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.