Kadar Kortisol, Transforming Growth Factor β, serta Derajat Adhesi Pasca Laparoskopi dan Laparotomi
DOI:
https://doi.org/10.21776/ub.jkb.2016.029.01.13Keywords:
derajat adhesi, kortisol, laparotomi, laparoskopi, TGF-βAbstract
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.
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