ABSTRAK
Pendahuluan : Pemasangan double-J stent DJ stent sering dilakukan sebagai pertimbangan pertama untuk dekompresi obsruksi ureter akibat kanker serviks. Namun pemasangan DJ stent pada pasien ini tidak selalu berhasil. Penelitian ini bertujuan untuk mengetahui faktor pra operasi pada pasien kanker serviks yang dapat memengaruhi kegagalan pemasangan DJ stent.Metode : Penelitian ini merupakan studi analitik prospektif terhadap pasien kanker serviks yang direncanakan pemasangan DJ stent ureter di RSUP H. Adam Malik Medan sejak tanggal 1 Januari 2015 hingga 31 Juli 2016. Usia,derajat hidronefrosis, stadium tumor, riwayat radioterapi, fungsi ginjal preoperasi merupakan variabel yang dinilai sebagai faktor prediksi. Faktor-faktor tersebut akan dianalisis secara bivariat untuk kemudian diikutkan dalam regresi logistik sebagai analisis multivariat.Hasil : Studi ini melibatkan 40 pasien kanker serviks dengan rata-rata usia 48,5 tahun dan 72,5 pasien merupakan stadium IIIB. Pemasangan DJ stent tidak berhasil dilakukan pada 31 orang 77.5 dengan muara ureter yang tidak terlihat sebagai penyebab terbanyak kegagalan pemasangan DJ stent 54.9 . Pada analisis bivariat, ditemukan bahwa stadium kanker serviks, sisi hidronefrosis, serta kadar ureum dan kreatinin serum berpengaruh terhadap kebehasilan pemasangan DJ stent p
ABSTRACT
Introduction Insertion of double J stent DJ stent has often used as first choice of method in decompressing obstructed ureters in cervical cancer patients, but it was not always successful. This study was conducted to analyze preoperative factors affecting failures in insertion of DJ Stent.Methods This is an analytical study with prospective design. All cervical cancer patients that was planned on insertion of DJ stent in RSUP H. Adam Malik Medan from January 1st 2015 until July 31st 2016 were included. Age, hydronephrosis degree, tumor staging, history of radiotherapy, and renal function status were included in bivariate analysis. Those with significant results were then included in multivariate analysis of logistic regression.Results Samples were 40 cervical cancer patients with mean age of 48.5 years old which were 72.5 in stage IIIB. Insertion of DJ stent was failed in 31 patients 77.5 with unidentified ureteral openings as the main cause of failure. From bivariate analysis, stage, hydronephrosis side, and renal function test ureum and creatinine were statistically significant factors. Those were then included in multivariate analysis and serum creatinine was the only significant factor. It was then included in ROC analysis and a cut off point of 3.38 mg dL was retracted as the most sensitive and specific 84 and 88 respectively in predicting insertion of DJ stent failure.Conclusions Serum creatinine was the only predictive factor of DJ stent insersion failure. This result can be used as clinical consideration in planning an insertion of DJ stent in cervical cancer patients. |
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