Abstract

To investigate that the bacteriological concentration and pH value in peritoneal drainage fluid might serve as indicators of early diagnosis of anastomotic leakage following rectal resection. We prospectively analyzed consecutive patients who were treated for rectal diseases with anastomosis at the department of general surgery, the affiliated hospital of Nanjing University Medical School between August 2018 and December 2020. The bacteriological concentration and the pH value in peritoneal drainage fluid were tested on the first, fourth, seventh days postoperatively. A total of 300 consecutive patients underwent rectal resection were tested. 21 patients present with AL and the overall AL rate was 7%. The bacteriological concentration in peritoneal drainage fluid of AL group was significantly higher than that in non-AL group. The AUC value was 0.98 (95% confidence intervals 0.969–1.000) according to the ROC curve. The best cut-off value was 1143/uL. The sensitivity and specificity were 100% and 93.19% respectively. There was no difference of pH value between the AL and non-AL groups. According the results of present study, a high bacteriological concentration in peritoneal drainage fluid is a good marker for predicting and diagnosing AL following rectal resection. However, owing to the limitation of the sample, there was no validation attempt in the study. A large sample study is needed to validate the conclusion.

Highlights

  • To investigate that the bacteriological concentration and pH value in peritoneal drainage fluid might serve as indicators of early diagnosis of anastomotic leakage following rectal resection

  • There was a series of researches focused on exploring the markers for early diagnosis of Anastomotic leakage (AL), such as c-reactive protein (CRP), procalcitonin (PCT), leukocyte, cytokine and so o­ n5,6

  • We collected the literature and found few researches focused on this topic. This prospective study aimed to investigate whether the bacteriological concentration and pH value in peritoneal drainage fluid might serve as indicators of early diagnosis AL following rectal resection

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Summary

Introduction

To investigate that the bacteriological concentration and pH value in peritoneal drainage fluid might serve as indicators of early diagnosis of anastomotic leakage following rectal resection. According the results of present study, a high bacteriological concentration in peritoneal drainage fluid is a good marker for predicting and diagnosing AL following rectal resection. There was a series of researches focused on exploring the markers for early diagnosis of AL, such as c-reactive protein (CRP), procalcitonin (PCT), leukocyte, cytokine and so o­ n5,6. These markers are mainly tested in the serum and the sensitivity and specificity are not very high. We collected the literature and found few researches focused on this topic

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