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Assessing the Diagnostic Value of Laparoscopic Port Air Content in Detecting Anastomotic Leaks After Colorectal
Vahid Ahmadi1, Seyed Hamzah Mousavie2, Hamed Vaseghi3
1Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.
Abstract:
Background and ObjectivesAnastomotic leakage (AL) is a severe complication after colorectal surgery, affecting patient outcomes. Early detection is essential, but current methods are limited. This study aimed to assess the relationship between air volume at laparoscopic port sites in early postoperative CT scans (days 3-4) and the occurrence of AL.MethodsSixty patients who underwent colorectal surgery with primary anastomosis were included. Two expert radiologists, blinded to clinical outcomes, reviewed postoperative CT scans (days 3-4) and classified port air content (PAC) as "No Air," "Low," or "High." AL was detected based on clinical and surgical criteria. Logistic regression modeling predicted Clinically Identified Leak (CIL) and Surgically Confirmed Leak (SCL).ResultsPatients with no air at port sites had significantly lower CIL rates compared to those with low or high PAC (P < .001). High PAC was a strong predictor of SCL (OR = 88.117, P = .002). The area under the receiver operating characteristic curve was high for both CIL (0.896) and SCL (0.898), indicating excellent model performance.ConclusionThe presence and volume of air at port sites on CT scans were closely associated with AL, suggesting a fast, minimally invasive method for early detection. Further research is required to confirm these findings.
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