Procalcitonin and C-Reactive Protein as Early Predictors of Anastomotic Leak in Colorectal Surgery

• DOI: 10.1097/dcr.0b013e31826ce825
• Publication Date: 2013-03-09T15:10:50Z
• Authors: Alvaro Garcia-Gra...; Matteo Frasson; Blas Flor-Lorente; Francisco Blanco; Ramon Puga; Arturo Carratalá; Eduardo Garcia-Gr...
• Keywords: Procalcitonin; Colorectal Surgery; Surgical oncology

Although the early diagnosis of anastomotic leak is a key point in reducing its clinical consequences, daily practice, often late.The aim this study was to determine whether procalcitonin and C-reactive protein are good predictors colorectal surgery.This prospective observational study.This conducted by specialized multidisciplinary team tertiary teaching hospital.A series 205 consecutive patients who underwent elective surgery unit prospectively analyzed. The following data were collected: demographic, surgical, ASA class, POSSUM, morbidity. During first 5 postoperative days, procalcitonin, protein, leukocytes, platelets, vital signs evaluated daily.Daily assessment variable serological days.The primary outcome measure area under curve at receiving operating characteristic analysis different variables relation leak.Anastomotic detected 17 (8.3%) patients; 11(5.4%) had major (need for drainage or reoperation). None shown be reliable detection leak, considering both minor (maximum <0.80). In contrast, when only leaks, on days 3 (p < 0.0001, >0.80). best combination day (area = 0.86), with cutoff 0.31 ng/mL, resulting 100% sensitivity, 72% specificity, negative predictive value, 17% positive value.Only symptomatic investigated rule out leakage.Procalcitonin after resection, although more accurate. Raised serum concentration renders necessary careful evaluation patient before discharge.