Hiraki Masatsugu, Tanaka Toshiya, Sato Hirofumi, Miyake Shuusuke, Kubo Hiroshi, Shinkai Yukio, Sadashima Eiji, Kitahara Kenji
Department of Surgery, Saga Medical Center Koseikan, Saga, Japan.
Medical Research Institute, Saga Medical Center Koseikan, Saga, Japan.
J Surg Case Rep. 2023 Jul 29;2023(7):rjad432. doi: 10.1093/jscr/rjad432. eCollection 2023 Jul.
A prospective pilot study was conducted on 11 patients with rectal cancer to investigate fecal calprotectin (FC) as a diagnostic tool for detecting anastomotic leakage (AL) after low anterior resection. Among the 11 patients, 1 patient (9.1%) experienced AL (Clavien-Dindo Grade IIIa). During the post-operative course until post-operative day (POD) 5, the white blood cell count of the patient with AL was within the normal range. The C-reactive protein level in the AL and non-AL groups showed a similar time course. On the other hand, the FC level in patient with AL dramatically increased on POD5, while the FC level of the non-AL group remained relatively stable. There was no significant correlation between the preoperative FC level and the tumor circumference rate, tumor size, depth of invasion or stage. This pilot study showed the possibility of FC as a useful diagnostic tool for the detection of AL after low anterior resection for rectal cancer.
对11例直肠癌患者进行了一项前瞻性初步研究,以探讨粪便钙卫蛋白(FC)作为低位前切除术术后检测吻合口漏(AL)的诊断工具的可行性。11例患者中,1例(9.1%)发生AL(Clavien-Dindo IIIa级)。在术后至术后第5天(POD)的过程中,发生AL的患者白细胞计数在正常范围内。AL组和非AL组的C反应蛋白水平呈现相似的时间变化过程。另一方面,发生AL的患者在POD5时FC水平显著升高,而非AL组的FC水平保持相对稳定。术前FC水平与肿瘤周长率、肿瘤大小、浸润深度或分期之间无显著相关性。这项初步研究表明,FC有可能作为低位直肠癌前切除术后检测AL的有用诊断工具。