High amylase concentration in drainage liquid can early predict proximal and distal intestinal anastomotic leakages: A prospective observational study
Background: Anastomotic leak (AL) is a serious complication in digestive surgery. Early diagnosis might allow clinicians to anticipate appropriate management. The aim of this study was to assess the predictive value of amylase concentration in drain fluid for the early diagnosis of digestive tract A...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Journal of Research in Medical Sciences |
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| Online Access: | http://www.jmsjournal.net/article.asp?issn=1735-1995;year=2023;volume=28;issue=1;spage=5;epage=5;aulast=Amroun |
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| author | Koceila Amroun Sophie Deguelte Zoubir Djerada Laurent Ramont Cyril Perrenot Linda Rached Yohan Renard Rami Rhaiem Reza Kianmanesh |
| author_facet | Koceila Amroun Sophie Deguelte Zoubir Djerada Laurent Ramont Cyril Perrenot Linda Rached Yohan Renard Rami Rhaiem Reza Kianmanesh |
| author_sort | Koceila Amroun |
| collection | DOAJ |
| description | Background: Anastomotic leak (AL) is a serious complication in digestive surgery. Early diagnosis might allow clinicians to anticipate appropriate management. The aim of this study was to assess the predictive value of amylase concentration in drain fluid for the early diagnosis of digestive tract AL. Materials and Methods: Hundred and fourteen consecutive patients “at risk” of AL, in whom a flexible drainage was placed by surgeon's choice after digestive anastomosis were included. Patients with eso-gastric, bilio-digestive, and pancreatic anastomoses were excluded. Drain amylase measurement (DAM) was routinely performed on postoperative day (POD) 1, 3, 5–7. DAM values were compared between patients with postoperative AL versus patients without AL. A receiver-operating curve (ROC) with calculation of the areas under the ROC curves area under curves was performed and a cutoff value of DAM was calculated. Results: AL occurred in 25 patients (AL group) and 89 patients did not present AL (C group). The mean DAM was significantly higher in AL group versus C Group on POD 1, 3, and 5. A cutoff value of 307 IU/L predicted the occurrence of AL with a sensitivity and specificity of 91% and 100%, respectively. Positive and negative predictive values were 100% and 97.5%, respectively. Patients with AL had an elevated DAM prior to the appearance of any clinical signs of AL. Conclusion: High level DAM could accurately predict AL for proximal and distal digestive tract anastomoses. This simple, noninvasive, and low-cost method can accurately predict early AL and help physicians to perform appropriate imaging and treatment. |
| first_indexed | 2024-03-12T13:45:13Z |
| format | Article |
| id | doaj.art-92ddf6d3c1e940d9946c5b504292f20d |
| institution | Directory Open Access Journal |
| issn | 1735-1995 1735-7136 |
| language | English |
| last_indexed | 2024-03-12T13:45:13Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Research in Medical Sciences |
| spelling | doaj.art-92ddf6d3c1e940d9946c5b504292f20d2023-08-23T09:43:20ZengWolters Kluwer Medknow PublicationsJournal of Research in Medical Sciences1735-19951735-71362023-01-012815510.4103/jrms.jrms_273_21High amylase concentration in drainage liquid can early predict proximal and distal intestinal anastomotic leakages: A prospective observational studyKoceila AmrounSophie DeguelteZoubir DjeradaLaurent RamontCyril PerrenotLinda RachedYohan RenardRami RhaiemReza KianmaneshBackground: Anastomotic leak (AL) is a serious complication in digestive surgery. Early diagnosis might allow clinicians to anticipate appropriate management. The aim of this study was to assess the predictive value of amylase concentration in drain fluid for the early diagnosis of digestive tract AL. Materials and Methods: Hundred and fourteen consecutive patients “at risk” of AL, in whom a flexible drainage was placed by surgeon's choice after digestive anastomosis were included. Patients with eso-gastric, bilio-digestive, and pancreatic anastomoses were excluded. Drain amylase measurement (DAM) was routinely performed on postoperative day (POD) 1, 3, 5–7. DAM values were compared between patients with postoperative AL versus patients without AL. A receiver-operating curve (ROC) with calculation of the areas under the ROC curves area under curves was performed and a cutoff value of DAM was calculated. Results: AL occurred in 25 patients (AL group) and 89 patients did not present AL (C group). The mean DAM was significantly higher in AL group versus C Group on POD 1, 3, and 5. A cutoff value of 307 IU/L predicted the occurrence of AL with a sensitivity and specificity of 91% and 100%, respectively. Positive and negative predictive values were 100% and 97.5%, respectively. Patients with AL had an elevated DAM prior to the appearance of any clinical signs of AL. Conclusion: High level DAM could accurately predict AL for proximal and distal digestive tract anastomoses. This simple, noninvasive, and low-cost method can accurately predict early AL and help physicians to perform appropriate imaging and treatment.http://www.jmsjournal.net/article.asp?issn=1735-1995;year=2023;volume=28;issue=1;spage=5;epage=5;aulast=Amrounamylaseanastomotic leakagedigestive anastomosisdrain fluid |
| spellingShingle | Koceila Amroun Sophie Deguelte Zoubir Djerada Laurent Ramont Cyril Perrenot Linda Rached Yohan Renard Rami Rhaiem Reza Kianmanesh High amylase concentration in drainage liquid can early predict proximal and distal intestinal anastomotic leakages: A prospective observational study Journal of Research in Medical Sciences amylase anastomotic leakage digestive anastomosis drain fluid |
| title | High amylase concentration in drainage liquid can early predict proximal and distal intestinal anastomotic leakages: A prospective observational study |
| title_full | High amylase concentration in drainage liquid can early predict proximal and distal intestinal anastomotic leakages: A prospective observational study |
| title_fullStr | High amylase concentration in drainage liquid can early predict proximal and distal intestinal anastomotic leakages: A prospective observational study |
| title_full_unstemmed | High amylase concentration in drainage liquid can early predict proximal and distal intestinal anastomotic leakages: A prospective observational study |
| title_short | High amylase concentration in drainage liquid can early predict proximal and distal intestinal anastomotic leakages: A prospective observational study |
| title_sort | high amylase concentration in drainage liquid can early predict proximal and distal intestinal anastomotic leakages a prospective observational study |
| topic | amylase anastomotic leakage digestive anastomosis drain fluid |
| url | http://www.jmsjournal.net/article.asp?issn=1735-1995;year=2023;volume=28;issue=1;spage=5;epage=5;aulast=Amroun |
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