Budin Constantin, Staniloaie Daniel, Vasile Danut, Ilco Alexandru, Balan Daniela-Gabriela, Popa Cristian Constantin, Stiru Ovidiu, Tulin Adrian, Enyedi Mihaly, Miricescu Daniela, Georgescu Dragos Eugen, Georgescu Teodor Florin, Badiu Dumitru Cristinel, Mihai Doina-Andrada
Department of General Surgery, Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Department of General Surgery, Bucharest Emergency University Hospital, 050098 Bucharest, Romania.
Exp Ther Med. 2021 May;21(5):523. doi: 10.3892/etm.2021.9955. Epub 2021 Mar 22.
Anastomotic leaks (ALs) remain the most severe complication in digestive surgery, as well as the most consumptive in terms of human and financial resources. There is an abundance of international research which has focused on identifying and correcting risk factors, and on individualized surgical management as well. The most frequent risk factors are male sex, obesity, diabetes, advanced malignant disease, ASA score, perioperative blood loss or perioperative transfusion, long operation time, emergency operation and altered nutritional status. The aim of the present study was to measure the preoperative serum calcium level and to find a possible correlation between calcium levels and the risk of AL occurrence. A retrospective analysis of medical records for 122 patients who underwent surgical gut resection with anastomosis for different pathologies was carried out. Preoperative serum calcium level and the occurrence of AL was noted. The results revealed that the average value of total blood calcium was 8.78 mg/dl, without a significant difference in sex groups. Hypocalcemia was identified in 44 patients (36.1%). AL was identified in 8 patients (6.6%), with a statistically insignificant difference between male and female patients. The average value of blood calcium in the AL patient group was 8.07 mg/dl, while in patients without AL the average value was 8.83 mg/dl. Hypocalcemia, defined as a serum calcium level below 8.5 mg/dl, was observed in 7 of the 8 patients presenting with AL (87.5%) and 37 patients who did not present with AL (32.5%), a significant difference with which to consider and include hypocalcemia in the group of risk factors for AL (P=0.001). In conclusion, preoperative low serum calcium level can represent a risk factor for AL in digestive surgery.
吻合口漏（ALs）仍然是消化外科中最严重的并发症，也是人力和财力消耗最大的并发症。有大量国际研究聚焦于识别和纠正风险因素以及个体化手术管理。最常见的风险因素包括男性、肥胖、糖尿病、晚期恶性疾病、美国麻醉医师协会（ASA）评分、围手术期失血或围手术期输血、手术时间长、急诊手术以及营养状况改变。本研究的目的是测量术前血清钙水平，并找出钙水平与AL发生风险之间可能存在的相关性。对122例因不同病理情况接受肠道切除吻合手术的患者的病历进行了回顾性分析。记录术前血清钙水平和AL的发生情况。结果显示，总血钙平均值为8.78mg/dl，不同性别组之间无显著差异。44例患者（36.1%）存在低钙血症。8例患者（6.6%）发生了AL，男性和女性患者之间无统计学显著差异。发生AL的患者组血钙平均值为8.07mg/dl，未发生AL的患者组血钙平均值为8.83mg/dl。在8例发生AL的患者中有7例（87.5%）以及37例未发生AL的患者中有37例（32.5%）观察到血清钙水平低于8.5mg/dl的低钙血症，这一显著差异提示应将低钙血症纳入AL的风险因素组中加以考虑（P=0.001）。总之，术前低血清钙水平可能是消化外科中AL的一个风险因素。
