TERAPI GIZI PADA ADENOCARSINOMA ESOPHAGEAL JUNCTION POST GASTRECTOMI PARTIAL DAN GASTROSTOMI FEEDING
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Abstract
Intervensi nutrisi harus menjadi bagian penting dari pendekatan multimoda terhadap kanker kaheksia. Tujuan utama terapi nutrisi pada penderita kanker adalah mempertahankan atau meningkatkan status gizi sehingga dapat memperkecil terjadinya komplikasi, meningkatkan efektivitas terapi kanker (bedah, kemoterapi, radiasi), kualitas hidup dan survival penderita. Pria usia 60 tahun dikonsulkan dengan diagnosis Gastroesophageal junction adenocarcionma (GEJAC) dan malnutrisi berat (Subjective Global Assesment Skor C). Pasien memiliki riwayat asupan yang kurang dan perubahan konsistensi asupan selama 6 bulan dan memberat 1 bulan terakhir karena disfagia. Terapi nutrisi pre-operatif diberikan dengan target 2100 kkal secara bertahap melalui oral dan parenteral dengan protein 1,5 gram/kgBB ideal/hari. Pemberian nutrisi post-operasi dimulai bertahap melalui enteral (gastrostomi) dan parenteral dengan protein dinaikkan menjadi 1,7 gram/kgBB ideal/hari. Pada akhir masa perawatan terdapat perbaikan metabolik seperti albumin dan jumlah leukosit dari post-operasi hingga akhir masa perawatan. Penganan nutrisi perlu dilakukan pada pasien kanker yang akan menjalani operasi untuk optimalisasi kondisi pre-operasi dan memperbaiki klinis dan metabolik pasien post-operasi.
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