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.
Keywords : Procalcitonin; Anastomotic leak; Early diagnosis.