics of subjects and recanalization Data is treated using SPSS ver 20 0Results Forty three samples were collected consists of 24 extremities post MOCA samples and 19 extremities post EVLT samples Most subjects on MOCA group were 7mm were 13 19 extremities On MOCA group total recanalization were 2 24 extremities and partial were 8 24 extremities EVLT group total recanalization were 1 19 extremities and partial were 3 19 extremities Relationship between subjects clinical characteristics with recanalization event p 0 05 Conclusion Recanalization tendency in MOCA is higher compared to EVLT There is no statistically significant assosiation between clinical characteristic of the subjects and recanalization but the highest diameter VSM 7 mm pre surgery proportionally is higher in MOCA 3 4 extremities compared to EVLT 3 13 extremities ;Background Endovenous ablation for varicose vein of the limb in Indonesia has been done since 2010 EVLT has been done in RSCM since 2013 and MOCA in RSUP Fatmawati in 2014 There has not any evaluation been done for recanalization post MOCA and EVLT procedure in Indonesia Method This study was descriptive analytic with cross sectional design Subjects post MOCA or EVLT with time span 3 18 months post procedure are interviewed and USG vascular examination is done on operated limb in order to evaluate the recanalization Secondary data pre surgery are taken from medical records Clinical characteristics of the subjects are seek comparing possibility of recanalization post MOCA and EVLT procedure in order to see the correlation between clinical characteristics of subjects and recanalization Data is treated using SPSS ver 20 0Results Forty three samples were collected consists of 24 extremities post MOCA samples and 19 extremities post EVLT samples Most subjects on MOCA group were 7mm were 13 19 extremities On MOCA group total recanalization were 2 24 extremities and partial were 8 24 extremities EVLT group total recanalization were 1 19 extremities and partial were 3 19 extremities Relationship between subjects clinical characteristics with recanalization event p 0 05 Conclusion Recanalization tendency in MOCA is higher compared to EVLT There is no statistically significant assosiation between clinical characteristic of the subjects and recanalization but the highest diameter VSM 7 mm pre surgery proportionally is higher in MOCA 3 4 extremities compared to EVLT 3 13 extremities

Abstrak :
Latar belakang :Tesis ini membahas tentang analisis kasus kematian pada pasien Aneurisma aorta abdominal di RSUP Fatmawwati yang menjalani operasi elektif. Sampel dan Metode : Data pasien diambil periode 2013 sampai April 2018. Semua pasien yang meninggal dari operasi elektif aneurisma aorta abdominal akan di data. Penelitian ini ditampilkan dalam bentuk deskriptif, dengan data kualitatif dan kuantitatif. Data kualitatif didapatkan dengan melakukan wawancara dengan tim operasi, operator, tim anestesi dan paramedis instrumen. Data kuantitatif didapatkan dengan telusur rekam medis. Hasil : Terdapat 27 kasus, selama periode 2013 sampai April 2018. Hanya 15 kasus yang rekam medis lengkap, 5 kasus hidup, 2 kasus meninggal pada operasi emergency dan 8 kasu meninggal pada operasi elektif. Dari 8 kasus ini, 5 kasus disertai anemia dan trombositopenia yang menetap sampai pada tahap postoperasi, 2 kasus dengan gangguan ginjal dan 1 kasus dengan penyebab yang belum jelas. Pada 8 kasus kematian, lama operasi berkisar dari 4 jam 20 menit sampai 8 jam 10 menit. Jumlah perdarahan berkisar dari 750 cc sampai 7.000 cc. Kadar creatinin preoperasi, berkisar dari 1,0 sampai 4,3 mg/dL. Kadar creatinin postoperasi berubah dari 1,0 sampai 4,5 mg/dL. Kadar hemoglobin postoperasi berkisar 5,9 sampai 9,4 g/dL. Kadar trombosit, berkisar 45.000 sampai 108.000/uL. Rata rata jumlah perdarahan adalah 3.156 cc. Kesimpulan : Penelitian ini menyimpulkan bahwa kasus dengan hasil akhir kematian, sebagian besar disertai oleh jumlah perdarahan yang masif. Perbaikan yang dilakukan untuk resusitasi komponen darah tidak mencapai hasil yang optimal. ......Background : The aim of this study is to confirm the factors that affect the mortality following open elective abdominal aortic aneurysm repair. Subject and Methode : This study was a retrospective study. Qualitative and quantitave data were collected from interviewing the team in charge and from the hospital database medical record. The data were collected for five years, from 2013 until April 2018. Data will be displayed in descriptive. Result : Twentyseven cases were hospitalized during the periode of 2016 until April 2018. Ten cases were not availlable to analyze, medical record were missing. Out of two case from these fivteen cases, was an emergency case. Five cases were alive when they discharge from the hospital. The other eight were elective cases and were able to analyze. Five cases, out of this eight, were accompanied by anemia and thrombositopenia, which last until they all move from the surgery room to the ICU. Two cases with renal disfunction, and one case with unclear cause of death. Duration of surgery in all this elective cases, ranged from 4 hours 20 minutes until 8 hours 10 minutes. Bood loss during surgery, estimated from 750 cc to 7.000 cc. Preoperative creatinin level, ranged from 1,0 to 4,3 mg/dL. Postoperative cretainin level, ranged from 1,0 to 4,5 mg/dL. Postoperative hemoglobin level, ranged from 5,9 to 9,4 g/dL. Postoperative platelet count , ranged from 45.000 to 108.000/uL. Mean blood loss during surgery was 3.156 cc. Conclusion : This study concluded that most of the death case was accompanied by massive bleeding. And all those attempt to improve by blood rescusitation, was not promptly worked.