Penentuan Tingkat Kedaruratan Bedah Adenoma Hipofisis Melalui Stratifikasi Prabedah di Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo

• Main Authors: Renindra Ananda Aman, Aryandhito Widhi Nugroho
• Format: Article
• Language: English
• Published: Universitas Indonesia 2020-10-01
• Series: Journal Kedokteran Indonesia
• Subjects: tingkat kedaruratan bedah; adenoma hipofisis; trans-sfenoid; stratifikasi pra bedah
• Online Access: http://journal.ui.ac.id/index.php/eJKI/article/view/11930

<p class="MsoNormal" style="margin-right: 4.75pt; text-align: justify;"><em><span style="font-size: 8.0pt; line-height: 107%; font-family: &quot;Arial&quot;,sans-serif; color: black;">Adenoma hipofisis menyebabkan defisit neurologis yang memerlukan tata laksana tepat. Belum ada standar baku penetapan tingkat kedaruratan bedah untuk adenoma hipofisis. Penelitian ini bertujuan mengetahui distribusi tingkat kedaruratan bedah pengangkatan tumor melalui operasi trans-sfenoid pada pasien adenoma hipofisis. Penelitian retrospektif berbasis rekam medik dilakukan pada 50 pasien adenoma hipofisis yang menjalani operasi pengangkatan tumor dengan teknik trans-sfenoid di Departemen Bedah Saraf FKUI-RSUPNCM pada tahun 2018-2019. Proporsi pasien yang menjalani operasi elektif dan dipercepat dibandingkan dengan stratifikasi risiko prabedah menurut tingkat kedaruratan bedah A/B/C/D. Proporsi pasien yang menjalani operasi elektif dan dipercepat adalah 86% dan 14%, sedangkan proporsi tingkat kedaruratan bedah adalah 54% (A), 36% (B), 8% (C), dan 2% (D). Median hari waktu tunggu menuju operasi [min-max] adalah 77,6 (4-549) hari (A); 45,4 (7-258) hari (B); 71 (8-140) hari (C); dan 99 hari (D); tidak terdapat perbedaan bermakna. Terdapat ketidaksesuaian proporsi antara pasien kategori dipercepat/elektif dan tingkat kedaruratan bedah A/B/C/D serta tidak ada perbedaan waktu tunggu menuju operasi pada keempat kelompok risiko operasi A/B/C/D. Diperlukan penelitian lebih lanjut untuk menetapkan manfaat stratifikasi risiko prabedah tumor hipofisis terhadap luaran pasien pasca operasi pengangkatan tumor melalui operasi trans-sfenoid. </span></em></p> <p class="MsoNormal" style="margin-right: 4.75pt; text-align: justify;">&nbsp;</p> <p class="MsoNormal" style="margin-right: 4.75pt; text-align: justify;"><strong><span style="font-size: 11.5pt; line-height: 107%; font-family: &quot;Arial&quot;,sans-serif; color: black;">Determination of Surgical Emergency Levels of Pituitary Adenoma Patients Through Pre-Surgical Stratification at the dr. Cipto Mangunkusumo National Hospital </span></strong></p> <p class="MsoNormal" style="margin-right: 4.75pt; text-align: justify;">&nbsp;</p> <p class="MsoNormal" style="margin-right: 4.75pt; text-align: justify;"><em><span style="font-size: 8.0pt; line-height: 107%; font-family: &quot;Arial&quot;,sans-serif; color: black;">Pituitary adenomas may cause neurological deficits that require prompt management. There is no standard for determining the level of surgical emergencies for pituitary adenomas. The author aims to know the distribution of pituitary adenomas surgically removed through trans-sphenoid surgery. This medical record-based retrospective study was conducted on 50 pituitary adenoma patients who underwent trans-sphenoidal surgery at the Department of Neurosurgery, dr. Cipto Mangunkusumo National Hospital in 2018-2019. The proportion of patients undergoing elective and urgent surgery is compared with pre-surgical risk stratification according to the level of A/B/C/D surgical emergencies. The proportions of patients who underwent elective and urgent surgery were 86% and 14% respectively, while the proportion of surgical emergencies for each group was 54% (A), 36% (B), 8% (C), and 2% (D). The median waiting time to surgery [min-max] for each group is 77.6 (4-549) days (A); 45.4 (7-258) days (B); 71 (8-140) days (C); and 99 days (D); no significant difference were found. There was a large discrepancy in the proportion between patients included in the urgent/elective category and the level of emergency A/B/C/D surgery. Furthermore, there is no difference in waiting time for surgery between the four risk groups for A/B/C/D. Further research is needed to establish the benefits of preoperative risk stratification of pituitary adenoma in terms of patient outcomes after trans-sphenoid surgery.</span></em></p> <p class="MsoNormal" style="margin-right: 4.75pt; text-align: justify;">&nbsp;</p><br />