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Related Experiment Video

Updated: Jan 7, 2026

Murine Ileocolic Bowel Resection with Primary Anastomosis
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Nutritional and inflammatory biomarkers in predicting spontaneous anastomotic leakage closure following

Tianchi Yu1, Xiaofeng Liao2, Shikun Luo2

  • 1Interventional Department, Jiangning Hospital, Nanjing, Jiangsu, China.

Frontiers in Nutrition
|December 29, 2025
PubMed
Summary

A decreasing C-reactive protein-lymphocyte ratio (CLR) after surgery may predict spontaneous resolution of anastomotic leakage (AL) following enterocutaneous fistula (ECF) resection. This finding aids in managing AL post-ECF surgery.

Keywords:
fistulaoutcomespostoperativespontaneous closuresurgery

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Inflammatory Markers

Background:

  • Anastomotic leakage (AL) is a significant complication after enterocutaneous fistula (ECF) resection.
  • Predicting spontaneous AL resolution is crucial for patient management and outcomes.

Purpose of the Study:

  • To investigate the correlation between the C-reactive protein-lymphocyte ratio (CLR) and spontaneous anastomotic leakage (AL) resolution.
  • To assess CLR as a potential predictor for AL closure following ECF resection.

Main Methods:

  • Retrospective cohort analysis of 107 adult patients undergoing ECF resection with AL.
  • CLR levels were monitored post-surgery, with logistic regression and restricted cubic splines used to evaluate the relationship between CLR and AL resolution at 30 and 90 days.

Main Results:

  • Spontaneous AL resolution occurred in 32.7% by 30 days and 84.1% by 90 days.
  • CLR on day 7 post-leakage predicted 30-day resolution (OR=0.97, p=0.03), and CLR on day 14 predicted 90-day resolution (OR=0.88, p=0.003).
  • A J-shaped curve illustrated the relationship between CLR and closure rates; pancreatitis-related ECFs showed lower resolution rates (OR=0.21, p=0.02).

Conclusions:

  • A declining CLR post-leakage may serve as a supportive predictor for spontaneous AL closure after ECF resection.
  • CLR monitoring could offer valuable insights into AL management strategies.