KADAR KORTISOL, TRANSFORMING GROWTH FACTOR β (TGF-β), SERTA DERAJAT ADHESI PASCA LAPAROSKOPI DAN LAPAROTOMI (Penelitian Eksperimental pada Kelinci yang Dilakukan Abrasi Ileum)

Abstract

ABSTRACT Background: Intraperitoneal adhesions after abdominal surgery occurred in 50-97% cases, and the most cause is laparotomy. This research was done to know the difference between laparoscopy and laparotomy regarding the peritoneal adhesion degree, cortisol and TGF- β level. Material and Method: A randomized control trial post test only design was done on both groups. The 1st group (X1) was performed laparotomy and ileum abrasion, while the 2nd group (X2) was performed laparoscopy, both treatment performed under general anaesthesia. The blood sampel was taken just before and 6 hours after operation to measure the cortisol level. Seven days later, both groups were terminated by making vertebrae cervical dislocation and than performed laparotomy to assess the intraperitoneal adhesion and to collected the peritoneal fluid to measure the TGF-β levels. The differences regarding cortisol and TGF-β level were analyzed by independent t-test, while the intraperitoneal adhesion was analyzed by Mann Whitney. Pearson’s test was performed to analyze the correlation between cortisol and TGF-β level, while the correlation between TGF-β level and the adhesion degree analyzed by Spearman’s test. Result: There were significant difference in the cortisol (mean 20,03 ± 1,550 ng/ml.), TGF-β level (mean 6.772,50 ± 414,77 pg/ml.)and the adhesion degree among both groups (p = 0.021, p < 0.001, p = 0.002 ). There were strong positif correlation between cortisol with TGF-β level (p = 0.030, r = 0.632) and very strong positive correlation between TGF-β level with the adhesion degree (p = 0.001, r = 0.941). Conclusion : Laparoscopic surgery can minimize the increase of the TGF-β and cortisol level, so as to lower the incidence of adhesion. Key words : Degrees of adhesion, cortisol, TGF-β,laparotomy, laparoscopy.