Anastomotic Rings and Inflammation Values as Biomarkers for Leakage of Stapled Circular Colorectal Anastomoses
Reliable markers to predict or diagnose anastomotic leakage (AL) of stapled circular anastomoses following colorectal resections are an important clinical need. Here, we aim to quantitatively investigate the morphology of anastomotic rings as an early available prognostic marker for AL and compare t...
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MDPI AG
2022-11-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/12/2902 |
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| author | Feng Zhang Song Qiao Ning Yao Chunqiao Li Marie-Christin Weber Benedict Jefferies Helmut Friess Stefan Reischl Philipp-Alexander Neumann |
| author_facet | Feng Zhang Song Qiao Ning Yao Chunqiao Li Marie-Christin Weber Benedict Jefferies Helmut Friess Stefan Reischl Philipp-Alexander Neumann |
| author_sort | Feng Zhang |
| collection | DOAJ |
| description | Reliable markers to predict or diagnose anastomotic leakage (AL) of stapled circular anastomoses following colorectal resections are an important clinical need. Here, we aim to quantitatively investigate the morphology of anastomotic rings as an early available prognostic marker for AL and compare them to established inflammatory markers. We perform a prospective single-center cohort study, including patients undergoing stapled circular anastomosis between August 2020 and August 2021. The predictive value of the anastomotic ring configuration and the neutrophil-to-lymphocyte ratio (NLR) regarding anastomotic leakage is examined by ROC analyses and compared to the C-reactive protein (CRP) as an established marker. We included 204 patients, of which 19 suffered from anastomotic leakage (LEAK group), while in 185 patients the anastomoses healed well (HEAL group). The minimal height of the anastomotic rings as a binary classifier had a good ROC-AUC of 0.81 but was inferior to the NLR at postoperative day (POD) 5, with an excellent ROC-AUC of 0.93. Still, it was superior to the NLR at POD 3 (0.74) and the CRP at POD 3 (ROC-AUC 0.54) and 5 (ROC-AUC 0.70). The minimal height of the anastomotic rings as indicator for technically insufficient anastomoses is a good predictor of AL, while postoperatively the NLR was superior to the CRP in prediction of AL. |
| first_indexed | 2024-03-09T17:09:16Z |
| format | Article |
| id | doaj.art-618e681cfc904d97bda9c29e8c898d4c |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T17:09:16Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-618e681cfc904d97bda9c29e8c898d4c2023-11-24T14:15:13ZengMDPI AGDiagnostics2075-44182022-11-011212290210.3390/diagnostics12122902Anastomotic Rings and Inflammation Values as Biomarkers for Leakage of Stapled Circular Colorectal AnastomosesFeng Zhang0Song Qiao1Ning Yao2Chunqiao Li3Marie-Christin Weber4Benedict Jefferies5Helmut Friess6Stefan Reischl7Philipp-Alexander Neumann8Department of Surgery, Klinikum rechts der Isar, School of Medicine, Technical University of Munich (TUM), 81675 Munich, GermanyDepartment of General Surgery, Tongren Municipal People’s Hospital of Guizhou Medical University (GMU), Tongren 554300, ChinaDepartment of Pathology, Tongren Municipal People’s Hospital of Guizhou Medical University (GMU), Tongren 554300, ChinaDepartment of Surgery, Klinikum rechts der Isar, School of Medicine, Technical University of Munich (TUM), 81675 Munich, GermanyDepartment of Surgery, Klinikum rechts der Isar, School of Medicine, Technical University of Munich (TUM), 81675 Munich, GermanyDepartment of Surgery, Klinikum rechts der Isar, School of Medicine, Technical University of Munich (TUM), 81675 Munich, GermanyDepartment of Surgery, Klinikum rechts der Isar, School of Medicine, Technical University of Munich (TUM), 81675 Munich, GermanyInstitute of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich (TUM), 81675 Munich, GermanyDepartment of Surgery, Klinikum rechts der Isar, School of Medicine, Technical University of Munich (TUM), 81675 Munich, GermanyReliable markers to predict or diagnose anastomotic leakage (AL) of stapled circular anastomoses following colorectal resections are an important clinical need. Here, we aim to quantitatively investigate the morphology of anastomotic rings as an early available prognostic marker for AL and compare them to established inflammatory markers. We perform a prospective single-center cohort study, including patients undergoing stapled circular anastomosis between August 2020 and August 2021. The predictive value of the anastomotic ring configuration and the neutrophil-to-lymphocyte ratio (NLR) regarding anastomotic leakage is examined by ROC analyses and compared to the C-reactive protein (CRP) as an established marker. We included 204 patients, of which 19 suffered from anastomotic leakage (LEAK group), while in 185 patients the anastomoses healed well (HEAL group). The minimal height of the anastomotic rings as a binary classifier had a good ROC-AUC of 0.81 but was inferior to the NLR at postoperative day (POD) 5, with an excellent ROC-AUC of 0.93. Still, it was superior to the NLR at POD 3 (0.74) and the CRP at POD 3 (ROC-AUC 0.54) and 5 (ROC-AUC 0.70). The minimal height of the anastomotic rings as indicator for technically insufficient anastomoses is a good predictor of AL, while postoperatively the NLR was superior to the CRP in prediction of AL.https://www.mdpi.com/2075-4418/12/12/2902anastomotic ringcolorectal anastomosisanastomotic leakageneutrophil to lymphocyte ratiostapler anastomosis |
| spellingShingle | Feng Zhang Song Qiao Ning Yao Chunqiao Li Marie-Christin Weber Benedict Jefferies Helmut Friess Stefan Reischl Philipp-Alexander Neumann Anastomotic Rings and Inflammation Values as Biomarkers for Leakage of Stapled Circular Colorectal Anastomoses Diagnostics anastomotic ring colorectal anastomosis anastomotic leakage neutrophil to lymphocyte ratio stapler anastomosis |
| title | Anastomotic Rings and Inflammation Values as Biomarkers for Leakage of Stapled Circular Colorectal Anastomoses |
| title_full | Anastomotic Rings and Inflammation Values as Biomarkers for Leakage of Stapled Circular Colorectal Anastomoses |
| title_fullStr | Anastomotic Rings and Inflammation Values as Biomarkers for Leakage of Stapled Circular Colorectal Anastomoses |
| title_full_unstemmed | Anastomotic Rings and Inflammation Values as Biomarkers for Leakage of Stapled Circular Colorectal Anastomoses |
| title_short | Anastomotic Rings and Inflammation Values as Biomarkers for Leakage of Stapled Circular Colorectal Anastomoses |
| title_sort | anastomotic rings and inflammation values as biomarkers for leakage of stapled circular colorectal anastomoses |
| topic | anastomotic ring colorectal anastomosis anastomotic leakage neutrophil to lymphocyte ratio stapler anastomosis |
| url | https://www.mdpi.com/2075-4418/12/12/2902 |
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