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CHAPTER IV

RESULT AND DISCUSSION

4.1 RESULT

Based on the data obtained from hospital medical records DR Hasan

Sadikin General Hospital obtained as follows:

Patients who are indicated for thoracotomy decortication

Indicated for thoracotomy decortication Total (%)

successfully undergo the procedures

5 (38.5%)

failed to undergo the procedures 8 (61.5%)

From the total 13 patients who are indicated for thoracotomy

decortication, only 5 patient successfully undergo the operation while the rest is

failed to undergo the procedures. The main reason for failing the procedure is

because the patient refuse the operation due to the uncertainty of the operation

time, some afraid of the operation, and one patient died during the treatment 15

days after the decision to undergo the operation

Table 4.1.2.after undergo the procedures

Condition after operation Total (%)

Safely return home 5 (100%)

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Died in hospital 0 (0%)

All 5 patient safely return home after the procedures with no mortality

Total waiting time

Total waiting time Total (%)

< 5 days 0 (0 %)

> 5 days 5 (100 %)

All patients have to wait more than 5 days to undergo the operation, all

because there is no available intensive care for the post-operative treatment so the

operation has to be postponed although the patient has been indicated and ready

for thoracotomy decortication.

This uncertainty led to some patients eventually decided not to undergo

surgery. We noticed that the fastest waiting time for this procedures is 6 days and

one patient has to wait for 30 days to undergo this procedures, with the average

waiting time 14.8 days.

Post operative treatments

Post operative treatments Total (%)

< 5 days 2 (40%)

5 – 10 days 1 (20%)

> 10 days 2 (40%)

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The average post-operative treatment for thoracotomy decortication is

between 5- 10 days. In our study the fastest post-operative treatment is 3 days

treatment and the longest is 12 days treatment with the average 7.6 days post-

operative treatment

We noted that the average length of stay for patient who indicated for

thoracotomy decortication surgery is 42 days.

4.2 DISCUSSION

There are 8 (61.5 %) patient who failed to undergo thoracotomy

decortication from 13 patient who are indicated for this procedures. The main

reason for this to happen is the uncertainty of the operation time, some patient has

to wait for 30 days to undergo this procedure because of the unavailability of post-

operative intensive care.

The discrepancy between the number of available intensive room and the

number of demand make it very difficult for the patient to access an intensive care

unit.

And it lead us to some delaying and cancelation of the procedure and

eventually make the length of stay prolonged. With the prolonged length of stay it

will increase the risk of nosocomial infection such as pneumonia or other disease

and definitely will not make any benefit for the patient nor the hospital. It will

aggravated the disease, increasing the physiological burden, be a burden to the

family, and even risk the life of the patient and finally will increased the health

cost.

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Before the clinician decide a patient whether needed thoracotomy

decortication or not, some diagnosis and criteria has to meet first and of course it

also take time and money, we noted that the average length of stay for patient who

indicated for thoracotomy decortication surgery is 42 days. Imagine how much

money the government or the patient has to spend or how much risk factor for

nosocomial infection to happen. It is definitely a high cost health and far from an

ideal health system.

The overall outcome patient who has been undergo thoracotomy

decortication is excellent, although thoracotomy decortication is one of many

risky operative, all patient has return safely to their house with the average 7.6

days post-operative treatment