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Drainage fluid LDH and neutrophil to lymphocyte ratio as biomarkers for early detecting anastomotic leakage in patients undergoing colorectal surgery.
Agnello, Luisa; Buscemi, Salvatore; Di Buono, Giuseppe; Vidali, Matteo; Lo Sasso, Bruna; Agrusa, Antonino; Ciaccio, Marcello.
Afiliação
  • Agnello L; Department of Biomedicine, Neurosciences and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine and Clinical Laboratory Medicine, University of Palermo, Palermo, Italy.
  • Buscemi S; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy.
  • Di Buono G; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy.
  • Vidali M; Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan, Italy.
  • Lo Sasso B; Department of Biomedicine, Neurosciences and Advanced Diagnostics, Institute of Clinical Biochemistry, Clinical Molecular Medicine and Clinical Laboratory Medicine, University of Palermo, Palermo, Italy.
  • Agrusa A; Department of Laboratory Medicine, AOUP "P. Giaccone", Palermo, Italy.
  • Ciaccio M; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy.
Clin Chem Lab Med ; 62(5): 967-978, 2024 Apr 25.
Article em En | MEDLINE | ID: mdl-37988156
OBJECTIVES: In this study, we investigated the role of several circulating and drainage fluid biomarkers for detecting postoperative complications (PCs) and anastomotic leakage (AL) in patients undergoing colorectal surgery. METHODS: All consecutive patients undergoing colorectal surgery between June 2018 and April 2020 were prospectively considered. On postoperative days (POD) 1, 3, and 5, we measured lactate dehydrogenase (LDH) in drainage fluid, C-reactive protein (CRP) in serum and drainage fluid, and neutrophil to lymphocyte ratio (NLR). RESULTS: We enrolled 187 patients. POD1 patients with AL had higher serum CRP levels, while on POD3 and on POD5 higher NLR and serum CRP. LDH and CRP in drainage fluid were also significantly higher at both time points. The area under the curves (AUCs) of serum and drainage fluid CRP were 0.752 (0.629-0.875) and 0.752 (0.565-0.939), respectively. The best cut-off for serum and drainage fluid CRP was 185.23 and 76 mg/dL, respectively. The AUC of NLR on POD3 was 0.762 (0.662-0.882) with a sensitivity and specificity of 84 and 63 %, respectively, at a cut-off of 6,6. Finally, drainage fluid LDH showed the best diagnostic performance for AL, with an AUC, sensitivity, and specificity of 0.921 (0.849-0.993), 82 %, and 90 % at a cut-off of 2,186 U/L. Trends in serum parameters between patients with or without PCs or AL were also evaluated. Interestingly, we found that NLR decreased faster in patients without PCs than in patients with PCs and patients with AL. CONCLUSIONS: Drainage fluid LDH and NLR could be promising biomarkers of PCs and AL.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cirurgia Colorretal / Fístula Anastomótica Limite: Humans Idioma: En Revista: Clin Chem Lab Med Assunto da revista: QUIMICA CLINICA / TECNICAS E PROCEDIMENTOS DE LABORATORIO Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Itália

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cirurgia Colorretal / Fístula Anastomótica Limite: Humans Idioma: En Revista: Clin Chem Lab Med Assunto da revista: QUIMICA CLINICA / TECNICAS E PROCEDIMENTOS DE LABORATORIO Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Itália