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Kadar Kortisol, Transforming Growth Factor β, serta Derajat Adhesi Pasca Laparoskopi dan Laparotomi

Agung Pribadi, Ignatius Riwanto, Selamat Budijitno
  Jurnal Kedokteran Brawijaya, Vol 29, No 1 (2016),  pp.64-68  

Abstract


Adhesi intraperitoneal pasca bedah abdomen terjadi pada 50-97% kasus adhesi, dengan penyebab terbanyak adalah laparotomi. Penelitian ini bertujuan membuktikan perbedaan dampak laparoskopi dan laparotomi terhadap derajat adhesi peritoneal, kadar kortisol dan TGF-β. Desain randomized control trial post test only diterapkan pada dua kelompok, yaitu kelompok laparoskopi dan laparotomi dalam anestesi umum. Sampel darah diambil sesaat sebelum dan 6 jam paska operasi untuk pemeriksaan kadar kortisol. Tujuh hari pasca operasi dilakukan terminasi, dilanjutkan laparotomi untuk penilaian adhesi intraperitoneal, dan pengambilan cairan peritoneum untuk pemeriksaan kadar TGF-β. Hasil penelitian menunjukkan ada perbedaan bermakna pada kenaikan kadar kortisol (rerata 20,03±1,550ng/ml), TGF-β (rerata 6.772,50±414,77pg/ml), dan derajat adhesi antara kedua kelompok (p=0,021, p<0,001, p=0,002). Terdapat korelasi positif kuat antara kadar kortisol denganTGF-β (p=0,030, r=0,632) dan korelasi positif yang signifikan antara kadar TGF-β dengan derajat adhesi (p=0,001, r=0,941). Penelitian ini membuktikan bahwa bedah laparoskopi dapat mengurangi peningkatan kadar kortisol dan TGF-β, serta insidens adhesi.


Keywords


derajat adhesi; kortisol; laparotomi; laparoskopi; TGF-β

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References


Arung W, Meurisse M, and Detry O. Pathophysiology and Prevention of Postoperative Peritoneal Adhesions. World Journal of Gastroenterology. 2011; 17(41): 4545-4553.

Liakakos T, Thomakos N, Fine PM, Dervenis C, and Young RL. Peritoneal Adhesions: Etiology, Pathophysiology, and Clinical Significance. Recent Advances in Prevention and Management. Digestive Surgery. 2001; 18(4): 260-273.

Ayten R, Çetinkaya Z, Girgin M, Ozercan I, Ustundag B, and Aygen E. The Effects of Intraperitoneal Sildenafil Administration on Healing of Left Colonic Anastomoses and Intra-Abdominal Adhesion Formation in the Presence of Intra-Abdominal Infection. Diseases of Colon and Rectum. 2008; 51(12): 1837-1841.

Celik A, Ucar AE, Ergul E, Bekar ME, and Kusdemir A. Which is Most Effective in Prevention of Postoperative Intraperitoneal Adhesion-Methylene Blue, Low molecular Weight Heparin or Vitamin A: An Experimental Study in Rats. The Internet Journal of Surgery 2008; 15(1).

Duron JJ. Postoperative Intraperitoneal Adhesion Pathophysiology. Colorectal Disease 2007; 9(2): 14-24.

Attard JP and MacLean AR. Adhesive Small Bowel Obstruction: Epidemiology, Biology and Prevention. Canadian Journal of Surgery. 2007; 50(4): 291-300.

Hellebrekers BW and Kooistra T. Pathogenesis of Postoperative Adhesion Formation. The British Journal of Surgery. 2011; 98(11): 1503-1516.

Cheong YC, Laird SM, Li TC, Shelton JB, Ledger WL, and Cooke ID. Peritoneal Healing and Adhesion Formation/Reformation. Human Reproduction Update. 2001; 7(6): 556-566.

Binnebösel M, Klink CD, Serno J, et al. Chronological Evaluation of Inflammatory Mediators during Peritoneal Adhesion Formation Using a Rat Model. Langenbeck's Archives of Surgery. 2011; 396(3): 371-378.

Veenhof AA, Sietses C, von Blomberg BM, et al. The Surgical Stress Response and Postoperative Immune Function after Laparoscopic or Conventional Total Mesorectal Excision in Rectal Cancer: A Randomized Trial. International Journal of Colorectal Disease. 2011; 26(1): 53– 59.

Pismensky SV, Kalzhanov ZR, Eliseeva MY, Kosmas IP, and Mynbaev OA. Severe Inflammatory Reaction Induced by Peritoneal Trauma is the Key Driving Mechanismof Postoperative Adhesion Formation. BioMed Central Surgery. 2011; 11: 30.

Brokelman WJA, Lensvelt M, Rinkes IHMB, Klinkenbijl JHG, and Reijnen MMPJ. Peritoneal Changes due to Laparoscopic Surgery. Surgical Endoscopy. 2011; 25(1): 1–9.

Friedrich M, Rixecker D, and Friedrich G. Evaluation of Stress-Related Hormones after Surgery. Clinical Experimental Obstetrics and Gynecology. 1999; 26(2): 71-75.

Harjai MM and Kumar A. Comparison of Systemic Stress Response in Open Surgery versus Laparoscopic Surgery in Children. Journal of Paediatric Surgery Specialities. 2010; 91: 63-68.

Lwanga SK and Lemeshow S. Sample Size Determination in Health Studies. A Practical Manual. Geneva: World Health Organization; 1991.

Nair SK, Bhat IK, and Aurora AL. Role of Proteolytic Enzyme in the Prevention of Postoperative Intraperitoneal Adhesions. Archives of Surgery. 1974; 108(6): 849–853.

Dimopoulou I, Tzanela M, Vassiliadi D, et al. Pituitary-Adrenal Responses Following Major Abdominal Surgery. Hormones. 2008; 7(3): 237-242.

Ohene-Yeboah M, Adippah E, and Gyasi-Sarpong K. Acute Intestinal Obstruction in Adults in Kumasi, Ghana. Ghana Medical Journal. 2006; 40(2): 50–54.

Desborough JP. The Stress Response to Trauma and Surgery. British Journal of Anaesthesia. 200; 85(1); 109-117.

Hanafi Β. Patogenesis, Pencegahan dan Pengelolaan Adhesi Intraperitoneum Paska Bedah. Disampaikan pada Muktamar IKABDI VI. Semarang 2002.




DOI: http://dx.doi.org/10.21776/ub.jkb.2016.029.01.13

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