Early prediction of anastomotic leakage after colorectal surgery by measuring peritoneal cytokines: prospective study.
BACKGROUND
Anastomotic leakage (AL) is a major cause of postoperative mortality and morbidity in colorectal surgery. We investigated the early prediction of peritoneal cytokine levels in developing AL after colorectal surgery.


METHODS
Thirty-four patients with colorectal carcinoma, who underwent elective surgery, were included prospectively. Peritoneal samples were collected on the fifth postoperative day and interleukin (IL)-6, IL-10 and tumor necrosis factor-alpha were measured. Patients were divided into two groups: those with clinical evidence of AL (group 1) and those without any evidence of AL (group 2).


RESULTS
Of the 34 patients undergoing anastomoses, clinically evident AL occurred in 4 patients (11.7%). There was a positive correlation between AL and peritoneal cytokine levels and blood loss and operation time and hospital stay. Peritoneal cytokine levels were significantly higher in group 1 as compared to group 2. The significant increase in patients with AL was observed between peritoneal cytokine levels and the postoperative days. However, a significant decrease in patients without AL was observed.


CONCLUSIONS
The peritoneal cytokine levels can be an additional diagnostic tool that can support the early prediction of AL in colorectal surgery.
Department of General Surgery, Istanbul Medical Faculty, Istanbul University, 34093 Capa, Istanbul, Turkey.
Burak
B
Uğraş
Murat
M
Giriş
Yeşim
Y
Erbil
Murat
M
Gökpinar
Gamze
G
Citlak
Halim
H
Işsever
Alp
A
Bozbora
Serdar
S
Oztezcan
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy; D012809:Colon, Sigmoid / Q000601:surgery; D016207:Cytokines / Q000032:analysis*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000032:analysis; D015850:Interleukin-6 / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010537:Peritoneum / Q000737:chemistry*; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery; D017792:Surgical Stapling; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D016207:Cytokines; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10