Abstract
// Wei Ge 1 and Gang Chen 1 1 Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, P. R. China Correspondence to: Gang Chen, email: 331812195@qq.com Keywords: anastomotic leakage; early diagnosis; colorectal resection; biomarkers; inflammatory Received: September 26, 2017 Accepted: October 27, 2017 Published: December 22, 2017 ABSTRACT Anastomotic leakage (AL) is one of the most serious complications of colorectal resection, causing sepsis, reducing overall in-hospital survival and increasing the risk of local and distant recurrences. So, early diagnosis of AL is very important. To improve the early diagnosis of AL following colorectal resection, a number of studies have investigated potential biomarkers to predict AL. In this review, we summarized the biomarkers, which had been shown to be useful in early diagnosis of AL. The results showed that c-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC), cytokines, and so on were hot study biomarkers, which were proved to be reliable predictors of AL. Besides, drainage indexes such as microbiological study, potential of hydrogen (PH), carcinoembryonic antigen (CEA), and so on also helped to indicate early AL. Although there have been many studies on this field, rigorous homogeneous and prospective trials are demanded to explore ideal biomarkers to early diagnose AL.
Highlights
At present, surgery is the main treatment of colorectal tumor
We summarized the biomarkers, which had been shown to be useful in early diagnosis of Anastomotic leakage (AL)
The results showed that c-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC), cytokines, and so on were hot study biomarkers, which were proved to be reliable predictors of AL
Summary
Surgery is the main treatment of colorectal tumor. Enhanced recovery after surgery (ERAS) has gained momentum in the management of the colorectal cancer patient, which reduces morbidity and shortens the hospital stay [1]. Almeida et al performed a study to demonstrate the value of postoperative serum CRP in the identification of increased risk of AL after colorectal surgery. PCT has another interesting characteristic that its level increases before clinical signs present All these characteristics make PCT as an ideal tool for early diagnosis of AL after colorectal surgery. There are a series of studies showed that PCT help to early diagnose AL following colorectal surgery. 157 patients underwent major elective colorectal surgery were involved in this study They demonstrated the high accuracy of the PCT concentrations measured on day 1 following colorectal resection in the early prediction of AL. Another study by Marek showed that PCT measurement on POD 3 following colorectal cancer resection can positively identify patients at low risk of anastomotic leakage. The results showed that examination of PCT in drain fluid could not help to detect AL
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