Niels Komen1, Juliette Slieker2, Paul Willemsen3, Guido Mannaerts4, Piet Pattyn5, Tom Karsten6, Hans de Wilt7, Erwin van der Harst8, Yolanda B de Rijke9, Magdalena Murawska10, Johannes Jeekel2, Johan F Lange2. 1. Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands. Electronic address: nielskomen@hotmail.com. 2. Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands. 3. Department of Surgery, ZNA Middelheim, Antwerp, Belgium. 4. Department of Surgery, St. Franciscus Gasthuis, Rotterdam, The Netherlands. 5. Department of Surgery, University Hospital Ghent, Ghent, Belgium. 6. Department of Surgery, Reinier de Graaf Groep, Delft, The Netherlands. 7. Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands. 8. Department of Surgery, Maasstad Ziekenhuis, Rotterdam, The Netherlands. 9. Department of Clinical Chemistry, Erasmus University Medical Center, Rotterdam, The Netherlands. 10. Department of Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.
Abstract
BACKGROUND: We aim to determine if C-reactive protein (CRP), lipopolysaccharide-binding protein (LBP), and procalcitonin (PCT) in drain fluid can serve as screening tools for colorectal anastomotic leakage (CAL). METHODS: Patients included in this multicenter prospective observational study underwent left hemicolectomy, sigmoid resection, high anterior resection, low anterior resection, or subtotal colectomy. During the first 5 postoperative days, CRP, LBP, and PCT were determined on drain fluid. RESULTS: In total 243 patients were included, of whom 19 (8%) developed CAL. CRP levels were higher in patients with leakage on day 3 and day 5, levels of LBP were higher on days 2, 3, and 4, and PCT levels were higher on day 5. Multivariate analysis showed LBP to be significantly related to CAL. An increase in the average initial value at the first postoperative day with 1 standard deviation increased the risk of leakage by 1.6 times. CONCLUSION: Increased concentrations of LBP in drain fluid are significantly associated to a higher chance of CAL and could contribute in a future prognostic model for CAL.
BACKGROUND: We aim to determine if C-reactive protein (CRP), lipopolysaccharide-binding protein (LBP), and procalcitonin (PCT) in drain fluid can serve as screening tools for colorectal anastomotic leakage (CAL). METHODS:Patients included in this multicenter prospective observational study underwent left hemicolectomy, sigmoid resection, high anterior resection, low anterior resection, or subtotal colectomy. During the first 5 postoperative days, CRP, LBP, and PCT were determined on drain fluid. RESULTS: In total 243 patients were included, of whom 19 (8%) developed CAL. CRP levels were higher in patients with leakage on day 3 and day 5, levels of LBP were higher on days 2, 3, and 4, and PCT levels were higher on day 5. Multivariate analysis showed LBP to be significantly related to CAL. An increase in the average initial value at the first postoperative day with 1 standard deviation increased the risk of leakage by 1.6 times. CONCLUSION: Increased concentrations of LBP in drain fluid are significantly associated to a higher chance of CAL and could contribute in a future prognostic model for CAL.
Authors: C L Sparreboom; N Komen; D Rizopoulos; A P Verhaar; W A Dik; Z Wu; H L van Westreenen; P G Doornebosch; J W T Dekker; A G Menon; F Daams; D Lips; W M U van Grevenstein; T M Karsten; Y Bayon; M P Peppelenbosch; A M Wolthuis; A D'Hoore; J F Lange Journal: Colorectal Dis Date: 2019-08-09 Impact factor: 3.788
Authors: Christoph Paasch; Silke Rink; Marcus Steinbach; Sören Kneif; Dirk Peetz; Andre Klötzler; Ulrich Gauger; Klaus Mohnike; Michael Hünerbein Journal: Ann Med Surg (Lond) Date: 2018-09-21