PENGARUH ENTEROKOLITIS DAN TANPA ENTEROKOLITIS PRA OPERASI TERHADAP KEJADIAN HIRSCHPRUNG-ASSOCIATED ENTEROCOLITIS PASCA SOAVE DAN TRANSANAL ENDORECTAL PULL THROUGH PADA PASIEN PENYAKIT HIRSCHSPRUNG DI RSUP DR. SARDJITO YOGYAKARTA

OVI ASEP WAHYUDIN, Dr. dr. Akhmad Makhmudi, SpB, SpBA(K)

2020 | Tesis-Spesialis | ILMU BEDAH

Latar Belakang: Hirschsprung Disease (HD) terjadi ketika ganglia parasimpatis pada dinding usus gagal berkembang. Hirschsprung-Associated Enterocolitis (HAEC) adalah komplikasi yang sering terjadi dengan risiko morbiditas dan mortalitas tertinggi. HAEC dapat terjadi sebelum operasi atau pasca operasi. Penelitian kejadian HAEC di RSUP Dr. Sardjito sudah pernah dilakukan sebelumnya, namun hingga saat ini belum ada penelitian yang menganalisis pengaruh enterokolitis pra operasi dan tanpa enterokolitis terhadap kejadian HAEC pasca operasi. Tujuan: Untuk mengetahui pengaruh enterokolitis pra operasi dan tanpa enterokolitis terhadap kejadian HAEC pasca Soave dan Transanal Endorectal Pull Through (TEPT). Metodologi: Data diambil dari rekam medis pasien dan dinilai dengan metode Delphi untuk mendiagnosis HAEC. Kemudian data dianalisis secara statistik menggunakan SPSS. Hasil: Ada 77 pasien. Pre operatif dengan Enterokolitis 10,4% dan tanpa enterokolitis 89,6%. HAEC pasca operasi ditemukan pada 75% pasien dengan enterokolitis pra operasi (p: 0,001, OR: 26,57) dan 10,1% pasien tanpa enterokolitis pra operasi (p: 0,001, OR: 0,04). Kesimpulan: Terdapat pengaruh signifikan enterokolitis pra operasi terhadap kejadian HAEC pasca operasi, sebagai faktor risiko terhadap kejadian HAEC. Ada pengaruh yang signifikan tanpa enterokolitis pra operasi terhadap kejadian HAEC pasca operasi, sebagai faktor pencegahan terhadap kejadian HAEC.

Background: Hirschsprung Disease (HD) occurs when parasympathetic ganglia on bowels wall fail to develop. Hirschsprung-Associated Enterocolitis (HAEC) is a common complication with the highest risk of morbidity and mortality. HAEC can occur pre-operatively or post-operatively. Research of HAEC incidence in RSUP Dr. Sardjito has been done before and but up to now there arent any research that analyze the effect of pre-operative enterocolitis and without enterocolitis to post-operative HAEC incidence yet. Objective: To know the effect of pre-operative enterocolitis and without enterocolitis to HAEC incidence post Soave and Transanal Endorectal Pull Through (TEPT). Methods: Data were taken from patients medical records and assesed using Delphi method to diagnose HAEC. Then, data were statistically analyzed using SPSS. Result: There were 77 patients. Pre operative with Enterocolitis 10,4% and without enterocolitis 89,6%. Post-operative HAEC was found in 75% patients with pre-operative enterocolitis (p: 0,001, OR : 26.57) and 10,1% patients without pre-operative enterocolitis (p: 0,001, OR : 0,04). Conclusion: There is a significant effect of pre-operative enterocolitis to post -operative HAEC incidence, as a risk factor to HAEC incidence. There is a significant effect of without pre-operative enterocolitis to post -operative HAEC incidence, as preventif factor to HAEC incidence.

Kata Kunci : Hirschsprung, Hirschsprung Associated Entero-colitis, pra operasi enterocolitis, Soave, TEPT, Hirschsprung, Hirschsprung Associated Entero-colitis, pre-operative enterocolitis