Serum markers for the early diagnosis of intestinal anastomotic leak
after gyne-oncological operations
Abstract
Objective: To analyze the serum markers for the early diagnosis of
intestinal anastomotic leak (AL) after the gyne-oncological operations.
Methods: Between September 2017 and March 2021, patients with an
intestinal anastomosis performed during the gyne-oncological surgeries
were identified from a tertiary center 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<0.05). Although it was not statistically significant
(p>0.05), median PCT values (ng/mL) on POD 8-10 were higher
in the AL group compared with no leak group. The best cutt-off point for
PCT on POD 9 was determined to be 0.11 ng/mL (AUC: 0.917, Sensitivity =
%100.0, specifity = %66.7, positive predictive value = %66.7,
negative predictive value = %100.0). Conclusion: Serum PCT and CRP
concentrations were not found to be helpfull for the early diagnosis of
AL in patients operated for gyne-oncological malignancies. Low levels of
albumin and platelets in the first days after the operation may be clue
for a possible AL.