EFEKTIFITAS TEKNIK LAPAROSKOPIK DIBANDINGKAN DENGAN OPERASI TERBUKA PADA PEMASANGAN KATETER TENCKHOFF

Muhammad Reyanul Firdaus, dr. Danarto, Sp.B, Sp.U (K).; dr. Indrawarman, Sp.U

2016 | Tesis-Spesialis | SP UROLOGI

Pendahuluan. Pilihan terapi gagal ginjal terminal adalah transplantasi ginjal, hemodialisis, dan dialisis peritoneal. Penderita gagal ginjal kronik yang menjalani dialisis peritoneal (CAPD) memerlukan pemasangan kateter tenckhoff untuk akses dialisis. Insersi kateter tenckhoff secara laparoskopik memiliki keuntungan dan kekurangan dibandingkan operasi terbuka. Tujuan. Untuk mengetahui efektivitas insersi kateter tenckhoff secara laparoskopik dibandingkan dengan operasi terbuka di RSUP Dr. Sardjito Yogyakarta. Cara. Data pasien yang menjalani insersi kateter tenckhoff Januari 2014-Desember 2015 dikumpulkan dan dicatat dari rekam medik. Dilakukan evaluasi mengenai efektivitas masingmasing operasi berupa demografi, cara pemasangan, durasi operasi dan komplikasi pasca operasi. Data dianalisis dengan SPSS 17. Hasil. Terdapat 75 pasien gagal ginjal yang menjalani insersi kateter tenckhoff, terdiri dari 34 (45.3%) pasien perlaparoskopi dan 41(54.7%) pasien secara operasi terbuka. Pasien laki-laki sebanyak 38 (50,7%) pasien dan perempuan 37 (49.3%) pasien. Lama operasi pada teknik operasi laparoskopik 56 + 20 menit dan pada operasi terbuka 71 + 17 menit. Komplikasi infeksi luka operasi pada teknik laparoskopi sebanyak 1 (2,9%) pasien dan pada teknik operasi terbuka sebanyak 8 (19,5%) pasien. Pada analisis bivariat teknik operasi laparoskopi secara signifikan menurunkan kejadian komplikasi luka operasi dan durasi operasi bila dibandingkan dengan teknik operasi terbuka dengan nilai p < 0.05 Kesimpulan. Teknik operasi laparoskopi lebih baik dibandingkan dengan teknik operasi terbuka pada insersi kateter tenckoff dengan kejadian komplikasi infeksi luka operasi lebih rendah dan durasi operasi lebih cepat.

Preliminary. The terminal renal failure choice of therapy is kidney transplantation, hemodialysis and peritoneal dialysis. Patients with chronic renal failure undergoing peritoneal dialysis (CAPD) requires Tenckhoff catheter for dialysis access. Tenckhoff catheter insertion laparoscopically has advantages and disadvantages compared to open surgery. Aim. To determine the effectiveness of catheter Tenckhoff laparoscopically compared with open surgery at Dr. Sardjito Hospital. Way. Data of patients who underwent catheter insertion Tenckhoff January 2014-December 2015 were collected and recorded from medical records. An evaluation of the effectiveness of each operation such as demographics, how to install, duration of surgery and postoperative complications. Data were analyzed with SPSS 17. Results. There are 75 patients with renal failure who underwent catheter insertion Tenckhoff, consisting of 34 (45.3%) patients laparascopically and 41 (54.7%) patients in the open surgery. Male patients were 38 (50.7%) patients and 37 women (49.3%) patients. Duration procedure in laparoscopic techniques were 56 + 20 minutes and 71 + 17 minutes in open procedure. Complications of surgical site infection in laparoscopic techniques in 1 (2.9%) patients and in open surgical techniques as much as 8 (19.5%) patients. In bivariate analysis techniques of laparoscopic surgery significantly decreased the incidence of surgical wound complications and duration of surgery compared with open surgery technique (p < 0.05). Conclusion. Laparoscopic surgical technique is better than open surgery techniques at the catheter Tenckhoff insertion with the incidence of complications of surgical wound infection is lower and the duration of surgery more quickly.

Kata Kunci : katetertenckoff, CAPD, CKD, catheter tenckhoff