Value of CRP and MMP-9 detection for diagnosis of anastomotic leakage after rectal cancer anterior resection / 重庆医学

Objective To investigate the clinical value of continuously detecting serum and pelvic drainage fluid C-reactive protein (CRP) and drainage fluid matrix metalloproteinase-9 (MMP-9) in the early diagnosis of anastomotic leakage after anterior resection of low rectal cancer.Methods The levels of CRP and MMP-9 in serum and pelvic drainage fluid were measured on postoperative 1,3,5,7 d in 158 patients with low rectal cancer anterior resection.The patients were divided into the anastomotic group (n=9) and non-anastomotic leakage group (n=149).The differences in the detection values between the two groups were compared and analyzed statistically.Results Among 158 cases,anastomotic leakage occurred in 9 cases.The correlation analysis of serum and drainage fluid CRP detection value and postoperative days (POD) in the two groups showed the POD 3,POD 5 and POD 7 difference was statistically significant (P＜0.05).The ROC curve analysis showed that the accuracy of the serum and drainage fluid CRP continuous detection for diagnosing the anastomotic leakage on postoperative 3 d was middle,which on postoperative 5,7 d was higher.The patients with CRP detection value ＞ 128.23 mg/L and drainage fluid CRP ＞89.93 mg/L on postoperative 5 d and those with CRP detection value＞113.71 mg/L and drainage fluid CRP＞81.75 mg/L on postoperative 7 d developed the anastomotic leakage.The drainage fluid MMP-9 detection value had no statistical difference between the anastomotic leakage group and the non-anastomotic leakage group (P＞0.05).Conclusion Continuous detection of serum and drainage fluid CRP level can be used for early diagnosing postoperative anastomotic leakage in low rectal cancer anterior resection.The drainage fluid MMP-9 continuous detection has no relation with early diagnosis of anastomotic leakage after low rectal cancer anterior resection.

Analysis on related risk factors of anastomotic leakage after low rectal cancer resection operation / 重庆医学

Objective To explore the related risk factors of anastomotic leakage after low rectal cancer anterior resection op-eration .Methods The clinical data of 158 patients with low rectal cancer anterior resection operation in this hospital from January 2011 to June 2016 were retrospectively analyzed .The clinical features and treatment factors were performed the univariate and mult-ivariate correlation analysis .Results The total incidence rate of anastomotic leakage was 5 .7% (9/158) .The univariate analysis showed that the age ,sex ,body mass index(BMI) ,preoperative concurrent disease ,tumor stage ,location ,pathological type ,preopera-tive intestinal obstruction and surgical mode (laparoscopy and laparotomy) had no significant correlation with postoperative anasto-motic leakage (P>0 .05) .Preventive ileostomy did not affect the incidence rate of anastomotic leakage (P=0 .694) .Postoperative placement of anorectal decompression tube could reduce the incidence rate of anastomotic leakage (P=0 .047) .The univariate and multivariate analysis showed that postoperative diarrhea was an independent risk factor for anastomotic leakage occurrence (OR=10 .522 ,P=0 .001) .Conclusion Postoperative early diarrhea is an independent risk factor for anastomotic leakage occurrence after rectal cancer anterior resection operation .Postoperative placement of anorectal decompression tube can reduce the incidence rate of anastomotic leakage .