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ORIGINAL RESEARCH ARTICLE

An early detector of anastomosis leakage following colorectal cancer surgery in intensive care

İbrahim Mungan1* ,  Erdal Birol Bostancı2 ,  Erbil Türksal3 ,  Büşra Tezcan4 ,  Sema Turan4
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1 Kocaeli Darica Farabi Training and Research Hospital, Department of Intensive Care Unit, Darica, Kocaeli, Türkiye
2 Ankara Training and Research City Hospital, Department of Gastrointestinal Surgery, Ankara, Türkiye
3 Ankara Keçiören Training and Research Hospital, Department of Anesthesiology, Ankara, Türkiye
4 Ankara Training and Research City Hospital, Department of Intensive Care Unit, Ankara, Türkiye
CP 2023, 5(1), 2374
Submitted: 18 January 2023 | Accepted: 21 March 2023 | Published: 31 March 2023
© 2023 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Colorectal cancer, comprising 10% of global cancer cases, often leads to anastomosis leakage (AL), a significant post-operative complication. Previous research on AL has highlighted the inflammatory response as a common risk factor and a potential diagnostic tool. This study aimed to investigate the inflammatory markers linked to AL and their prospective use as predictors of AL. This retrospective study was conducted in the intensive care unit of a state hospital in Ankara, Turkey. AL was detected through computed tomography and clinical evaluation (e.g., peritonitis and clinical deterioration). Inflammatory markers, including C-reactive protein and neutrophil-to-lymphocyte ratio (NLR), were examined in this study. A total of 410 patients were included in this study, among whom AL was observed in 26 cases (6.3%). The pre-operative levels of inflammatory markers did not differ between AL-positive and AL-negative groups, whereas the post-operative levels significantly differed between the groups (P < 0.05), particularly regarding post-operative NLR levels (P < 0.001). The predictive power of the difference in NLR was more prominent than the other inflammatory markers. In addition, the area under the curve of the NLR difference was sufficient to effectively predict AL. As the manifestation of AL signs and symptoms often occur in the later stages of inflammation, the early detection of inflammatory marker changes could signal the pre-emptive development of AL and enhance its management. In summation, the findings of this study further established the clinical potential of inflammatory markers for the early detection of AL, albeit requiring validation and support from additional prospective studies.

Keywords
Colorectal cancer
Surgery
Anastomosis leakage
Inflammatory marker
Prediction
Early detection
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
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Cancer Plus, Electronic ISSN: 2661-3840 Print ISSN: 2661-3832, Published by AccScience Publishing
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