引流液内毒素作为结直肠术后吻合口漏的早期预测指标。

IF 1.6 4区 医学 Q2 SURGERY
Takashi Matsunaga, Toru Miyake, Takeru Maekawa, Fumie Tsukaguchi, Toru Obata, Tomoharu Shimizu, Masaji Tani
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引用次数: 0

摘要

目的:探讨内毒素(ET)测定对大肠癌术后吻合口漏(AL)的预测价值。方法:采用内毒素散射光度法(ET- esp)和浊度法(ET- tub)测定术后第0天(POD)、第1天(POD)和第3天(POD)引流液中的ET水平,比较肿瘤坏死因子(TNF)-α。结果:162例患者中有8例(4.9%)发生AL。AL组患者POD0上ET-ESP、ET-TUB、TNF-α水平及POD1上血清c反应蛋白(CRP)水平均显著升高。与ET-TUB (0.869, p = 0.230)和TNF-α (0.758, p = 0.034)水平相比,ET-ESP水平(0.903)的受试者工作特征曲线下面积(AUROC)对AL的预测能力更早、更好;POD1上CRP水平的AUROC(0.711)低于其他参数。在亚组分析中,136例结直肠癌(CRC)患者中有5例(3.7%)发生了AL。此外,POD0的ET-ESP水平对结直肠癌后AL的预测效果相对较好(AUROC: ET-ESP [0.871], ET-TUB[0.840],以及POD0的TNF-α[0.737])。结论:引流液中的ET水平,特别是用ESP测量的ET水平,可能具有早期预测crs后AL的能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Endotoxin in drainage fluid as an early and predictive marker of anastomotic leakage after colorectal surgery.

Purpose: To assess the predictive value of the endotoxin (ET) assay for the detection of anastomotic leakage (AL) after colorectal surgery (CRS).

Methods: ET levels in the drainage fluid were measured using endotoxin scattering photometry (ET-ESP) and turbidimetric (ET-TUB) assays on postoperative day (POD) zero, POD1 and POD3, comparing tumor necrosis factor (TNF)-α.

Results: AL was observed in 8 (4.9%) of the 162 patients. ET-ESP, ET-TUB, and TNF-α levels on POD0 and serum C-reactive protein (CRP) on POD1 were significantly elevated in the AL group. The area under the receiver operating characteristic curve (AUROC) for ET-ESP level (0.903) on POD0 showed early and better predictive performance for AL compared to that for ET-TUB (0.869, p = 0.230) and TNF-α (0.758, p = 0.034) levels on POD0; the AUROC for CRP level (0.711) on POD1 was inferior to other parameters. In subgroup analysis, five (3.7%) of 136 patients with colorectal cancer (CRC) developed AL. Additionally, the ET-ESP level on POD0 showed relatively good predictive performance for AL after CRC (AUROC: ET-ESP [0.871], ET-TUB [0.840], and TNF-α [0.737] on POD0).

Conclusion: ET levels in drainage fluid, especially those measured using ESP, on POD0 may have an early predictive ability to detect AL post-CRS.

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来源期刊
Surgery Today
Surgery Today 医学-外科
CiteScore
4.90
自引率
4.00%
发文量
208
审稿时长
1 months
期刊介绍: Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.
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