Serum markers for the early diagnosis of intestinal anastomotic leak after gynaecological operations


Kuru O., Cakir I., AKGÖR U., Sen S., Gorgulu G., Ozdemir H. E. , ...More

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, 2021 (Peer-Reviewed Journal) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume:
  • Publication Date: 2021
  • Doi Number: 10.1111/ijcp.14609
  • Journal Name: INTERNATIONAL JOURNAL OF CLINICAL PRACTICE
  • Journal Indexes: Science Citation Index Expanded, Scopus, CAB Abstracts, CINAHL, EMBASE, International Pharmaceutical Abstracts, MEDLINE

Abstract

Objective To analyse the serum markers for the early diagnosis of intestinal anastomotic leak (AL) after the gynaecological operations. Methods Between September 2017 and March 2021, patients with an intestinal anastomosis performed during the gynaecological surgeries were identified from a tertiary centre in Turkey. As the local guideline of the clinic, all these patients were followed by measuring serum samples including procalcitonin (PCT) and C-reactive protein (CRP) on postoperative day (POD) 1 through the day of discharge or the day of re-operation for AL. Results 12.5% (5/40) of the patients suffered an AL and 4 of them were re-operated. The mean albumin values on POD 3-4 and the mean platelet values on POD 1 were lower in the AL group (P < .05). Although it was not statistically significant (P > .05), median PCT values (ng/mL) on POD 8-10 were higher in the AL group compared with no leak group. The best cut-off point for PCT on POD 9 was determined to be 0.11 ng/mL (AUC: 0.917, Sensitivity = 100.0%, specificity = 66.7%, positive predictive value = 66.7%, negative predictive value = 100.0%). Conclusion Serum PCT and CRP concentrations were not found to be helpful for the early diagnosis of AL in patients operated for gynaecological malignancies. Low levels of albumin and platelets in the first days after the operation may be clue for a possible AL.