Procalcitonin as an early marker in the detection of anastomotic intestinal leak in a Universitary Hospital of Bogotá

Journal of Coloproctology - Tập 40 - Trang 376-385 - 2020
Elkin Eduardo Benítez Navarrete1, Tatiana Carolina Beltrán-García2, María Fernanda Mosquera1, Valeria Martinez Rojas3, Daniel Alejandro Buitrago Medina4, Carlos Edgar Figueroa Avendaño5
1Universidad del Rosario, Cirugía General, Bogotá, Colombia
2Universidad del Rosario, Cirugía General y Epidemiología, Bogotá, Colombia
3Medicina General Universidad del Rosario, Bogotá, Colombia
4Universidad del Rosario, Salud Pública, Bogotá, Colombia
5Hospital Universitario Mayor, Cirugía de Colon y Recto, Bogotá, Colombia

Tóm tắt

Abstract Introduction Anastomotic leakage is a complication of intestinal anastomosis, with an incidence of 2%–7% in centers of experience. To be able to achieve an early detection, serological markers such as Procalcitonin were included. Methods Descriptive retrospective cohort study of patients taken to colorectal surgery with intestinal anastomosis, the objective is to estimate association between procalcitonin (≥2 ng/dl) as an early inflammatory marker and anastomotic leakage in a Coloproctological Service of a highest level of health care hospital, between September 2017 and January 2019. Results Cohort of 237 patients, 51% women (18–89 years), with multiple comorbidities in 81% of patients, colon cancer was the most operated pathology (53.1%). Laparoscopic approach was the most applied 60.34%, colorectal anastomosis was the most frequently performed (47.26%). Ileocolic anastomosis presented a higher frequency (43.75%-n:7) of dehiscence. Anastomotic leakage was associated with a serum procalcitonin positive 3 days postoperatively (p-value <0.05). Patients with a positive result had 4.28 times higher risk of presenting an anastomotic leak, compared to this risk in those patients with negative results 3 days postoperatively, this association was statistically significant 95% CI (1.34–14.16); p value <0.05. Conclusion Anastomotic leakage is a source of morbidity in patients taken to intestinal anastomosis. It's necessary to guarantee an early diagnosis of this complication, prevent abscesses and secondary peritonitis, providing adequate treatment and even reducing the associated mortality. We recommend including the procalcitonin in the assessment protocol on the third day of postoperative follow-up.

Tài liệu tham khảo

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Journal of Coloproctology

Tập 40

376-385

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