Alsaleh Ahmad, Pellino Gianluca, Christodoulides Natasha, Malietzis George, Kontovounisios Christos
Department of Colorectal Surgery, Chelsea and Westminster Hospital, 369 Fulham Rd, London, SW10 9NH, UK.
Department of Medical, Surgical, Neurological, Metabolic and Ageing Sciences, Universitá della Campania "Luigi Vanvitelli, Naples, Italy.
Updates Surg. 2019 Mar;71(1):17-20. doi: 10.1007/s13304-019-00627-2. Epub 2019 Feb 8.
Anastomotic leak (AL) is a serious post-operative complication in colorectal surgery. It can lead to devastating morbidity and mortality. Clinicians usually depend on a combination of clinical, biochemical and radiological findings to diagnose this problem. In our article, we tried to look if electrolyte disturbances could be indicators for intra-abdominal sepsis due to AL. Systematic review of the literature identifies a potential correlation between electrolyte alterations and AL in digestive surgery. The following databases were searched: PubMed, EMBASE and MIDLINE. The review adhered to the PRISMA statement for systematic review. Our literature search did not identify any articles linking any electrolyte disturbances-except for hyponatremia-to AL. Pathophysiology of these electrolyte disturbances does not seem to be linked to AL, except for hyponatremia which might be explained. Our review included 442 patients with intra-abdominal sepsis and 1133 controls. The mean specificity of hyponatremia being associated with intra-abdominal sepsis is 86%, whereas mean sensitivity is 28%. Hyponatremia seems to be a significant and clinically relevant marker for of intra-abdominal sepsis and AL.
吻合口漏（AL）是结直肠手术中一种严重的术后并发症。它可导致严重的发病率和死亡率。临床医生通常依靠临床、生化和影像学检查结果相结合来诊断这一问题。在我们的文章中，我们试图研究电解质紊乱是否可能是AL所致腹腔内感染的指标。对文献的系统评价发现，消化手术中电解质改变与AL之间存在潜在关联。我们检索了以下数据库：PubMed、EMBASE和MIDLINE。该评价遵循系统评价的PRISMA声明。我们的文献检索未发现除低钠血症外，任何将其他电解质紊乱与AL联系起来的文章。除了可能得到解释的低钠血症外，这些电解质紊乱的病理生理学似乎与AL无关。我们的评价纳入了442例腹腔内感染患者和1133例对照。低钠血症与腹腔内感染相关的平均特异性为86%，而平均敏感性为28%。低钠血症似乎是腹腔内感染和AL的一个重要且具有临床相关性的标志物。
