Patients with colon illness are recovering more quickly after surgery because to minimum access surgery and standardised recovery methods. Despite these advancements, anastomotic leaking remains one of the most feared consequences after colorectal surgery, with rates ranging from 3-27 percent depending on risk factors. Clinical indications of peritonitis and/or clinical evidence of free faecal fluid within the belly or emerging from the drain site are both examples of anastomotic leakage. Biomarkers including lactate/pyruvate ratio and cytokines like IL-6, IL-10, and TNF-alpha were shown to be elevated in patients who developed symptomatic anastomotic leakage before clinical symptoms appeared in some investigations.
The following are the goals and objectives:
1. To determine the sensitivity and specificity of systemic (CRP, leukocytes, procalcitonin) and peritoneal drain-fluid biomarkers interleukin-6, interleukin-10, tumour necrosis factor- (IL-6, IL-10, TNF-) in the early detection of anastomotic leak after colo-rectal surgery.
2. To see if there's a link between rising biomarker levels and the severity of clinical symptoms in people who've had colo-rectal surgery.
After getting sufficient ethical permission, the current study was a prospective observational study done on 60 patients over a two-year period in the Postgraduate Department of Surgery, Government Medical College, Srinagar. All patients who had various colo-rectal surgeries for various purposes were thoroughly monitored in the post-operative period, and their systemic and drain fluid markers were sent for estimation on days 1-7 post-operatively, with the data analysed using SPSS V 22.
The average age of the patients was 54.8711.901 years, with 44 patients (73.3%) being males and 16 patients (26.7%) being females. The average CRP level was 2.78000.500 mg/L, the average total leukocyte count was 10.7830.940 thousands, and the average serum procalcitonin level was 0.3650.1385 ng/ml among systemic producers. The mean IL-6 level was 3551.0661311.965 pg/ml, the mean IL-10 level was 628.533460.358 pg/ml, and the mean TNF-a level was 16.3916.736 pg/ml among peritoneal fluid drain bio-makers. In 16 individuals, anastomotic leak following colorectal surgery was discovered (26.7 percent ). In our study, there was a significant correlation between the rise in levels of peritoneal drain fluid biomarkers and the severity of clinical symptoms in patients who had colo-rectal surgeries, but no such correlation existed between the rise in levels of systemic markers and the severity of clinical symptoms.
Conclusion: Systemic biomarkers are poor predictors of anastomotic leak following colorectal surgery. Peritoneal fluid drain biomarkers, on the other hand, show a high sensitivity and specificity when it comes to predicting anastomotic leak.Author(S) Details
Ferkhand Mohi Ud Din
Department of Surgery, Govt. Medical College, Srinagar, Jammu and Kashmir, India.
Ashiq Hussain Raina
Department of Surgery, Govt. Medical College, Srinagar, Jammu and Kashmir, India.
Irshad Ahmad Kumar
Department of Surgery, Govt. Medical College, Srinagar, Jammu and Kashmir, India.
Mumtaz Din wani
Department of Surgery, Govt. Medical College, Srinagar, Jammu and Kashmir, India.
Aabid Rasool Bhat
Department of Surgery, Govt. Medical College, Srinagar, Jammu and Kashmir, India.
Zubair Gul
Department of Surgery, Govt. Medical College, Srinagar, Jammu and Kashmir, India.
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