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Role of Inflammatory Markers as Predictors of Anastomotic Leak in Colorectal Surgery – An Indian Study | ||
| Iranian Journal of Colorectal Research | ||
| دوره 12، شماره 4، اسفند 2024 اصل مقاله (761.15 K) | ||
| نوع مقاله: Research/Original Article | ||
| شناسه دیجیتال (DOI): 10.30476/acrr.2025.102730.1216 | ||
| نویسندگان | ||
| Ashok Kumar* 1؛ Ravindra Budhwani2؛ Vikas Agarwal3 | ||
| 1Department of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow-226014, INDIA | ||
| 2Department of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow-226014, India | ||
| 3Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow-226014, India | ||
| چکیده | ||
| Background: Anastomotic leak (AL) following colorectal surgery can lead to significant morbidity and mortality, with an incidence ranging from 2% to 14%. Early diagnosis and management are crucial for improving patient outcomes. However, the clinical detection of leaks is often delayed, adversely affecting these outcomes. Therefore, there is a pressing need for serum markers that can serve as diagnostic tools prior to the onset of clinical manifestations. The objective of this study is to investigate the changes in serum C-reactive protein (CRP), albumin, leukocyte indices, and interleukin-6 (IL-6), and to access their association with AL in colorectal anastomosis. Methods: This prospective observational pilot study included 30 patients undergoing elective colorectal resection and anastomosis for both benign and malignant conditions at the Department of Surgical Gastroenterology, SGPGIMS Lucknow, a tertiary care teaching hospital in northern India, from April 2021 to March 2022. Serum C-reactive protein (CRP), albumin, total leukocyte count (TLC), complete blood counts, platelet count, and IL-6 levels were measured preoperatively and postoperatively. Patients were divided into two groups: Group 1, which experienced anastomotic leaks, and Group 2, which did not. Changes in these markers were compared preoperatively and on postoperative days (POD) 1, 3, and 7. To compare the changes between groups, the Mann–Whitney U test was utilized, and multivariate analysis was conducted to identify predictors of anastomotic leaks using Firth logistic regression. A P value of <0.05 was considered statistically significant. Results: Group 1 comprised 4 patients (13.3%), while Group 2 included 26 patients (86.7%). A statistically significant difference was observed in serum CRP levels (P=0.001), neutrophil-to-lymphocyte ratio (NLR) (P=0.009), and serum IL-6 levels (P=0.03) on POD 3 between group 1 and group 2. In the multivariate analysis utilizing Firth logistic regression, serum CRP exhibited OR=1.09 and NLR demonstrated OR=1.28. Conclusion: A significant increase in serum CRP, NLR, and IL6 on POD 3 may serve as valuable markers for the early detection of AL. | ||
| کلیدواژهها | ||
| Colorectal surgery؛ Anastomotic leak؛ C-reactive protein؛ Colorectal neoplasms | ||
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آمار تعداد مشاهده مقاله: 44 تعداد دریافت فایل اصل مقاله: 52 |
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