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Procalcitonin as a Biomarker for Detecting Anastomotic Leak Following Elective Colectomy

  • 0Department of Surgery, Te Whatu Ora - Counties Manukau, University of Auckland, Auckland, New Zealand.
The Journal of Surgical Research +

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September 11, 2025

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September 11, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Procalcitonin shows limited utility for early anastomotic leak (AL) detection after colonic resection. While elevated on postoperative day 3 in some analyses, it is not an independent biomarker for AL.

Area Of Science

  • Gastroenterology
  • Surgical Oncology
  • Clinical Diagnostics

Background

  • Anastomotic leak (AL) following elective colonic resection presents a significant diagnostic challenge.
  • Procalcitonin (PCT) is being investigated as a potential biomarker for early AL detection.
  • This study evaluates the diagnostic performance of PCT in patients undergoing elective colectomy.

Purpose Of The Study

  • To assess the effectiveness of procalcitonin (PCT) in identifying anastomotic leaks (AL) post-elective colectomy.
  • To compare PCT levels in patients with and without AL.
  • To determine if PCT can serve as an independent biomarker for AL detection.

Main Methods

  • Prospective observational study conducted across four New Zealand hospitals over three years.
  • Blood samples collected preoperatively and on postoperative days (PODs) 1-5 from patients undergoing elective colectomy.
  • Statistical analyses, including univariate and multivariable regression, and ROC curve analysis, were used to compare PCT levels between groups.

Main Results

  • Median PCT levels were higher in the AL group, with significance only on POD 3 (P=0.047).
  • Multivariable analysis did not confirm PCT as an independent predictor of AL.
  • ROC curves did not achieve an area under the curve >0.7, indicating poor diagnostic accuracy.
  • A significant difference in PCT was observed on POD 3 when AL was stratified into early and late groups.

Conclusions

  • Procalcitonin levels showed a significant univariate difference on POD 3 in patients with AL.
  • Stratifying AL into early and late groups revealed a significant difference on POD 3.
  • Procalcitonin does not appear to be an independently useful biomarker for detecting anastomotic leaks after elective colonic resection.

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