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Colorectal Dis ; 10(1): 75-80, 2008 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17666099

RESUMO

OBJECTIVE: This prospective study investigated the factors which might indicate anastomotic leakage after low anterior resection. METHOD: Thirty-three patients who underwent anterior resection for rectal carcinoma (n = 32) and severe dysplasia (n = 1), were monitored daily by serum C-reactive protein (CRP) and white blood cell count (WBC) estimations until discharge from hospital. Computed tomography (CT) scans were performed on postoperative days 2 and 7 and the amount of presacral fluid collection was assessed. All patients had a pelvic drain and the volume of drainage was measured daily. RESULTS: The level of the anastomosis was at a median 5 cm (3-12 cm) above the anal verge. There was no 30-day mortality. Nine (27.2%) of the 33 patients developed a symptomatic anastomotic leakage which was diagnosed at a median of 8 days (range 4-14) postoperatively. The serum CRP was increased in patients who leaked from postoperative day 2 onwards (P = 0.004 on day 2; P < 0.001 on day 3-8). The WBC was decreased in preoperatively irradiated patients on days 1-5 (P

Assuntos
Proteína C-Reativa/análise , Colectomia/efeitos adversos , Fístula Retal/etiologia , Neoplasias Retais/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anastomose Cirúrgica/efeitos adversos , Anastomose Cirúrgica/métodos , Biomarcadores Tumorais/sangue , Biópsia por Agulha , Distribuição de Qui-Quadrado , Colectomia/métodos , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Complicações Pós-Operatórias/diagnóstico , Probabilidade , Prognóstico , Estudos Prospectivos , Fístula Retal/sangue , Neoplasias Retais/mortalidade , Neoplasias Retais/patologia , Medição de Risco , Sensibilidade e Especificidade , Estatísticas não Paramétricas , Análise de Sobrevida
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