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"Latar Belakang: Mobilisasi dini merupakan faktor penting dalam meningkatkan luaran pascaoperasi kolorektal. Terdapat empat komponen dalam protokol ERAS untuk operasi kolorektal di Rumah Sakit Cipto Mangunkusumo (RSCM) yang dipegang penuh Anestesi yang diharapkan menunjang keberhasilan mobilisasi dini, yaitu pemberian profilaks Post Operative Nausea and Vomiting (PONV), multimodal analgesia intraoperasi, manajemen cairan intraoperasi dan manajemen nyeri pascaoperasi tanpa opioid. Meskipun keberhasilan mobilisasi dini dipengaruhi oleh nyeri, mual muntah, dan manajemen cairan intraoperasi, namun hingga saat ini belum jelas seberapa besar bobot setiap komponen anestesi ini terhadap keberhasilan mobilisasi dini. Metode: Penelitian ini merupakan penelitian kohort retrospekstif dengan pengambilan data sekunder pasien yang menjalani operasi kolorektal elektif di RSCM dari Januari 2020 hingga Desember 2022. Luaran yang dinilai adalah angka mobilisasi dini pascaoperasi dan faktor-faktor yang memengaruhinya (profilaksis PONV, multimodal analgesia, manajemen cairan, dan manajemen nyeri pascaoperasi tanpa opioid).Hasil: Total pasien yang terjadwal menjalani operasi kolorektal elektif di RSCM antara tahun 2020 hingga 2022 adalah 595 pasien dengan pasien yang memenuhi kriteria inklusi dan eksklusi sebanyak 343 pasien. Keberhasilan mobilisasi dini sebesar 39.7%. Manajemen cairan intraoperasi [RR 12.353, (95% CI 3.131-46.745), p < 0,001] dan manajemen nyeri pascaoperasi tanpa opioid [RR 3.647, (95% CI 1.444-108.764), p 0.029] merupakan faktor independen dalam keberhasilan mobilisasi dini.Simpulan: Faktor-faktor yang memengaruhi mobilisasi dini pascaoperasi kolorektal adalah manajemen cairan intraoperasi dan manajemen nyeri pascaoperasi tanpa opioid. Pemberian profilaksis PONV dan multimodal analgesia intraoperasi tidak memiliki hubungan yang signifikan terhadap mobilisasi dini.

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Background: Early mobilization is an important factor in increasing colorectal postoperative outcome. There are four components held by anesthesiologist in ERAS protokol for colorectal surgery in Cipto Mangunkusumo Hospital (RSCM) those are PONV prophylaxis, intraoperative fluid management, intraoperative analgesia multimodal, and opioid free postoperative pain management. Although early mobilization affected by postoperative pain, vomiting and nausea, and fluid balance therapy, nonetheless there is no clear evidence of how much each of these components will affect early mobilization.

Methods: This study is a retrospective cohort study by collecting secondary data from patients underwent elective colorectal surgery at RSCM from January 2020 to December 2022. The outcomes assessed were early mobilization rate and factors affecting it (PONV prophylaxis, intraoperative fluid management, intraoperative analgesia multimodal, and opioid free postoperative pain management).

Results: The total number of patients underwent elective colorectal surgery at RSCM during 2020 to 2022 was 595 patients and 343 patients fulfilled inclusion and exclusion criteria of this study. Early mobilization rate is 39.7%. Intraoperative fluid management [RR 12.353, (95% CI 3.131-46.745), p < 0,001] and opioid free postoperative pain management [RR 3.647, (95% CI 1.444-108.764), p 0.029] are independent factors affecting early mobilization.

Conclusion: Factors affecting colorectal postoperative early mobilization are intraoperative fluid management and opioid free postoperative pain management. PONV prophylaxis and intraoperative analgesia multimodal do not have significant effect on early mobilization"

"Pendahuluan: Spondilitis TB adalah penyakit infeksi yang disebabkan oleh mycobacterium tuberkulosis yang mengenai tulang belakang dan disebut juga dengan Pott’s disease. Pasien dengan spondylitis TB selain pengobatan dengan obat anti tuberculosis, di lakukan tindakan operasi yaitu Decompresi Stabilisasi Asuhan keperawatan dilaksanakan berdasarkan ilmu keperawatan yang diberikan dalam pelayanan melalui penerapan teori karena pada kasus spondilytis tb pada manajement penatalaksanaanya bergantung pada self care pasien. Temuan kasus: Nn A.V usia 20 tahun pasca operasi Decompresi Stabilisasi Posterior hari pertama dengan keluhan belumbisa bergerak karena nyeri di daerah luka operasi pasien belummelakukan mobilisasi . Diagnosis keperawatan utama yang didapat dari hasil pengkajian pada pasien ini adalah hambatan mobilisasi fisik dan nyeri akut. Intervesi: intervensi yang telah dilakukan pada pasien ini adalah lebih diutamakan pada saat mobilisasi terutama mobilisasi dini,sesera mungkin dengan latihan ROM aktif dan pasif Hasil: ROM zktif dilakukan oleh pasien setelah hari pertama di operasi dan mampu berjalan dengan menggunakan brace. Kesimpulan: Mobilisasi dini pada pasien dengan post stabiliasi pada pasien dengan spondylitis TBdapat mencegah terjadinya komplikasi post operasi dan pengurangan skala nyeri

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Introduction: TB spondylitis is an infectious disease caused by mycobacterium tuberculosis which affects the spine and is also called Pott's disease. Patients with TB spondylitis besides treatment with anti-tuberculosis drugs, surgery is carried out, namely Decompression Stabilization. Nursing care is carried out based on nursing knowledge provided in services through the application of Orem's self-care theory because in the case of spondylitis TB, the management depends on the patient's self-care. Case findings: Ms A.V, 20 years old postoperative Posterior Stabilization Decompression on the first day with complaints of not being able to move because of pain in the area of the surgical wound, the patient has not mobilized. The main nursing diagnoses obtained from the results of the assessment on this patient are physical mobilization barriers and acute pain. Intervention: interventions that have been carried out in these patients are prioritized during mobilization, especially early mobilization, as soon as possible with active and passive ROM exercises. Results: Active ROM was carried out by the patient after the first day of surgery and was able to walk using a brace. Conclusion: Early mobilization of patients with postoperative stabilization in patients with TB spondylitis can prevent postoperative complications and reduce pain scalem

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"Membandingkan secara klinis, radiologis dan komplikasi antara penggunaan antara graft iliak dan implant metal pada prosedur fusi dengan Teknik anterior korpektomi (ACCF) dengan analisa kohort retrospektif. 41 pasien yang menjalani operasi ACCF, 20 pasien dengan graft iliac dan 21 pasien dengan implan metal. Dilakukan evaluasi mulai dari 1,3,6,12 hingga 24 bulan pasca operasi. Studi ini membandingkan tingkat perbaikan klinis dan kualitas hidup sebelum dan setelah operasi menggunakan skor fungsional (VAS, Nurick, JOA dan KPS), radiologis dengan sudut cobb C2-C7, dan karakteristik demografi pasien (Obesitas, ASA, tingkat cedera jaringan, lama rawat (LOS)). Tidak ada perbedaan signifikan antara kedua kelompok yang ditemukan berdasarkan demografi, perbaikan klinis, radiologi dan komplikasi pasca operasi. Tingkat perbaikan klinis pada skor fungsional penggunaan graft iliak menunjukkan persentase lebih cepat dibandingkan dengan penggunaan metal terutama pada bulan 1, 3 dan 6 bulan, stabil pada follow up 12 bulan ke atas. Sudut Cobb C2-C7 pada kelompok graft iliak memberikan perubahan sudut rata-rata 13,3 (94%), kelompok metal rata-rata 14,8 (83%). Komplikasi graft iliak berupa nyeri pada daerah donor (regio iliak) 10% yang tidak ditemukan pada graft metal. Komplikasi lain seperti disfonia, disfagia, malposisi atau migrasi dari graft itu sendiri. Tingkat perbaikan klinis pasien yang telah dilakukan prosedur ACCF menunjukkan perbaikan klinis terutama dimulai pada 1-6 bulan pascaoperasi. Penggunaan graft iliaka dan metal memiliki hasil klinis dan radiologis yang sama. Namun penggunaan graft iliak dapat dijadikan pilihan utama dalam prosedur ini terkait dengan tingkat efisiensi terutama di negara berkembang.

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To compare cohort retrospectively to clinical, radiological and complications between the use of iliac graft and implant metal in anterior cervical corpectomy fusion (ACCF) procedures. 41 patients who had ACCF surgery, 20 patients with iliac graft and 21 patients with metal implants. Follow-up is done from 1,3,6,12 to 24 months post-surgery. The authors compared clinical improvement rates and quality of life using functional scores (VAS, Nurick, JOA and KPS), radiological with cobb angles C2-C7, complications, and characteristic demographics of patients (Obesity, ASA, tissue injury rates, length of stay (LOS)) at pre and postoperative. No significant differences between the two groups were found based on demographics, clinical improvement, radiology and postoperative complications. The percentage rate of clinical improvement of functional scores on the iliac graft showed a faster percentage of improvement compared to metal use especially in the months 1, 3 and 6 months, plateau at follow-up 12 months and above. Cobb C2-C7 angles in the iliac graft group provided an average angular change of 13.3 (94%), the metal group averaged 14.8 (83%). Complications of iliac graft in the form of pain in the donor site (reg. iliac) 10% that is not found in graft metal. Other complications such as dysphonia, dysphagia, malposition of the cervical plate or migration from the graft itself. The level of clinical improvement of patients who have performed the ACCF procedure shows clinical improvement primarily starting in the 1-6 months postoperatively. The use of iliac dan metal have similar clinical and radiological outcome. The use of iliac graft can be used as the main choice in this procedure related to the level of efficiency especially in developing countries."

"Pendahuluan: Overweight dan obesitas adalah masalah kesehatan umum yang mempengaruhi mobilitas pasien pasca operasi. Memahami faktor-faktor yang memengaruhi mobilisasi pasca operasi pada populasi ini penting untuk meningkatkan hasil pemulihan. Metode: Penelitian kuantitatif non-eksperimental ini menggunakan survei potong lintang untuk menilai variabel yang berkaitan dengan mobilisasi pasca operasi pada pasien overweight/obesitas. Pengumpulan data melibatkan instrumen observasional dan analisis statistik. Hasil: Mayoritas responden adalah laki-laki (53.3%), berpendidikan SMA (41.3%), bekerja (56.0%), dan menikah (75.3%). Mayoritas memiliki overweight (76%), menjalani operasi pencernaan (27.3%), menerima anestesi umum (71.3%), memiliki riwayat operasi sebelumnya (61.3%), tanpa komorbiditas (66%), dan tanpa komplikasi pasca operasi (82.0%). Ditemukan hubungan signifikan antara jenis operasi, komplikasi, dan hari pasca operasi (POD) dengan tingkat mobilisasi. Diskusi dan Kesimpulan: POD yang lebih lama berdampak negatif pada mobilisasi, sementara jenis operasi berdampak positif. Rekomendasi: meliputi perawatan keperawatan yang disesuaikan, program manajemen berat badan, manajemen anestesi yang hati-hati, dan protokol mobilisasi dini yang terstruktur.

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Introduction: Overweight and obesity are prevalent health issues affecting post-surgical patient mobility. Understanding factors influencing post-surgical mobilization in this population is crucial for improving recovery outcomes.

Method: This quantitative non-experimental study utilized a cross-sectional survey to assess variables related to post-surgical mobilization in overweight/obese patients. Data collection involved observational instruments and statistical analyses.

Results: Majority of respondents were male (53.3%), educated to high school level (41.3%), employed (56.0%), and married (75.3%). Most had overweight (76%), underwent digestive surgery (27.3%), received general anesthesia (71.3%), had previous surgeries (61.3%), no comorbidities (66%), and no post-operative complications (82.0%). Significant associations were found between surgery type, complications, and days post-operative (POD) with mobilization levels.

Discussion and Conclusion: Higher POD negatively impacts mobilization, while surgery type positively influences it.

Recommendations: include tailored nursing care, weight management programs, careful anesthesia management, and structured early mobilization protocols"

"Meningioma merupakan tumor intrakranial primer yang paling umum terjadi, terhitung sepertiga dari semua tumor yang menyerang sistem saraf pusat. Meningioma dapat mempengaruhi beberapa dimensi kehidupan seperti fisiologis, psikologis, dan sosial. Pembedahan adalah penatalaksanaan utama pada pasien meningioma. Kualitas hidup pasien meningioma pasca pembedahan dipengaruhi oleh beberapa faktor. Tujuan penelitian ini adalah untuk mengidentifikasi faktor-faktor yang berhubungan dengan kualitas hidup pasien meningioma dalam waktu 3 bulan hingga 1 tahun pasca pembedahan. Penelitian ini menggunakan metode cross sectional. Sebanyak 118 pasien meningioma pasca pembedahan yang dipilih menggunakan teknik purposive sampling. Hasil penelitian menunjukkan bahwa mayoritas pasien meningioma pasca pembedahan memiliki kualitass hidup kurang baik (79,7%). Faktor-faktor yang berhubungan dengan kualitas hidup pasien meningioma pasca pembedahan adalah usia (p=0,014), grade tumor (p=0,0001), status fungsional (p=0,0001), fatigue (p=0,001), illness perception (p=0,0001), dan dukungan sosial (p=0,001). Hasil analisis multivariat menunjukkan faktor yang paling dominan berhubungan dengan kualitas hidup pasien meningioma pasca pembedahan adalah status fungsional dengan nilai OR 6,728 (CI 95%= 1,655; 27,348). Penelitian ini diharapkan dapat menjadikan acuan bagi perawat dalam mengembangkan pengkajian keperawatan pada pasien meningioma pasca pembedahan terkait kualitas hidup.

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Meningioma is the most common primary intracranial tumor, accounting for one third of all tumors that attack the central nervous system Meningioma can affect several domains of life such as physiological, psychological, and social life. Surgery is the main management in meningioma patients. The aim of this study was to investigate the factors influencing quality of life in meningioma patients after surgery. This study was a cross sectional analytic design involved. A total of 118 postoperative meningioma patients were selected by purposive sampling technique. The results of this study indicate that the majority of patients have low quality of life (79.7%). Factors related to quality of life were age (p = 0.014), tumor grade (p = 0,0001), functional status (p = 0,0001), fatigue (p = 0,001), illness perception ( p = 0,0001), and social support (p = 0,001). Multivariate analysis showed that the most dominant factor associated with the quality of life was functional status (OR 6.728). This study is to provide input to nurses as reference in developing nursing assesment in  meningioma patients after surgery related quality of life."

"Latar Belakang Refleks okulokardiak (OCR) dapat menyebabkan penurunan denyut jantung signifikan dan peningkatan risiko mual muntah pascabedah. Kejadian refleks okulokardiak dilaporkan berkisar antara 14% hingga 90% yang dipengaruhi oleh agen anestesi, premedikasi, dan proses saat operasi.2 Terdapat banyak faktor yang memengaruhi kejadian refleks okulokardiak. Penelitian ini bertujuan mengetahui faktor yang memengaruhi refleks okulokardiak pada pembedahan mata di RSUPN Dr. Cipto Mangunkusumo yang merupakan rumah sakit rujukan dengan karakteristik pasien yang bervariasiMetode Penelitian ini adalah penelitian analitik dengan desain potong lintang, menggunakan data pasien pembedahan mata dengan anestesi umum di RSUPN Dr. Cipto Mangunkusumo periode Mei 2023 - Februari 2024. Analisis perbedaan kelompok dengan OCR dan tanpa OCR dilakukan dengan uji Mann Whitney dan chi-square. Analisis multivariat dengan regresi logistik metode backward dilakukan pada variabel yang dianggap memiliki pengaruh yang signifikan dengan refleks okulokardiak. Hasil Dari 178 data pasien yang terkumpul dilakukan eksklusi sehingga terdapat 165 pasien yang dianalisis. Faktor usia anak (0-18 tahun) memiliki OR=0,143 (p=0,015), strabismus memiliki OR 14,843 (p=0,000), konsentrasi agen anestesi inhalasi (sevoflurane dan desflurane) < 1 MAC memiliki OR 5,070 (p=0,004) berpengaruh secara signifikan dengan kejadian OCR. Namun, dosis opioid tidak terbukti signifikan berpengaruh dengan kejadian OCR (p=0,840) Kesimpulan Penelitian ini menunjukkan adanya pengaruh yang signifikan antara usia, jenis bedah, dan konsentrasi agen anestesi inhalasi terhadap kejadian refleks okulokardiak pada anestesi pembedahan mata di RSUPN Dr. Cipto Mangunkusumo.

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Introduction

The oculocardiac reflex (OCR) can cause a significant decrease in heart rate and increase the risk of postoperative nausea and vomiting. Many factors influence the occurrence of OCR. The incidence of OCR ranges from 14% to 90%, depending on the anesthetic agents, premedication, and surgical procedure. This study aims to identify the factors influencing OCR during eye surgery anesthesia at RSUPN Dr. Cipto Mangunkusumo, a referral hospital with a diverse patient population.

Method

This was an analytical study with a cross-sectional design, using data from patients undergoing eye surgery under general anesthesia at Dr. Cipto Mangunkusumo National Central General Hospital from May 2023 to February 2024. The association was analyzed using the Mann-Whitney test and chi-square test. Multivariate analysis with the backward logistic regression method was performed on variables considered to have a significant relationship with the oculocardiac reflex.

Results

178 patient records collected and 165 patients of it were analyzed after exclusions. Younger age (0-18 years) was significantly associated with OCR (OR=0.143, p=0.015), as well as strabismus surgery (OR=14.843, p=0.000) and concentration of inhalation anesthetic (sevoflurane and desflurane) ≤ 1 MAC (OR=5.070, p=0.004). However, opioid dosage did not show a significant association with OCR (p=0.840). Conclusion This study shows a significant influence between age, type of surgery, and concentration of inhalation anesthetic with the incidence of OCR in eye surgeries anesthesia at RSUPN Dr. Cipto Mangunkusumo."

"[ABSTRAK Pendahuluan Metastasis KGB pada keganasan kolorektal merupakan penentu independen faktor prognosis dan tatalaksana lanjutan Saat ini sistem baku penentuan stadium keganasan kolorektal adalah menurut sistem TNM dengan melihat jumlah KGB yang positif anak sebar Klasifikasi Jepang KJ menentukan stadium keganasan kolorektal dengan melihat distribusi metastasis KGB parakolika pararektal intermediate dan pangkal arteri mesenterika tanpa melihat jumlah KGB nya Metode Studi pendahuluan ini melakukan analisis terhadap 15 pasien keganasan sigmoid dan rektum yang menjalani pembedahan di RSCM dan RSUP Fatmawati periode September Oktober 2015 Dilakukan penilaian histopatologi terhadap spesimen tumor aspek yang dinilai adalah jumlah KGB yang positif anak sebar dan distribusi metastasis KGB Berdasarkan hasil tersebut dilakukan penentuan stadium menurut sistem TNM dan Klasifikasi Jepang serta dilakukan analisis kesesuaian Hasil dan pembahasan Didapatkan ge 12 KGB dari semua sampel Menurut sistem TNM terdapat 7 pasien stadium II 3 pasien stadium IIIb dan 5 pasien stadium IIIc sedangkan pada Klasifikasi Jepang terdapat 7 pasien stadium II 1 pasien stadium IIIa dan 7 pasien stadium IIIb Kecocokan antara kedua sistem klasifikasi dalam mendapatkan stadium II adalah 46 67 Penentuan stadium IIIa KJ dan stadium IIIa b TNM dengan kecocokan sebesar 6 7 Kecocokan sebesar 13 3 dalam menentukan stadium IIIb KJ dan stadium IIIc TNM Analisis kesesuaian terhadap kedua sistem klasifikasi didapatkan nilai Kappa sebesar 49 3 Kategori Sedang dengan P value 0 04 Kesimpulan Pada studi pendahuluan ini didapatlkan tingkat kesesuaian antara kedua sistem klasifikasi dalam menentukan stadium keganasan sigmoid dan rektum dengan kategori sedang Klasifikasi Jepang dapat dijadikan salah satu pertimbangan Diperlukan sampel yang lebih besar untuk meningkatkan akurasi tingkat kesesuaian Kata kunci metastasis KGB kolorektal sistem TNM Klasifikasi jepangPendahuluan Metastasis KGB pada keganasan kolorektal merupakan penentu independen faktor prognosis dan tatalaksana lanjutan Saat ini sistem baku penentuan stadium keganasan kolorektal adalah menurut sistem TNM dengan melihat jumlah KGB yang positif anak sebar Klasifikasi Jepang KJ menentukan stadium keganasan kolorektal dengan melihat distribusi metastasis KGB parakolika pararektal intermediate dan pangkal arteri mesenterika tanpa melihat jumlah KGB nya Metode Studi pendahuluan ini melakukan analisis terhadap 15 pasien keganasan sigmoid dan rektum yang menjalani pembedahan di RSCM dan RSUP Fatmawati periode September Oktober 2015 Dilakukan penilaian histopatologi terhadap spesimen tumor aspek yang dinilai adalah jumlah KGB yang positif anak sebar dan distribusi metastasis KGB Berdasarkan hasil tersebut dilakukan penentuan stadium menurut sistem TNM dan Klasifikasi Jepang serta dilakukan analisis kesesuaian Hasil dan pembahasan Didapatkan ge 12 KGB dari semua sampel Menurut sistem TNM terdapat 7 pasien stadium II 3 pasien stadium IIIb dan 5 pasien stadium IIIc sedangkan pada Klasifikasi Jepang terdapat 7 pasien stadium II 1 pasien stadium IIIa dan 7 pasien stadium IIIb Kecocokan antara kedua sistem klasifikasi dalam mendapatkan stadium II adalah 46 67 Penentuan stadium IIIa KJ dan stadium IIIa b TNM dengan kecocokan sebesar 6 7 Kecocokan sebesar 13 3 dalam menentukan stadium IIIb KJ dan stadium IIIc TNM Analisis kesesuaian terhadap kedua sistem klasifikasi didapatkan nilai Kappa sebesar 49 3 Kategori Sedang dengan P value 0 04 Kesimpulan Pada studi pendahuluan ini didapatlkan tingkat kesesuaian antara kedua sistem klasifikasi dalam menentukan stadium keganasan sigmoid dan rektum dengan kategori sedang Klasifikasi Jepang dapat dijadikan salah satu pertimbangan Diperlukan sampel yang lebih besar untuk meningkatkan akurasi tingkat kesesuaian Kata kunci metastasis KGB kolorektal sistem TNM Klasifikasi jepang;ABSTRACT Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification;Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification;Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification;Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification, Introduction Lymph node metastasis of colorectal cancer is an independent prognostic factor and guidance for adjuvant therapy TNM staging system has been used widely and became the gold standart for colorectal cancer staging nowadays TNM staging system classified cancer staging based on numbers of positive lymph node metastasis whether Japanese Classification based on distribution of lymph node metastasis paracolic rectal intermediate root of mesenteric artery Method This preliminary study analyzed 15 patients of sigmoid and rectal cancer underwent surgery at Cipto Mangunkusumo Hospital and Fatmawati Hospital between September and October 2015 We sent the specimen for histopathological evaluation about numbers of positive lymph nodes and lymph node metastasis distribution Based on the findings stage classifications was done by TNM staging system and Japanese Classification then we did agreement analysis Result We found ge twelve lymph nodes from every sample Based on TNM staging system there are 7 patients on stage II 3 patients on stage IIIb and 5 patients on stage IIIc meanwhile based on Japanese Classification there is 7 patients on stage II one patient at stage IIIa and 7 patients at stage IIIb Analysis of agreement between both classification resulted Kappa coeffisient 49 3 Moderate category with P value 0 04Conclusion This preliminary study shows that agreement between both classification in determining sigmoid and rectal staging is moderate category Japanese classification is feasible to be used Agreement accuracy may be obtained by collecting bigger samples Keywords Colorectal lymphnode metastasis TNM system Japanese Classification]"