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Predicting Value of Serum Procalcitonin, C-Reactive Protein, Drain Fluid Culture, Drain Fluid Interleukin-6, and Tumor Necrosis Factor-α Levels in Anastomotic Leakage after Rectal Resection.

Abstract Anastomotic leak is the most dreaded septic complication of colorectal surgical procedures. Death is proportional to the time between occurrence and diagnosis of the leakage. Biomarkers, which may help to predict anastomotic leakage before appearance of its clinical features, may be beneficial in preventing adverse outcomes. This study investigates a biomarker that might be useful to predict rectal anastomotic leakage before its clinical presentation.
PMID
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Authors

Mayor MeshTerms
Keywords

C-reactive protein

drain fluid culture

interleukin-6

procalcitonin

rectal anastomotic leakage

tumor necrosis factor-α

Journal Title surgical infections
Publication Year Start




PMID- 28394749
OWN - NLM
STAT- MEDLINE
DA  - 20170410
DCOM- 20170417
LR  - 20170417
IS  - 1557-8674 (Electronic)
IS  - 1096-2964 (Linking)
VI  - 18
IP  - 3
DP  - 2017 Apr
TI  - Predicting Value of Serum Procalcitonin, C-Reactive Protein, Drain Fluid Culture,
      Drain Fluid Interleukin-6, and Tumor Necrosis Factor-alpha Levels in Anastomotic 
      Leakage after Rectal Resection.
PG  - 350-356
LID - 10.1089/sur.2016.222 [doi]
AB  - BACKGROUND: Anastomotic leak is the most dreaded septic complication of
      colorectal surgical procedures. Death is proportional to the time between
      occurrence and diagnosis of the leakage. Biomarkers, which may help to predict
      anastomotic leakage before appearance of its clinical features, may be beneficial
      in preventing adverse outcomes. This study investigates a biomarker that might be
      useful to predict rectal anastomotic leakage before its clinical presentation.
      PATIENTS AND METHODS: Serum procalcitonin and C-reactive protein (CRP) levels,
      bacterial proliferation, interleukin-6 (IL-6) and tumor necrosis factor-alpha
      (TNF-alpha) levels of drain fluid were evaluated in 50 consecutive patients who
      underwent low anterior resection without diverting ostomy for rectal carcinoma.
      RESULTS: Anastomotic leakage occurred in seven of 50 (14%) patients. Serum CRP
      and procalcitonin levels at post-operative day three were higher in patients with
      anastomotic leakage (p = 0.01, p = 0.02 respectively). Drain TNF-alpha values
      were increased 63.2% on post-operative day five when compared with post-operative
      day three in patients with anastomotic leakage, but were decreased in patients
      without leakage. There was no statistical difference for drain IL-6 levels
      between groups. The bacterial proliferation rate of drain fluid culture in the
      leakage group was 42.9% at post-operative day three and 85.7% at post-operative
      day five (p = 0.29 and p = 0.0001, respectively). CONCLUSIONS: High serum CRP and
      procalcitonin values on post-operative day three are alarming, and assessment of 
      anastomotic leakage by abdominal imaging with rectal contrast is suggested. In
      addition, increasing levels of TNF-alpha and bacterial proliferation in drain
      fluid are predictive, whereas IL-6 is not.
FAU - Bilgin, Ismail Ahmet
AU  - Bilgin IA
AD  - 1 Cerrahpasa Medical Faculty, Department of General Surgery, Istanbul University 
      , Istanbul, Turkey .
FAU - Hatipoglu, Engin
AU  - Hatipoglu E
AD  - 1 Cerrahpasa Medical Faculty, Department of General Surgery, Istanbul University 
      , Istanbul, Turkey .
FAU - Aghayeva, Afag
AU  - Aghayeva A
AD  - 2 Medical Faculty, Department of General Surgery, Acibadem University , Istanbul,
      Turkey .
FAU - Arikan, Akif Enes
AU  - Arikan AE
AD  - 1 Cerrahpasa Medical Faculty, Department of General Surgery, Istanbul University 
      , Istanbul, Turkey .
FAU - Incir, Said
AU  - Incir S
AD  - 3 Clinical Laboratory, Koc University Hospital , Istanbul, Turkey .
FAU - Mamal Torun, Muzeyyen
AU  - Mamal Torun M
AD  - 4 Faculty of Medicine, Department of Medical Microbiology, Bahcesehir University 
      , Istanbul, Turkey .
FAU - Dirican, Ahmet
AU  - Dirican A
AD  - 5 Istanbul Medical Faculty, Department of Biostatistics, Istanbul University ,
      Istanbul, Turkey .
FAU - Erguney, Sabri
AU  - Erguney S
AD  - 1 Cerrahpasa Medical Faculty, Department of General Surgery, Istanbul University 
      , Istanbul, Turkey .
LA  - eng
PT  - Comparative Study
PT  - Evaluation Studies
PT  - Journal Article
DEP - 20170223
PL  - United States
TA  - Surg Infect (Larchmt)
JT  - Surgical infections
JID - 9815642
RN  - 0 (Biomarkers)
RN  - 0 (Interleukin-6)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - 9007-12-9 (Calcitonin)
RN  - 9007-41-4 (C-Reactive Protein)
SB  - IM
MH  - Aged
MH  - Anastomotic Leak/*diagnosis/*pathology
MH  - Biomarkers/*analysis
MH  - Body Fluids/chemistry
MH  - C-Reactive Protein/*analysis
MH  - Calcitonin/*blood
MH  - Female
MH  - Humans
MH  - Interleukin-6/analysis
MH  - Male
MH  - Middle Aged
MH  - Rectal Neoplasms/*surgery
MH  - Tumor Necrosis Factor-alpha/analysis
OTO - NOTNLM
OT  - *C-reactive protein
OT  - *drain fluid culture
OT  - *interleukin-6
OT  - *procalcitonin
OT  - *rectal anastomotic leakage
OT  - *tumor necrosis factor-alpha
EDAT- 2017/04/11 06:00
MHDA- 2017/04/18 06:00
CRDT- 2017/04/11 06:00
AID - 10.1089/sur.2016.222 [doi]
PST - ppublish
SO  - Surg Infect (Larchmt). 2017 Apr;18(3):350-356. doi: 10.1089/sur.2016.222. Epub
      2017 Feb 23.

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