PENGARUH EARLY FEEDING DAN DELAYED FEEDING TERHADAP KEBOCORAN ANASTOMOSIS DAN LAMA PERAWATAN DI RUMAH SAKIT PADA OPERASI RESEKSI ANASTOMOSIS GASTROINTESTINAL DI RSUP DR. SARDJITO

SUHARDI, dr. Agus Barmawi, Sp.B-KBD

2015 | Tesis | SP ILMU BEDAH

Latar belakang : Delayed feeding dipraktekkan karena ketakutan stres fisik akan mengganggu anastomosis. Early feeding dapat menurunkan angka kebocoran anastomosis gastrointestinal dan memperpendek lama perawatan rumah sakit. Tujuan : membandingkan pengaruh early feeding dan delayed feeding terhadap kebocoran anastomosis dan lama perawatan rumah sakit pada pasien pasca operasi reseksi anastomosis gastrointestinal di RSUP Dr. Sardjito, Yogyakarta. Metode : Penelitian kohort retrospektif terhadap 120 pasien yang menjalani operasi reseksi anastomosis gastrointestinal di RSUP Dr. Sardjito yang memenuhi kriteria inklusi dan eksklusi dibagi 2 kelompok, early feeding (EF,n=53) dan delayed feeding (DF,n=67) berdasarkan waktu memulai feeding. Early feeding didefinisikan sebagai pemberian makan enteral sejak 48 jam pasca operasi. Data yang terkumpul dibandingkan kebocoran anastomosis dan lama perawatan rumah sakit pada kedua kelompok tersebut kemudian dianalisis dengan uji T dan uji Chi-Square ( ���± = 0,05.) Hasil : 120 pasien dibagi dalam 2 kelompok dengan 53 pada kelompok EF dan 67 pada kelompok DF. Kelompok early feeding usia pasien antara 21-78 tahun dengan rerata usia 51,56���±14,96 mayoritasnya laki-laki (58,5%). Kelompok delayed feeding, usia pasien antara 19-82 tahun dengan rerata usia 51,58���±16,69, kebanyakan laki-laki (55,2%). Dua pasien (1,89%) kelompok early feeding dan 17 pasien (25,37%) kelompok delayed feeding mengalami kebocoran anastomosis pasca operasi yang signifikan secara statistik (p=0,0012; x2=10,36). Pada kelompok EF, rerata lama perawatan rumah sakit 12,85���±7,07 hari sedangkan kelompok DF 14,22���±9,02 hari (p=0,365). Kesimpulan: Early feeding pasca operasi reseksi anastomosis gastrointestinal lebih baik dalam menurunkan angka kebocoran anastomosis dibandingkan delayed feeding tetapi tidak dalam hal lama perawatan rumah sakit.

Background: Delayed feeding has been practiced for fear of physical stress disrupting the anastomosis. Early feeding may reduce the rate of gastrointestinal anastomotic leak and shorter duration of hospital stay. Objectives: to compare the rate of anastomotic leak following gastrointestinal resection anastomosis and duration of hospital stay between the early and delayed feeding group in post gastrointestinal resection anastomotic patient at dr. Sardjito General Hospital, Yogyakarta. Methods: Retrospective cohort study toward 120 patient who underwent gastrointestinal resection anastomosis at Dr. Sardjito general hospital that meet the inclusion and exclusion criteria. Patients were divided into two groups, early feeding group (EF,n=53) and delayed feeding group (DF,n=67) based on the time to start feeding. Early feeding is defined as initiation of enteral feeding within 48 hours post operatively. Data that has been collected were compared by the anastomotic leak and duration of hospital stay between the two groups. Data were analysed with student�¢ï¿½ï¿½s t test for continous data and chi square test for categorical data. Statistic is significant if the p-value < 0.05. Results: From 120 patient divided into two groups with 53 patient in EF group and 67 patient in DF group. dengan 53 pada kelompok EF dan 67 pada kelompok DF. In the early feeding group age ranged from 21-78 years with a mean age of 51,56���±14,96 years and the majority of them were males (58,5%). In the delayed feeding group patient age ranged from 19-82 years with a mean of age 51,58���±16,69 years with male predominance (55,2%). Two patients (1,89%) in early feeding (EF) group and 17 patients (25,37%) in delayed feeding (DF) group had anastomotic leak in the post-operative period which is statistically significant (p=0,0012; x2=10,36). In EF group, mean of duration of hospital stay was 12,85���±7,07 days, while in DF group mean of duration of hospital stay was 14,22���±9,02 days (p=0,365). Conclusions: Early feeding after gastrointestinal resection anastomosis operation better than delayed feeding in reducing the rate of anastomotic leak, but the not shorter the duration of hospital stay.

Kata Kunci : Kata kunci: early feeding, delayed feeding, reseksi anastomosis gastrointestinal.