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"Latar belakang. Adenokarsinoma kolorektal AKR merupakan keganasan gastrointestinal yang sering ditemukan dan mempengaruhi lebih dari satu juta individu di seluruh dunia. Identifikasi histologis invasi limfovaskular telah dikenali sebagai indikasi potensial untuk metastasis KGB dan indikasi prognostik dan prediktor dari luaran pasien.Metode.Penelitian ini adalah penelitian retrospektif dengan regresi logistik multivariat.Hasil. Hasil penelitian didapatkan faktor usia, diferensisasi tumor, pT, dan jenis kelamin tidak mempengaruhi kejadian invasi limfovaskular. AKR diferensiasi sedang dan jenis kelamin laki-laki didapatkan kejadian invasi limfovaskular yang lebih besar dibanding diferensiasi lain dan jenis kelamin perempuan.Kesimpulan. Faktor-faktor yang mepengaruhi invasi limfovaskular yaitu diferensiasi tumor, usia, jenis kelamin, lokasi tumor dan derajat patologis T tidak bermakna secara statistik. Invasi limfovaskular merupakan prediktor terjadinya metastasis KGB.

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Background. Adenocarcinoma colon and rectum are the most common gastrointestinal malignancy and afflict more than one million individual worlds wide. Histologic finding of limphovascular invasion has known as potensial indication for lymphatic metastatic and prognostic indication and predictor of patient outcome.Methods. This studi was retrospective, logistic regression test was used for multivariate analysis.Result. Result of this study ara gender, age, tumor differentiation and pT not significantly related to lymphovascular invasion. Mild differentiation and male gender recorded had bigger risk to had lymphovascular invasion descriptively.Conclusion. Factors affecting lymphovascular invasion ie tumor differentiation, age, sex, tumor location and pathologic T degree were not statistically significant. Lymphovascular invasion is a predictor of limph nodes metastasis."

"ABSTRAK Kanker kolorektal merupakan salah satu penyakit kanker yang angka kejadiannya semakin meningkat. Tujuan penelitian ini menganalisis faktor-faktor yang berhubungan dengan kualitas hidup penderita kanker kolorektal. Penelitian pre eksperimental korelasional deskriptif dengan menggunakan desain kajian potong lintang dengan tehnik total sampel yang menderita kanker kolorektal. Sampel berjumlah 50 orang yang diperoleh dari RS di Kota Makassar. Data dianalisis dengan menggunakan uji korelasi Pearson dan Spearman untuk melihat hubungan serta uji Chi square untuk melihat perbedaan. Hasil penelitian menunjukkan bahwa ada hubungan antara fatigue dengan kualitas hidup penderita kanker kolorektal (p˂ 0,05), ada hubungan antara depresi dengan kualitas hidup penderita kanker kolorektal (p˂ 0,05), dan ada perbedaan status perkawinan dengan kualitas hidup penderita kanker kolorektal (p˂ 0,05) sehingga melalui uji regresi linear didapatkan depresi merupakan faktor yang paling berhubungan dengan kualitas hidup penderita kanker kolorektal (p˂ 0,05). Aspek psikis merupakan komponen penting yang perlu diperhatikan dalam merawat pasien kanker kolorektal untuk mendapatkan kualitas hidup yang lebih baik.ABSTRACTDepression Related to Life Quality of Colorectal Cancer Patients in Makassar City Hospital. Colorectal cancer is a cancer which incidence increased year by year. This research aimed to analyse factors related to the quality of life of patients with colorectal cancer. The research applied descriptive pre-experimental correlations with a cross-sectional study design with a total sample technique of colorectal cancer. A sample of 50 people was obtained from the hospital in the city of Makassar. Data were analyzed using the Pearson and Spearman correlation test to find out the relationship, and Chi square test to find out the difference. The results showed that there was a relationship between fatigue and the quality of life of patients with colorectal cancer (p˂0,05) there was a relationship between depression and quality of life of patients with colorectal cancer (p˂0,05), and there were differences in marital status and quality of life for cancer patients colorectal (p˂0,05), so that through a linear regression test found depression was the most associated factor with quality of life of patients with colorectal cancer (p˂0,05). The important point during taking care of patients with colorectal cancers is consent in the psychological aspects to have a better quality of life."

"Loss of adenomatous polyposis coli (APC) function is typically an early event in sporadic colorectal cancer (CRC) pathogenesis. The key tumor suppressor function of the APC protein lies in its ability to destabilize free cytoplasmic beta catenin. This lead to the accumulation of nuclear beta catenin, and together with the DNA binding protein Tcf-4, function as a transcriptional activator. Accumulation of stabilized free â-catenin is considered as an early event and perhaps initiating the process in intestinal tumorigenesis. Neoplastic transformation in the CRC associated chronic colitis is considered similar to the adenoma-carcinoma sequence in sporadic CRC. The distinguish feature from the CRC-related colitis is the difference in time and frequency changes. Loss of APC function, regarded as the beginning of a very common event in sporadic CRC, but the CRC associated chronic colitis generally occurs at the end of the dysplasia-carcinoma sequence. This research was conducted to determine the subcellular location of beta catenin expression in chronic colitis, colorectal adenomas and carcinomas that were evaluated by immunohistochemical staining. It can be concluded that beta-catenin is a component that plays a role in the development of the CRC and the subcellular location of beta-catenin can describe its oncogenic activity."

"Latar Belakang : Kanker Kolorektal (KKR) masih menjadi masalah besar di dunia pada umumnya dan di Indonesia pada khususnya. Kolonoskopi dapat melihat lesi di kolon tetapi biayanya mahal bila dilakukan pada semua pasien asimtomatik. Memakai komponen unsur-unsur APCS dapat memprediksi KKR pada pasien simtomatik sehingga kolonoskopi hanya merupakan modalitas untuk menstratifikasi KKR.Tujuan : Mengetahui probabilitas kanker kolorektal menggunakan unsur-unsur APCS pada penderita simtomatik.Metode : Penelitian kasus-kontrol retrospektif dilakukan di RS Cipto Mangunkusumo Jakarta, sejak bulan Februari 2014 hingga Mei 2014. Data dikumpulkan dari catatan rekam medis pasien di RSCM. Kelompok kasus adalah subjek dengan kanker kolorektal, kelompok kontrol adalah subjek non-kanker kolorektal. Analisis bivariat dilakukan pada 4 variabel bebas dari unsur-unsur APCS yaitu usia, jenis kelamin, riwayat keluarga menderita KKR dan merokok. Semua variabel yang mempunyai nilai p<0,25 pada analisis bivariat dimasukkan ke dalam analisis multivariat dengan regresi logistik.Hasil : Pada 246 subjek, didapatkan wanita 127 (51,6 %), laki-laki 119 (48,4 %). Rerata usia 53 tahun, rentang usia 17 sampai 90 tahun. Berdasarkan hasil analisis multivariat terdapat dua variabel probabilitas terjadinya KKR berdasarkan unsurunsur APCS yang memiliki kemaknaan secara statistik, yaitu usia ≥50 tahun (OR 1,682; IK 95% 1,002-2,823; p=0,049) dan riwayat keluarga menderita KKR (OR 4,865; IK 95% 1,340-17,665; p=0,016). Probabilitas terjadinya KKR usia ≥ 50 tahun : 53,33%, penderita yang ada riwayat keluarga menderita KKR: 76,49%, usia ≥ 50 tahun serta ada riwayat keluarga menderita KKR : 84,74%. Probabilitas terjadinya KKR penderita simtomatik pada jenis kelamin dan merokok tidak bisa digunakan pada penelitian ini.Kesimpulan : Probabilitas terjadinya KKR pada populasi simtomatik paling tinggi pada usia diatas 50 tahun disertai dengan riwayat keluarga KKR.

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Background : Colorectal cancer (CRC) is still a major problem in the world in general and Indonesia in particular. Colonoscopy can see lesions in the colon but it is expensive if done at all asymptomatic patients. Wearing component elements of APCS can predicted CRC in symptomatic patients that colonoscopy is the only modality for stratifying CRC.

Objective: To determine the probability of colorectal cancer in patients with symptomatic use APCS.

Methods : The study uses a retrospective case-control study. Data were collected from patient medical record in RSCM. Group of cases is subject to the colorectal cancer, the control group is the subject of non-crc. Bivariate analyzes performed on 4 independent variables are age, gender, family history and smoking suffer crc. All variables that have a value of p <0.25 on bivariate analysis included in the multivariate analysis with logistic regression.

Results: In 246 subjects, found 127 women (51.6 %), 119 men (48.4%). Mean age 53 years, age range 17 to 90 years. Based on the results of the multivariat analysis, there are two variables that had a statistically significance, ie age ≥ 50 years (OR 1.682; CI 95% 1.002 to 2.823, p = 0.049) and family history suffer from CRC(OR 4.865; CI 95% 1.340 to 17.665 p = 0.016). The probability of CRC patients with symptomatic at age ≥ 50 years is 53.33%, patients who have a family history of suffering from the CRC was 76.49%, while patients aged ≥ 50 years and had family history of the CRC is at 84.74 %. The probability of the occurrence of symptomatic patients CRC on sex and smoking can not be used in this study.

Conclusion: The probability of colorectal cancer finding was highest among patient with age above 50 years and family history of CRC."

"ABSTRAK Pembedahan terbuka kolorektal mempunyai morbiditas yang tinggi. Laparoskopi kolorektal pertama kali diperkenalkan pada tahun 1991 dengan hasil morbiditas pascabedah yang rendah. Penelitian ini mengambil total sampel subjek kanker kolorektal yang menjalani pembedahan laparoskopi pada tahun 2010 hingga 2015. Data ditabulasi dan dianalsis untuk mendapatkan hasil jangka pendek dan kesintasan lima tahun. Didapatkan 65 data dengan 21 kasus kolon 32,3 dan 44 kasus rektum 67,7 ; 34 pria 52,3 31 wanita 47,7 dengan rata ndash;rata usia 57,17 tahun SD 13.380 . Pada kelompok kolon didapatkan rata ndash;rata durasi bedah 216,75 menit SD 65,94 dan kehilangan darah 159,75 mL SD 125,47 . Median VAS adalah empat; diet, mobilisasi dan lama rawat pascabedah didapatkan pada dua, empat dan tujuh hari. Kesintasan lima tahun pasien didapatkan 83 . Tidak ada komplikasi, pembedahan ulang dan infeksi luka operasi ILO pada kelompok ini. Pada kelompok rektum rata ndash;rata durasi bedah adalah 305,97 min SD 94,23 dan perdarahan intra operasi 150 mL SD 50 . Median VAS pascabedah tiga, diet dan mobilisasi pascabedah dua hari dan empat hari. Lama rawat pascabedah delapan hari. Kesintasan lima tahun adalah 58,5 . Morbiditas pascabedah lebih rendah dengan pembedahan laparoskopi dengan hasil kesintasan keseluruhan yang tidak berbeda dengan kesintasan pasien kanker kolorektal yang ditangani sebelumnya. ABSTRACT Conventional colorectal cancer surgery is often associated with high post operative moribidities. Laparoscopic colorectal surgery has reduced post operative morbidities with same survival outcomes of open surgery. Retrospective data of laparoscopic colorectal cancer surgery from 2010 to 2015 were collected, tabulated and analyzed to get early results and five years survival rate. There were 65 data, 21 colon cancer 32.3 and 44 rectal cancer 67.7 . Higher incidence of male patients n 34, 52.3 than female n 31, 47.7 with mean age of 57,17 13.38 years. Length of operation for colon group was 216.75 SD 65.94 mins with intra operative blood loss 159.75 SD 125.47 mL and post operative pain, on visual analog score VAS , was 4 2 5 . Post operative diet, mobilization and length of stay were 2 1 3 days, 4 2 7 days and 7 4 12 days respectively. The five years survival rate was 83 . In rectal group, length of operation was 305,97 SD 94,23 mins with intra operative blood loss 150 SD 50 mL. Post operative VAS, diet, mobilization and length of stay were 3 2 5 , 2 1 4 days, 4 2 22 days and 8 5 36 days respectively. Five years survival rate was 58.5 . Post operative morbidities in colorectal cancer decreases with laparoscopic resection with satisfactory overall survival rate."

"Colorectal polyp is one important factors that have roles in developing malignancy of lower gastrointestinal tract. Adenomatous polyp is the most common colorectal polyps and it has been known as a lesion precusor for transformation process in developing gastrointestinal malignancy...."

"Latar Belakang: Protokol ERAS (Enhanced Recovery After Surgery) adalah sebuah strategi perioperatif berbasis bukti, yang terbukti dapat menurukan lama perawatan pascaoperas dan angka komplikasi pada kasus pembedahan di bidang kolorektal. Penerapan ERAS terdiri atas 15 komponen, namum evaluasi penerapan komponen ini bila dihubungkan dengan luaran masih belum jelas. Metode: Studi retrospektif dilakukan kepada 63 pasien yang telah menjalani operasi elektif kolorektal berbasis protokol ERAS dari Januari 2015 hingga Desember 2017 di Rumah Sakit Cipto Mangunkusumo. Karakteristik pasien, demografi, termuan klinis dan lama perawatan dikumpulkan dari rekam medis. Hubungan antara jumlah komponen ERAS yang diterapkan dikaitkan dengan lama rawat dianalisis. Hasil: Semua pasien diterapkan jumlah komponen ERAS hingga maksimal 11 komponen dari total 15 komponen. Usia rata-rata pasien adalah 53 tahun; 46% pasien laki-laki, dan 54% perempuan. Tidak ditemukan angka mortalitas. Angka morbiditas sebesar 7,9%, disebabkan oleh infeksi luka operasi 1,6%, pneumonia 1,6%, dan retensi urin 4,8%. Lokasi tersering dari tumor kolorektal adalah sigmoid (47%). Prosedur operasi yang paling sering dikerjakan adalah tutup kolostomi (25,4%). Terdapat hubungan yang bermakna antara jumlah penerapan komponen protokol ERAS dan lama perawatan pasca operasi. (p<0.01, r = 0,568). Kesimpulan: Semakin banyak jumlah komponen ERAS yang diterapkan ke satu pasien, semakin singkat lama perawatan pasca operasi. Kata kunci: Enhanced Recovery After Surgery, Evaluasi, Kolorektal 

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Background. The enhanced recovery after surgery (ERAS) protocol in colorectal surgery has proven to be effective in reducing postoperative length of stay and perioperative complications rates in hospital. At Cipto Mangunkusumo Hospital, ERAS protocol for colorectal surgery has been known since 2015. However, there has never been a program evaluation of the ERAS components that has been applied in relation to outcomes.

Method. Sixty-three colorectal patients who underwent surgical procedures from 2015 to 2017 were retrospectively evaluated for complete implementation of ERAS protocol. Complete implementation is defined as the ability to accomplish 15 ERAS components. Demographic, clinical data, and length of stay (LOS) were also collected from medical records.

Results. Up to 11 out of 15 ERAS components were implemented to 63 patients. The proportion of male was 46% compare to female was 54%. The average age was 53 years old; mortality rates 0%, morbidity rates 7,9% (surgical site infection 1,6%; pneumonia 1,6%; and urinary retention 4,8%). The most common location of tumor and procedure were sigmoid (47,6%), colostomy closure (25,4%). It is found that there is a relationship between the total number of components that are corresponding to ERAS protocol per subject and the average length of stay. The more number of ERAS components that are fulfilled per subject, the shorter the average length of subject visits became (p<0,01, r = 0,568).

Conclusion. Cipto Mangunkusumo Hospital does not yet have an ERAS protocol for colorectal surgery, but has implemented 11 ERAS components out of a total of 15 ERAS components from Toronto as a perioperative management. The greater number of ERAS components that are applied to one subject, the shorter the postoperative care.

Keyword: Colorectal, enhanced recovery after surgery, evaluation"

"ABSTRACTWe conducted this study to establish whether drinking alcohol alters the risk of early-onset colorectal cancer (CRC) in Japanese patients with Lynch syndrome (LS). The subjects were 66 LS patients with pathogenic mutation of mismatch repair genes (MLH1, MSH2, and MSH6) from the nationwide Japanese retrospective multicenter study. Cox proportional hazards modeling was used to investigate the factors correlating with early-onset CRC diagnosis, using clinical data such as gender, tobacco use, alcohol consumption, body mass index, gene mutation (MLH1, MSH2 vs MSH6), and family cancer history. Alcohol was significantly correlated with an increased risk of early-onset CRC [HR 2.44, 95% CI 1.13-5.16 (p = 0.02)], but tobacco use was not [HR 0.8, 95%CI 0.38-1.62 (p = 0.53)]. These findings suggest that alcohol consumption is correlated with an earlier onset of CRC in Japanese patients with LS."

"Angka kejadian kanker kolorektal sebagai penyakit keganasan menduduki urutan kedua setelah kanker payudara pada wanita dan kanker paru pada pria.Karsinoma pada daerah kolon asenden dan tranversus biasanya menyebabkan perdarahan sedikit demi sedikit dan tidak dapat dideteksi oleh mata serta tidak menyebabkan rasa sakit.Tes kolon albumin merupakan tes imunokimia pertama untuk menentukan adanya albumin yang berasal dari darah pada penyakit kolorektal dan tes ini tidak memerlukan persiapan diit. Sampai saat ini pemeriksaan darah samar dalam tinja masih banyak menggunakan bensidin, o-tolidin, guaiak, tetapi untuk pemeriksaan dengan cara tersebut banyak kendalanya.Dalam penelitian ini dilaporkan hasil penelitian banding kedua pemeriksaan di atas terhadap 18 tinja penderita dengan suspek keganasan kolorektal. Kahan penelitian diambil dari 11 orang laki-laki dan 7 orang perempuan yang berusia antara 21-54 tahun. Dilakukan pula uji diagnostik dengan memakai kontrol pasangan penderita. Dengan tabel kontingensi 2 X 2 diperoleh sensitivitas 100%, spesifisitas 93,7% dan akurasi 96,77%

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Colon Albumin Test as a Screening Test for Colorectal Cancer

Colorectal cancer is the second most cancer found preceded by breast cancer in woman and lung cancer in men. Cancer of the ascending and transverse colon usually did not cause profuse bleeding that could be observed macroscopically and did not cause pain.

The colon albumin test is a novel immunochemical test to detect albumin caused by bleeding in the colorectal regions. ND diet restriction is required before performing this test. Although the gold standard tests using benzidine, o-tolidin or guaiac were still commonly used, many obstacles were also reported.

In this study, a comparative examination was done on 18 stool amples were obtained from 18 subjects with suspicious of colorectal cancer. Specimens were taken from 11 males and 7 females, 21 until 54 years old. Diagnostic test was done using matched controls. Using 2 X 2 contingency table it was found a 100%, sensitivity, 93,7% spesificity and 96,7% accuracy."