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首页> 外文期刊>The American Journal of Surgery >Acute phase proteins in drain fluid: A new screening tool for colorectal anastomotic leakage? the APPEAL study: Analysis of parameters predictive for evident anastomotic leakage
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Acute phase proteins in drain fluid: A new screening tool for colorectal anastomotic leakage? the APPEAL study: Analysis of parameters predictive for evident anastomotic leakage

机译：排出液中的急性期蛋白：一种用于结直肠吻合口漏出的新筛查工具？ APPEAL研究：可预测明显吻合口漏漏的参数分析

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摘要

Background We aim to determine if C-reactive protein (CRP), lipopolysaccharide-binding protein (LBP), and procalcitonin (PCT) in drain fluid can serve as screening tools for colorectal anastomotic leakage (CAL). Methods Patients included in this multicenter prospective observational study underwent left hemicolectomy, sigmoid resection, high anterior resection, low anterior resection, or subtotal colectomy. During the first 5 postoperative days, CRP, LBP, and PCT were determined on drain fluid. Results In total 243 patients were included, of whom 19 (8%) developed CAL. CRP levels were higher in patients with leakage on day 3 and day 5, levels of LBP were higher on days 2, 3, and 4, and PCT levels were higher on day 5. Multivariate analysis showed LBP to be significantly related to CAL. An increase in the average initial value at the first postoperative day with 1 standard deviation increased the risk of leakage by 1.6 times. Conclusion Increased concentrations of LBP in drain fluid are significantly associated to a higher chance of CAL and could contribute in a future prognostic model for CAL.
机译：背景我们旨在确定排出液中的C反应蛋白（CRP），脂多糖结合蛋白（LBP）和降钙素原（PCT）是否可以用作结肠直肠吻合口漏（CAL）的筛查工具。方法该多中心前瞻性观察研究中的患者接受了左半结肠切除术，乙状结肠切除术，高位前切除术，低位前切除术或结肠大部切除术。在术后的前5天中，确定排出液中的CRP，LBP和PCT。结果共纳入243例患者，其中19例（8％）发展为CAL。渗漏患者在第3天和第5天的CRP水平较高，在第2天，第3天和第4天的LBP水平较高，而在第5天的PCT水平较高。多变量分析显示LBP与CAL显着相关。术后第一天平均初始值增加1个标准差，则漏血的风险增加1.6倍。结论排泄液中LBP浓度升高与CAL发生几率显着相关，并可能有助于CAL的未来预后模型。

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