Early prediction of anastomotic leakage after colorectal surgery by measuring peritoneal cytokines: Prospective study

Abstract

BACKGROUND: Anastomotic leakage (AL) is a major cause of postoperative mortality and morbidity in colorectal surgery. We investigated the early prediction of peritoneal cytokine levels in developing AL after colorectal surgery. METHODS: Thirty-four patients with colorectal carcinoma, who underwent elective surgery, were included prospectively. Peritoneal samples were collected on the fifth postoperative day and interleukin (IL)-6, IL-10 and tumor necrosis factor-alpha were measured. Patients were divided into two groups: those with clinical evidence of AL (group 1) and those without any evidence of AL (group 2). RESULTS: Of the 34 patients undergoing anastomoses, clinically evident AL occurred in 4 patients (11.7%). There was a positive correlation between AL and peritoneal cytokine levels and blood loss and operation time and hospital stay. Peritoneal cytokine levels were significantly higher in group 1 as compared to group 2. The significant increase in patients with AL was observed between peritoneal cytokine levels and the postoperative days. However, a significant decrease in patients without AL was observed. CONCLUSION: The peritoneal cytokine levels can be an additional diagnostic tool that can support the early prediction of AL in colorectal surgery.