The importance of presepsin value in detection of gastrointestinal anastomotic leak: a pilot study

J Surg Res. 2018 Aug:228:100-106. doi: 10.1016/j.jss.2018.02.059. Epub 2018 Mar 31.

Abstract

Background: Early diagnosis of anastomotic leakage is the most important factor in reducing its morbidity and mortality. Anastomotic integrity monitoring of the leukocyte count (WBC), C-reactive protein (CRP), and neutrophil-lymphocyte ratio (NLR) are commonly used laboratory parameters. The availability of follow-up presepsin anastomotic integrity was investigated in this study.

Materials and methods: This study included patients who had gastrointestinal anastomosis due to major abdominal surgery between January 2016 and February 2017. Blood samples were collected to determine the WBC, CRP, NLR, and presepsin values before the anastomosis was performed and then taken on postoperative days 1, 3, and 5.

Results: This is a prospective nonrandomized study with 100 consecutive patients enrolled in the anastomosis group (male/female, 42:58). WBC, CRP, NLR, and presepsin values are based on certain days in the complication group, and the complication group increased with statistical significance. Presepsin had a specificity of 98.63% in determining anastomotic leak.

Conclusions: Presepsin can be used as a supplemental marker with CRP and NLR for anastomotic integrity.

Keywords: Anastomosis; Anastomotic leak; Detection; Inflammation; Presepsin.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anastomosis, Surgical / adverse effects
  • Anastomotic Leak / blood
  • Anastomotic Leak / diagnosis*
  • Anastomotic Leak / etiology
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • Digestive System Surgical Procedures / adverse effects*
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Lipopolysaccharide Receptors / blood*
  • Male
  • Middle Aged
  • Peptide Fragments / blood*
  • Pilot Projects
  • Postoperative Period
  • Preoperative Period
  • Prospective Studies
  • ROC Curve
  • Time Factors
  • Young Adult

Substances

  • Biomarkers
  • Lipopolysaccharide Receptors
  • Peptide Fragments
  • presepsin protein, human
  • C-Reactive Protein