Faktor Risiko Mortalitas Pasien Penyakit Hirschsprung Pascaoperasi Transabdominal Approach dan Transanal Swenson-like Pull-through

Santi Andriyani, Prof. dr. Gunadi, PhD, Sp.BA, Subsp.D.A.(K) ; dr. Kristy Iskandar, M.Sc, Ph.D, Sp.A(K)

2025 | Skripsi | PENDIDIKAN DOKTER

Latar Belakang: Tatalaksana bedah untuk pasien penyakit Hirschsprung salah satunya dengan operasi transabdominal approach dan transanal Swenson-like pull-through. transanal Swenson-like pull-through memiliki trauma minimal dengan pemulihan yang cepat. Berdasarkan penelitian terdahulu, pada kedua jenis operasi tersebut ditemukan angka mortalitas yang beragam.

Tujuan: Penelitian ini bertujuan untuk mengetahui dan membandingkan frekuensi kematian pasien penyakit Hirschsprung pascaoperasi transabdominal approach dan transanal Swenson-like pull-through di RSUP Dr. Sardjito Yogyakarta.

Metode: Penelitian dibuat secara cross sectional dengan analisis univariat berupa deskriptif. Data berasal dari rekam medis pasien di RSUP Dr. Sardjito Yogyakarta dari Januari 2020 hingga Mei 2025. Data sekunder yang dikumpulkan berupa riwayat kesehatan pasien yang pernah menjalani operasi transabdominal approach atau transanal swenson-like Pull-through hingga riwayat kematian.    

Hasil: Frekuensi kematian pasien penyakit Hirschsprung pascaoperasi transanal Swenson-like pull-through sebesar 3.7?n transabdominal approach sebesar 2.67% secara stastistika tidak ada perbedaan yang signifikan pada penelitian terdahulu dengan yang sekarang. Penyebab kematian langsung dari pasien pascaoperasi transanal Swenson-like pull-through yaitu syok sepsis dan respiratory failure. Penyebab kematian langsung dari pasien pascaoperasi transabdominal approach yaitu cardiogenic shock, shock sepsis, dan DIC dengan riwayat sepsis.

Kesimpulan: Frekuensi kematian pasien penyakit Hirschsprung pascaoperasi transabdominal approach dan transanal Swenson-like pull-through di RSUP Dr. Sardjito Yogyakarta dapat dikategorikan rendah. Tidak ada perbedaan yang signifikan terkait perbandingan frekuensi kematian antara pasien penyakit Hirschsprung pascaoperasi transabdominal approach dengan transanal Swenson-like pull-through di RSUP Dr. Sardjito Yogyakarta.

Background: Surgical management for Hirschsprung disease patients includes transabdominal approach and transanal Swenson-like pull-through surgery. transanal Swenson-like pull-through has minimal trauma with rapid recovery. Based on previous studies, mortality rates vary between both types of surgery.

Objective: This study aims to determine and compare the mortality rate in Hirschsprung disease patients after transabdominal approach and transanal Swenson-like pull-through surgery at Dr. Sardjito General Hospital, Yogyakarta.

Method: The study was conducted cross-sectionally with descriptive univariate analysis. Data came from patient medical records at Dr. Sardjito General Hospital, Yogyakarta from January 2020 to May 2025. Secondary data collected were in the form of medical history of patients who had undergone transabdominal approach or transanal Swenson-like pull-through surgery up to death.

Results: The mortality rates of Hirschsprung's disease patients after transanal Swenson-like pull-through surgery was 3.7% and transabdominal approach was 2.67% statistically there was no significant difference in previous and current studies. The direct causes of death of patients after transanal Swenson-like pull-through surgery were septic shock and respiratory failure. The direct causes of death of patients after transabdominal approach surgery were cardiogenic shock, septic shock, and DIC with a history of sepsis.

Conclusion: The mortality rates of Hirschsprung's disease patients after transabdominal approach and transanal Swenson-like pull-through surgery at Dr. Sardjito General Hospital, Yogyakarta can be categorized as low. There was no significant difference related to the comparison of the mortality rates between Hirschsprung's disease patients after transabdominal approach and transanal Swenson-like pull-through surgery at Dr. Sardjito General Hospital, Yogyakarta.

Kata Kunci : Penyakit Hirschsprung, Transabdominal approach, Transanal Swenson-like pull-through, Faktor risiko, Mortalitas