Silvia-Angélica Rojas-Machado1, Manuel Romero2, Antonio Arroyo3, Adaly Rojas-Machado1, Jerónimo López4, Rafael Calpena4. 1. Coloproctology Unit, Department of Surgery, University Hospital of Alicante, Spain. 2. Coloproctology Unit, Department of Surgery, University Hospital of Alicante, Spain; Department of Pathology and Surgery, School of Medicine, Miguel Hernandez University, Elche, Spain. 3. Department of Pathology and Surgery, School of Medicine, Miguel Hernandez University, Elche, Spain. Electronic address: arroyocir@hotmail.com. 4. Department of Pathology and Surgery, School of Medicine, Miguel Hernandez University, Elche, Spain.
Abstract
BACKGROUND: We have obtained a diagnostic score (DIACOLE) in order to detect anastomotic leakage in the postoperative period of colorectal cancer surgery. METHODS: Systematic review to identify any symptoms and clinical or analytical signs associated with anastomotic leakage after colorectal cancer surgery and a meta-analysis of each of these factors. The DIACOLE score encompasses all factors that reached statistical significance in their respective meta-analyses. The value of each factor in the score was determined depending the Napierian logarithm of the odds ratios. The index was validated using collected data at our institution. RESULTS: We identified 13 potential signs and symptoms of anastomotic leakage to elaborate the DIACOLE score. The predictive power of the DIACOLE was validated in a case-control study, resulting in an Area Under Curve (AUC) of 0.911 and a 95% confidence interval. These values were considered indicative of a very good diagnostic score. CONCLUSIONS: If DIACOLE score is > 3.065, a blood count and re-evaluating the score daily are recommended. If the DIACOLE>5.436, a radiological test is advised. We have developed free software to obtain DIACOLE value.
BACKGROUND: We have obtained a diagnostic score (DIACOLE) in order to detect anastomotic leakage in the postoperative period of colorectal cancer surgery. METHODS: Systematic review to identify any symptoms and clinical or analytical signs associated with anastomotic leakage after colorectal cancer surgery and a meta-analysis of each of these factors. The DIACOLE score encompasses all factors that reached statistical significance in their respective meta-analyses. The value of each factor in the score was determined depending the Napierian logarithm of the odds ratios. The index was validated using collected data at our institution. RESULTS: We identified 13 potential signs and symptoms of anastomotic leakage to elaborate the DIACOLE score. The predictive power of the DIACOLE was validated in a case-control study, resulting in an Area Under Curve (AUC) of 0.911 and a 95% confidence interval. These values were considered indicative of a very good diagnostic score. CONCLUSIONS: If DIACOLE score is > 3.065, a blood count and re-evaluating the score daily are recommended. If the DIACOLE>5.436, a radiological test is advised. We have developed free software to obtain DIACOLE value.
Authors: Nuno J G Rama; Marlene C C Lages; Maria Pedro S Guarino; Óscar Lourenço; Patrícia C Motta Lima; Diana Parente; Cândida S G Silva; Ricardo Castro; Ana Bento; Anabela Rocha; Fernando Castro-Pocas; João Pimentel Journal: World J Gastroenterol Date: 2022-06-28 Impact factor: 5.374