Predictive Biomarkers for the Early Detection of Anastomotic Leaks in Colorectal Surgeries: A Systematic Review

Wahidullah Dost ^1,2, Mohammad Qaher Rasully ², Mohammad Nazir Zaman ²

⁰Surgery/Medicine, Kabul University of Medical Sciences, Kabul, AFG.

Cureus +

|

December 30, 2024

View abstract on PubMed

Summary

Early detection of anastomotic leaks (ALs) in colorectal surgery is crucial. C-reactive protein (CRP) is a reliable biomarker for identifying AL risk post-surgery, complemented by procalcitonin (PCT) and white blood cell (WBC) counts.

Area Of Science

Colorectal Surgery
Surgical Complications
Biomarker Discovery

Background

Anastomotic leaks (ALs) are severe postoperative complications in colorectal surgery.
ALs lead to increased morbidity, prolonged hospital stays, and mortality.

Purpose Of The Study

To systematically review predictive biomarkers for early detection of ALs.
To evaluate the diagnostic accuracy and clinical utility of these biomarkers.

Main Methods

Systematic literature search following PRISMA guidelines.
Included studies examining C-reactive protein (CRP), procalcitonin (PCT), and white blood cell (WBC) count.
Analyzed 20 studies with 59-2,655 patients undergoing colorectal surgery.

Main Results

C-reactive protein (CRP) is a reliable biomarker, especially elevated on postoperative days 3-4, indicating AL risk with high negative predictive value.
Procalcitonin (PCT) shows promise as a complementary biomarker for infectious complications.
White blood cell (WBC) count has limited predictive value alone but may assist other markers.

Conclusions

CRP is a key biomarker for early anastomotic leak detection in colorectal surgery.
PCT and WBC counts can supplement CRP for improved diagnostic accuracy.
Novel biomarkers in peritoneal fluid show potential for enhanced AL detection.

Keywords:

anastomosis anatomotic leak colorectal crp procalcitonin surgery systematic review wbc