PERBANDINGAN LUARAN PEMBERIAN EARLY FEEDING DENGAN DELAYED FEEDING PADA PASIEN PASCA OPERASI ELEKTIF RESEKSI ANASTOMOSE GASTROINTESTINAL DAN PINTASAN BILIODIGESTI DI RSUP DR. SARDJITO

Francisca Christauriza Ari Pratomo, dr. Agus Barmawi, Sp.B-KBD.

2016 | Tesis-Spesialis | S2 Ilmu Bedah

Latar Belakang : Masa puasa (nil by mouth) telah dikenal selama bertahun-tahun dan dipraktekkan selama 50 tahun terakhir setelah tindakan operasi saluran cerna dimana dalam tindakan tersebut dilakukan anastomosis usus. Tidak ada bukti bahwa mengistirahatkan usus dan mempuasakan pasien paska operasi akan menguntungkan bagi penyembuhan luka dan integritas anastomosis. Namun ada bukti-bukti bahwa nutrisi luminal dapat meningkatkan penyembuhan luka dan kekuatan anastomosis, terutama pada pasien-pasien yang malnutrisi. (Choudhury,2014;Alkareem,2013). Tujuan Penelitian: Umum : membandingkan early feeding dan delayed feeding pada pasien-pasien pasca operasielektif reseksi anastomosis gastrointestinal dan pintasan biliodigesti. Khusus :Mengetahui luaran early feeding dibandingkan dengan delayed feeding dalam hal pengaruhnya terhadap kebocoran anastomosis gastrointestinal, lama perawatan rumah sakit, toleransi diet dan kejadian infeksi luka operasi Metode Penelitian: Desain penelitian kohort prospektif, subjek dipilih secara purposive sampling .Pengolahan data secara manual meliputi tahap pengumpulan data dan tabulasi data. Data dianalisis dengan menggunakan analisis univariat, analisis bivariat berupa uji chi square dan students t test dengan tingkat kemaknaan = 0,05serta uji regresi logistik untuk mengetahui hubungan antar variabel. Kesimpulan : Tidak ada perbedaan bermakna antara early feeding dan delayed feeding dalam hal kebocoran anastomosis, infeksi luka operasi dan lama perawatan umah sakit. Early feeding mampu mentoleransi diet paska operasi dengan baik.

The Background : Fasting period (nil by mouth) has been known for many years and has been practised for 50 years after the procedure of the operation of the digestive system where in that procedure had done anastomosis of the intestines. There is no evidence that deteriorating intestines and starvasting the postoperative patients will benefit for wound healing and the integrity of the anastomosis. But there is evidence that luminal nutrition can improve wound healing and the strength of the anastomosis, especially in patients with malnutrition. (Choudhury,2014;Alkareem,2013). The purpose of: General : compare early feeding versus delayed feeding on patients after elective resection anastomosis of gastrointestinal and shunting biliodigestive. Special : to know the outcome of early feeding versus delayed feeding in terms of its influence to gastrointestinal anastomosis leakage, length of stay at hospital, diet tolerance and surgical wound infection. Research Method: research design was prospective cohort, subject selected by purposive sampling . Data processing manually include the data collection and tabulation of data. The data will be analyzed using univariat analysis, analysis bivariat, chi square test and students t-test with the level of statistical significance = 0,05and logistic regression test to know the relationship between the variables. Conclusions : There is no significant difference between early feeding and delayed feeding in terms of leakage anastomosis, surgical wound infection and length of stay at the hospital. Early feeding is well able to tolerate the diet of postoperative.

Kata Kunci : early feeding, delayed feeding, resection anastomosis gastrointestinal, shunting biliodigestive