Almutairi Farooq M
Clinical Laboratories Sciences, College of Applied Medical Sciences, University of Hafr Al-Batin, Hafr Al-Batin, SAU.
Cureus. 2024 Jun 15;16(6):e62432. doi: 10.7759/cureus.62432. eCollection 2024 Jun.
Due to its diverse presentation, anastomotic leakage (AL) following colorectal surgery is challenging to detect and frequently discovered when the patient becomes critically ill. When diagnosing AL in its early stages, biomarkers play a large role. This review was conducted to evaluate the diagnostic value of biomarkers in AL after colorectal surgeries. A literature search was undertaken electronically in major search engines such as Medline (PubMed), Google Scholar, ScienceDirect, EMBASE, and CENTRAL (Cochrane Library) databases. Observational studies of both retrospective and prospective nature were included. Origin Pro 2022 (Origin Labs) software was used to assess the prevalence of AL and generate the forest plot. A total of 13 articles fulfilled the eligibility criteria. A pooled prevalence of 9.19% was noted for AL in colorectal surgeries. In the present review, the observed sensitivity for C-reactive protein (CRP) was 80.5% and the specificity was 84% (postoperative day three). In contrast, these were 100% and 83.9% for procalcitonin on postoperative day five. CRP showed the highest diagnostic accuracy and excels at eliminating AL, but combining biomarkers can increase the diagnostic precision of early detection of AL.
由于结直肠手术后吻合口漏（AL）的表现多样，其检测具有挑战性，且常在患者病情危重时才被发现。在早期诊断AL时，生物标志物起着重要作用。本综述旨在评估生物标志物在结直肠手术后AL中的诊断价值。通过在主要搜索引擎如Medline（PubMed）、谷歌学术、ScienceDirect、EMBASE和CENTRAL（Cochrane图书馆）数据库中进行电子文献检索。纳入了回顾性和前瞻性的观察性研究。使用Origin Pro 2022（Origin Labs）软件评估AL的患病率并生成森林图。共有13篇文章符合纳入标准。结直肠手术中AL的合并患病率为9.19%。在本综述中，观察到C反应蛋白（CRP）在术后第三天的敏感性为80.5%，特异性为84%。相比之下，降钙素原在术后第五天的敏感性和特异性分别为100%和83.9%。CRP显示出最高的诊断准确性，在排除AL方面表现出色，但联合使用生物标志物可以提高AL早期检测的诊断精度。
