Rasio Neutrofil Limfosit sebagai Prediktor Kejadian Kebocoran Anastomosis pada Pasien Kanker Kolorektal
DOI:
https://doi.org/10.35790/ecl.v12i3.58246Abstract
Abstract: Anastomotic leakage is a serious complication following colorectal cancer resection that can increase morbidity and mortality. This study aimed to analyze the potential of the neutrophil-lymphocyte ratio (NLR) as a predictor of anastomotic leakage in colorectal cancer patients. This was a retrospective analytical and observational study involving 30 patients who underwent colorectal cancer resection and anastomosis at Prof. Dr. R. D. Kandou Hospital in Manado. The NLR values were analyzed preoperatively and on the first (D+1), third (D+3), fifth (D+5), and seventh (D+7) postoperative days. The results showed significant differences in NLR values between leakage and non-leakage groups across all phases (p<0.001). The receiver operating characteristic (ROC) curve analysis yielded optimal NLR cut-offs for leakage prediction: preoperative >2.1150, D+1 >3.4750, D+3 >2.7650, D+5 >3.0200, and D+7 >3.2850, with sensitivity and specificity reaching 100% in several phases. In conclusion, neutrophil-lymphocyte ratio has a potential as an accurate predictor of anastomotic leakage, enabling early detection and improved risk management. Further research with larger samples is needed to validate these findings and explore their clinical applications.
Keywords: neutrophil-lymphocyte ratio; anastomotic leakage; colorectal cancer
Abstrak: Kebocoran anastomosis merupakan komplikasi serius pasca reseksi kanker kolorektal yang dapat meningkatkan morbiditas dan mortalitas. Penelitian ini bertujuan menganalisis potensi rasio neutrofil limfosit (RNL) sebagai prediktor kejadian kebocoran anastomosis pada pasien kanker kolorektal. Penelitian ini menggunakan metode observasional analitik retrospektif, melibatkan 30 pasien yang menjalani reseksi dan anastomosis kanker kolorektal di RSUP Prof. Dr. R. D. Kandou Manado. Nilai RNL dianalisis pada fase preoperatif, hari pertama (H+1), ketiga (H+3), kelima (H+5), dan ketujuh (H+7) pasca operasi. Hasil penelitian memperlihatkan perbedaan bermakna nilai RNL antara kelompok kebocoran dan tanpa kebocoran pada semua fase (p<0,001). Analisis kurva ROC menghasilkan cut-off optimal RNL untuk prediksi kebocoran: preoperatif >2,1150, H+1 >3,4750, H+3 >2,7650, H+5 >3,0200, dan H+7 >3,2850, dengan sensitivitas dan spesifisitas mencapai 100% pada beberapa fase. Simpulan penelitian ini ialah rasio neutrofil limfosit memiliki potensi sebagai prediktor yang akurat untuk kebocoran anastomosis, serta memungkinkan deteksi dini dan manajemen risiko yang lebih baik. Penelitian lebih lanjut dengan sampel yang lebih besar diperlukan untuk memvalidasi temuan ini dan mengeksplorasi aplikasi klinisnya.
Kata kunci: rasio neutrofil limfosit; kebocoran anastomosis; kanker kolorektal
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