The Significance of Blood and Peritoneal Fluid Biochemical Markers in Identifying Early Anastomotic Leak following Colorectal Resection—Findings from a Single-Center Study
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Sample Description
3.2. Serum and EDTA Blood Biomarkers
3.3. Abdominal Drainage Fluid Biomarkers
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Anastomotic Leakage | ||
---|---|---|
No | Yes | |
CEA0 | 2.1 (1.6–5.25; 36) | 4.6 (1.8–21.1; 3) |
CEA1 | 2.2 (1.2–9.5; 31) | 2.55 (1.2–3.9; 2) |
CEA2 | 2.1 (1.15–7.35; 36) | 3.2 (1.2–10.5; 3) |
CEA3 | 2.05 (1.1–5.7; 32) | 2.8 (1.1–9.7; 3) |
CEA4 | 2 (1–4.7; 33) | 5.85 (3.2–8.5; 2) |
CEA5 | 1.95 (1.1–6.3; 34) | 2.6 (1.2–8.1; 3) |
CEA6 | 1.75 (1–5.5; 30) | 2.5 (1–7.3; 3) |
CRP0 | 5 (5–31; 39) | 17 (5–133; 3) |
CRP1 | 14 (5–54; 31) | 22.5 (7–38; 2) |
CRP2 | 82 (50–115; 37) | 49 (33–125; 3) |
CRP3 | 126 (73–175; 33) | 146 (20–196; 3) |
CRP4 | 127 (77.5–170.5; 36) | 155 (112–198; 2) |
CRP5 | 80.5 (59–111; 34) | 73 (12–125; 3) |
CRP6 | 64 (39–92; 31) | 46 (16–77; 3) |
L0 | 8 (6.2–9.3; 39) | 6.4 (5.6–8.3; 3) |
L1 | 12.6 (10.1–15.2; 33) | 16.2 (14.1–18.3; 2) |
L2 | 11.45 (10.1–13; 38) | 16.2 (8.9–19; 3) |
L3 | 9.1 (8.2–12.4; 34) | 11.5 (8–12.7; 3) |
L4 | 9 (7.2–12; 35) | 7.8 (5.4–10.2; 2) |
L5 | 8.45 (6.65–9.85; 32) | 8.4 (5.7–10; 3) |
L6 | 8.15 (6.2–10.2; 32) | 6.8 (5.9–10.3; 3) |
LAKTAT0 | 0.92 (0.74–1.3; 35) | 1.07 (0.93–1.98; 3) |
LAKTAT1 | 0.77 (0.6–1.35; 32) | 3.58 (2.17–4.98; 2) |
LAKTAT2 | 1 (0.7–1.35; 36) | 1.13 (0.49–1.38; 3) |
LAKTAT3 | 0.76 (0.59–1.08; 34) | 0.76 (0.52–0.95; 3) |
LAKTAT4 | 0.75 (0.68–1.14; 33) | 0.59 (0.43–0.75; 2) |
LAKTAT5 | 1.08 (0.8–1.4; 34) | 0.78 (0.7–0.85; 3) |
LAKTAT6 | 0.88 (0.66–1.26; 30) | 0.72 (0.64–2.16; 3) |
PCT0 | 0.02 (0.02–0.06; 38) | 0.03 (0.02–0.38; 3) |
PCT1 | 0.16 (0.04–0.42; 31) | 0.15 (0.11–0.18; 2) |
PCT2 | 0.32 (0.13–1.62; 36) | 0.44 (0.15–1.39; 3) |
PCT3 | 0.34 (0.16–1.84; 32) | 0.32 (0.15–3.61; 3) |
PCT4 | 0.28 (0.1–1.02; 36) | 1.82 (0.25–3.39; 2) |
PCT5 | 0.23 (0.08–0.68; 34) | 0.16 (0.08–2.01; 3) |
PCT6 | 0.18 (0.07–0.76; 29) | 0.19 (0.05–1.12; 3) |
Anastomotic Leakage | ||
---|---|---|
No | Yes | |
CEA0 | 19.9 (7.4–64.4; 21) | 32.2 (32.2–32.2; 1) |
CEA1 | 13.1 (6.7–41.6; 29) | 18.2 (14–32.2; 3) |
CEA2 | 4.2 (2.9–14.3; 32) | 5.4 (4.1–20.6; 3) |
CEA3 | 3.7 (1.4–17.5; 21) | 7.95 (1.9–14; 2) |
CEA4 | 1.3 (0.8–4.1; 23) | 1.8 (1.6–2; 2) |
CEA5 | 1.6 (0.8–5; 21) | 1.95 (1.5–2.4; 2) |
L0 | 8.72 (4.9–15.5; 21) | 5.37 (5.37–5.37; 1) |
L1 | 17.6 (5–35.35; 28) | 3.9 (2–24.9; 3) |
L2 | 4 (0.8–20.3; 33) | 5.3 (1.4–19; 3) |
L3 | 0.9 (0.38–2.41; 22) | 0.1 (0.04–0.15; 2) |
L4 | 0.53 (0.3–1.5; 23) | 1.45 (0.5–2.4; 2) |
L5 | 1.2 (0.5–2.4; 21) | 0.35 (0.3–0.4; 2) |
Laktat0 | 3.65 (2.1–4.61; 21) | 3.19 (3.19–3.19; 1) |
Laktat1 | 9.68 (6.4–13.39; 28) | 6 (5.4–13.1; 3) |
Laktat2 | 11.7 (8.6–14.68; 34) | 15 (8.2–15; 3) |
Laktat3 | 6.44 (4–11.9; 22) | 8.86 (8–9.71; 2) |
Laktat4 | 4.43 (3.48–7; 23) | 4.7 (2.6–6.8; 2) |
Laktat5 | 6.85 (3.7–8; 21) | 3.34 (3.27–3.4; 2) |
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n = 43 | |
Mean age (SD) | 69.9 (13.6) |
Male sex n (%) | 20 (46.5) |
Anastomotic leakage n (%) | 3 (7) |
Serum biomarkers before operation | |
Me (IQR) L | 8 (6.2–9.3) |
Me (IQR) CRP | 6 (5–31) |
Me (IQR) PCT | 0.02 (0.02–0.06) |
Me (IQR) lactate | 0.96 (0.74–1.3) |
Me (IQR) CEA | 2.2 (1.7–5.8) |
Type of Surgery | Number of Patients (%) |
---|---|
Laparoscopic Right hemicolectomy Resection of the sigmoid colon LAR 1 Resection of the rectosigmoid Resection of the transverse colon | 29 (67.4%) 14 (48.3%) 7 (24.1%) 5 (17.2%) 2 (6.9%) 1 (3.4%) |
Open Right hemicolectomy Resection of the sigmoid colon LAR 1 Resection of the rectosigmoid Resection of the transverse colon | 14 (32.6%) 7 (50%) 2(14.3%) 3 (21.4%) 2 (14.3%) 0 |
Anastomotic Leakage | p | ||
---|---|---|---|
No | Yes | ||
L ∆t1 − t0 | 4.7 (2.25–7.25; 32) | 8.85 (7.7–10; 2) | 0.071 |
CRP ∆∆t1 − t0 | 0 (−1–5; 30) | −46.5 (−95–2; 2) | 0.403 |
PCT ∆∆t1 − t0 | 0.13 (0.01–0.32; 29) | 0.12 (0.09–0.15; 2) | 0.903 |
Lactate ∆∆t1 − t0 | 0.02 (−0.36–0.5; 28) | 2.58 (1.1–4.05; 2) | 0.009 |
CEA ∆∆t1 − t0 | −0.4 (−0.7–0; 29) | −0.65 (−0.7–−0.6; 2) | 0.348 |
L ∆t2 − t0 | 3.4 (1.7–5.8; 37) | 7.9 (3.3–12.6; 3) | 0.104 |
CRP ∆t2 − t0 | 57 (31.5–81.5; 36) | 28 (−8–32; 3) | 0.06 |
PCT ∆t2 − t0 | 0.3 (0.12–1.44; 34) | 0.41 (0.13–1.01; 3) | 0.979 |
Lactate ∆t2 − t0 | 0.09 (−0.32–0.45; 31) | 0.06 (−1.49–0.45; 3) | 0.688 |
CEA ∆t2 − t0 | −0.55 (−1.15–−0.2; 32) | −1.4 (−10.6–−0.6; 3) | 0.14 |
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Janež, J.; Horvat, G.; Jerin, A.; Grosek, J. The Significance of Blood and Peritoneal Fluid Biochemical Markers in Identifying Early Anastomotic Leak following Colorectal Resection—Findings from a Single-Center Study. Medicina 2022, 58, 1253. https://doi.org/10.3390/medicina58091253
Janež J, Horvat G, Jerin A, Grosek J. The Significance of Blood and Peritoneal Fluid Biochemical Markers in Identifying Early Anastomotic Leak following Colorectal Resection—Findings from a Single-Center Study. Medicina. 2022; 58(9):1253. https://doi.org/10.3390/medicina58091253
Chicago/Turabian StyleJanež, Jurij, Gašper Horvat, Aleš Jerin, and Jan Grosek. 2022. "The Significance of Blood and Peritoneal Fluid Biochemical Markers in Identifying Early Anastomotic Leak following Colorectal Resection—Findings from a Single-Center Study" Medicina 58, no. 9: 1253. https://doi.org/10.3390/medicina58091253