Efektivitas Pemberian Metilprednisolon terhadap Pembentukan Seroma Pascaoperasi Mastektomi Modifikasi Radikal

Abstract

Seroma adalah pengumpulan cairan serous di subkutis dan merupakan komplikasi pascaoperasi kanker payudara yang paling sering dijumpai. Insidensinya mencapai lebih dari 60%. Walaupun tidak mengancam jiwa, namun dapat menimbulkan morbiditas yang serius. Berbagai penelitian dilakukan untuk menentukan faktor risiko untuk mencegah timbulnya seroma. Saat ini, seroma terjadi karena proses inflamasi pascaoperasi. Teori inilah yang mendasari peranan antiinflamasi terhadap pembentukan seroma. Diketahui obat golongan glukokortikoid, memiliki peranan menghambat respons inflamasi. Tujuan penelitian ini untuk menilai efek profilaksis pemberian metilprednisolon perioperatif mastektomi terhadap pembentukan seroma. Penelitian ini merupakan uji klinis secara acak tersamar ganda terhadap 2 kelompok, yaitu antara kelompok karsinoma payudara stadium lokal lanjut yang diberikan metilprednisolon perioperatif mastektomi sebagai kelompok perlakuan dan kontrol. Penelitian ini dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung, periode April–Juli 2013. Subjek penelitian meliputi 30 wanita yang memenuhi kriteria inklusi dan dibagi menjadi dua kelompok, 15 pasien diberikan metilprednisolon dan 15 pasien sebagai kontrol. Penelitian ini menggunakan uji-t tidak berpasangan dan Mann Whitney. Didapatkan perbedaan rata-rata volume drainase hari ke-1, pada kelompok metilprednisolon sebanyak 104,7 mL dan pada kontrol sebanyak 158 mL, namun secara statistik tidak bermakna (p=0,053). Demikian pula dengan hari-hari selanjutnya dan total seroma, tidak didapatkan perbedaan yang bermakna. Simpulan, pemberian metilprednisolon tidak efektif menurunkan volume drainase seroma pascaoperasi mastektomi. [MKB. 2014;46(2):88–93]

Kata kunci: Mastektomi, metilprednisolon, seroma

Effectiveness of Methylprednisolone on Post-Operative Seroma Formation Following Radical Modified Mastectomy

Seroma is a collection of serous fluid in the subcutaneous and is the most common complication of breast cancer surgery. The incidence is more than 60%. Although it is not life-threatening but it can cause serious morbidity. Various studies were conducted to determine the risk factors to prevent seroma formation. Currently, seroma occurrs due to postoperative inflammatory processes. This theory underlies the antiinflammatory role for seroma formation. Glucocorticoid drugs is known as playing a role in inhibiting the inflammatory response. The purpose of this study was to assess the prophylactic effect of perioperative administration of methylprednisolone on seroma formation. This study was a double-blind randomized control trial of 2 groups, i.e. a group of locally advanced breast carcinoma which were given methylprednisolone perioperatively as a treatment group and a control group. The research was conducted in Dr. Hasan Sadikin General Hospital Bandung from April to July 2013. Thirty women who met the inclusion criteria were included as subjects who were then divided into two groups: 15 women received methylprednisolone and 15 women serve as controls. This study used independent t and Mann-Whitney tests. There was a difference in the mean volume of drainage on day 1 between the methylprednisolone and control group as much as 104.7 mL and 158 mL, respectively, but not statistically significant (p=0.053). The same situation was also seen for the following days and total seroma, which was no significant difference was found. In conclusion, the use of methylprednisolone is not effective for reducing postoperative seroma drainage volume after mastectomy. [MKB. 2014;46(2):88–93]

Key words: Mastectomy, methylprednisolone, seroma

DOI:  10.15395/mkb.v46n2.279