HUBUNGAN ANTARA PENINGKATAN KADAR KORTISOL DARAH SEBAGAI RESPON TERHADAP STRESS DAN KADAR INTERLEUKIN-1 (IL-1) DENGAN DERAJAT ADHESI PASCA LAPAROTOMI DAN LAPAROSKOPI Penelitian Eksperimental pada Kelinci yang Dilakukan Abrasi Ileum

Abstract

Background : Post-operative abdominal peritoneal adhesions and the peLvis is a natural consequence of the peritoneal irritation due to infection or trauma surgery and the healing process, and the leading cause of morbidity. Most cause adhesion is the act of laparotomy than laparoskopic due to trauma and wounds considered more extensive.Peritoneal trauma operation besides stimulate the stress immune systemic marked by increasing levels cortisol blood, also causing migration and watchword some mediatory an immune response ( for example: IL-1, IL-6, IL-8, TNF-α ) hat initiated the activity of extrinsic coagulation resulting fibrin matrix, which ultimately happened adhesion process. On this research gonna prove the relations between levels of blood cortisol as response stress with elevated levels of IL-1 and degrees of adhesion after laparotomy and laparoskopy. Material and Method : A randomized post test only control group design on 12New Zealand were divided into 2 groups. The first group ( K1) was performed laparotomy with abration the ilium , group-2 ( K2) was performed laparoscopy with abration the ilium too.. All groups taken its blood sample befpre and 6 hours post operative to be assessed levels of cortisol with ELISA kit. Six days after operation , all group determinate and performed laparotomy, than assessed the degree of adhesion and the level of IL-1α from its peritoneal fluid. Statistical tests were used to assess defferences in the level of cortisol, IL-1α and degree do adhesion between laparotomy and laparoscopy. Pearson’s correlation test was performed to analyze the correlation between the level of cortisol and IL-1 .Correlation between the level of IL-1 and the degree of adhesion analyzed by Spearman’s correlation test. Result : There was significant difference in the level of cortisol, IL-1α and degree of adhesion among groups ( p = 0.021, p = 0.001, p = 0.002 ). There were positive correlation ( medium ) between the level of blood cortisol with IL-1α ( r = 0.688, p = 0.013 ) and significant positive correlation between the level of IL-1α with the degree of adhesion ( r=0,833, p = o.oo1 ). Conclusion : Laparoscopic surgery can minimize the effects of systemic stress and immune response, so as to lower the incidence of adhesion. Key words : Degrees of adhesion, cortisol, IL-1 α, laparotomy, laparoscopy.