Latar belakang: Argon Plasma Coagulation (APC) merupakan modalitas terapi yangbanyak digunakan untuk pengobatan kolitis radiasi pada pasien keganasan ginekologi,kolorektal dan urologi yang mendapatkan radioterapi di RSUPN-CM.Tujuan: Menilai hasil dari APC yang dilakukan pada penderita kolitis radiasi danfaktor perancunya.Metode: Penelitian deskriptif analitik dengan desain kohort retrospektif berdasarkandata dari rekam medis RSUPN-CM antara bulan April 2012 sampai dengan Oktober2019. Variabel yang dinilai meliputi umur, jenis kelamin, jenis keganasan, diabetesmelitus, hipertensi, dan status anemia, dengan luaran berupa keberhasilan APC.Pengujian kemaknaan statistik dilakukan sesuai dengan karakteristik data serta tujuanpenelitian, dengan p <0,05 dianggap bermakna. Juga dilakukan analisis multivariatuntuk melihat variabel perancu yang paling memengaruhi keberhasilan APC.Hasil: Sebanyak 180 pasien kolitis radiasi yang mendapatkan terapi APC memenuhikriteria penelitian dengan proporsi terbanyak berjenis kelamin perempuan sebesar89,4%, dan berusia >50 tahun sebanyak 83,9%. Sedangkan jenis tumor terbanyakadalah keganasan ginekologi sebanyak 88,9%. Sebanyak 81,3 % subyek mengalamikeberhasilan terapi APC. Nilai tengah frekuensi APC sebanyak 2 sesi dengan rentang1 sampai 12 sesi. Terdapat 180 subyek (100%) menderita anemia sebelum menjalaniAPC yang pertama. Kadar hemoglobin pada penderita APC meningkat denganmedian Hb sebelum APC pertama sebesar 8 g/dL (3-11 g/dL) menjadi 12 g/dL (10-14g/dL) sebelum APC terakhir. Sebanyak 59,2% subyek yang mengalami keberhasilanAPC tidak lagi menderita anemia setelah terapi APC, dengan perbaikan status anemiameningkat sebesar 1,628 kali lebih baik pada subyek yang mengalami keberhasilanAPC dibandingkan dengan subyek yang mengalami ketidakberhasilan terapi APC(p=0,017). Usia, jenis kelamin, jenis keganasan, hipertensi dan diabetes melitus bukanmerupakan faktor perancu terhadap status anemia pada keberhasilan APC.Kesimpulan: Terdapat perbaikan status anemia pada penderita kolitis radiasi yangmendapatkan terapi APC di RSUPN-CM.
Background: Argon Plasma Coagulation (APC) is recently widely used in thetreatment of radiation colitis among patients with gynecology, colorectal andurology malignancy.Purpose: To measure the result of APC conducted on radiation colitis patients and itscounfounding factors.Methods: An analytic descriptive study with retrospective cohort design based onRSUPN-CM database between April 2012 until October 2019. Variables measuredwere age, gender, tumor types, diabetes melitus, hypertension, and anaemia, withefficacy of APC treatment as the outcome. Statistical tests conducted according tocharacteristics and the purpose of the study, with p value <0.05 consideredsignificant. Multivariate analysis was also conducted to evaluate which factorsinfluenced to the efficacy of APC therapy.Results: As much as 180 radiation colitis patients received APC treatment fulfilledinclusion criteria with characteristics female patients (89.4%), and age >50 years old(83.9%) were found in this study. Types of tumor were dominated by gynecologymalignancy (88.9%). As much as 81.3% subjects had successful APC treatment.Median number of efficacy of APC treatment in this study was 2 sessions. All of thesubjects had anaemia before the first APC treatment. There was improvement in Hblevel, median Hb before the first APC treatment was 8 g/dL (3-11 g/dL) and medianHb level before the last APC treatment was 12 g/dL (10-14 g/dL). As much as 59.2%subjects who had successful APC treatment were no longer anaemia after APCtreatment, with improvement of anaemia status was 1.628 times more likely insubjects who had successful APC treatment compared to subjects who did not havesuccessful APC treatment (p=0.017). Age, gender, malignancy types, hypertensiondan diabetes melitus were not confounding factors to anaemia status in successfulAPC treatment.Conclusion: There was improvement in anaemia status on radiation colitis patientsreceiving APC treatment in RSUPN-CM. |
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