Anastomotic leakage after elective colorectal surgery: a prospective multicentre observational study on use of the Dutch leakage score, serum procalcitonin and serum C-reactive protein for diagnosis.

BJS Open
Italian ColoRectal Anastomotic Leakage (iCral) Study Group

Abstract

The purpose of this study was to test use of the Dutch leakage score (DLS), serum C-reactive protein (CRP) and serum procalcitonin (PCT) in the diagnosis of anastomotic leakage (AL) after elective colorectal resection in a prospective observational study. Patients undergoing elective colorectal resection with anastomosis in 19 centres were enrolled over a 1-year period from September 2017. The DLS and CRP and PCT levels were evaluated on postoperative day (POD) 2, POD3 and POD6. Statistical analysis, including determination of the area under the receiver operating characteristic (ROC) curve (AUC), was performed for the primary endpoint of AL; secondary endpoints were morbidity and mortality rates ( ClinicalTrials.gov identifier: NCT03560180). Among 1546 patients enrolled, the AL rate was 4·9 per cent. Morbidity and mortality rates were 30·2 and 1·3 per cent respectively. With respect to AL, DLS performed better than CRP and PTC levels on POD2 and POD3 (AUC 0·75 and 0·84), whereas CRP levels were documented with better AUC values on POD6 (AUC 0·81). Morbidity was poorly predicted, whereas mortality was best predicted by PCT on POD2 (AUC 0·83) and by DLS on POD3 and POD6 (AUC 0·87 and 0·98 respectively). Overall, the combination ...Continue Reading

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Citations

May 22, 2020·Updates in Surgery·Marco CaricatoUNKNOWN Italian Colorectal Anastomotic Leakage (iCral) study group
Feb 9, 2021·International Journal of Colorectal Disease·Denise E YeungAndrew W Torrance
Feb 15, 2021·Updates in Surgery·Tommaso GiulianiClaudio Bassi
Oct 30, 2020·International Journal of Colorectal Disease·UNKNOWN Italian ColoRectal Anastomotic Leakage (iCral) study groupMarco Catarci
Jan 5, 2021·Current Opinion in Critical Care·Philippe MontraversAurélie Gouel-Cheron
Apr 12, 2021·BMC Surgery·Gian Luca BaiocchiMarco Catarci
Jun 14, 2021·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Francesco GuerraUNKNOWN Italian Colorectal Anastomotic Leakage (iCral) Study Group
Sep 15, 2021·Surgical Endoscopy·Marco CatarciUNKNOWN Italian ColoRectal Anastomotic Leakage (iCral) study group

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Clinical Trials Mentioned

NCT03560180

Software Mentioned

STATA®

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