Diagnostic accuracy of procalcitonin for the early diagnosis of anastomotic leakage after colorectal surgery: a meta‐analysis

2019 ◽  
Vol 90 (5) ◽  
pp. 675-680
Author(s):  
Bruce Su'a ◽  
Senitila Tutone ◽  
Wiremu MacFater ◽  
Ahmed Barazanchi ◽  
Weisi Xia ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Early Diagnosis ◽  
Diagnostic Accuracy ◽  
Anastomotic Leakage ◽  
Meta Analysis

scholarly journals CAN FLUORESCENT ANGIOGRAPHY REDUCE THE LEAK RATE OF COLONIC ANASTOMOSES? (a meta-analysis)

2019 ◽  
Vol 18 (4) ◽  
pp. 139-150
Author(s):  
M. V. Alekseev ◽  
Yu. A. Shelygin ◽  
E. G. Rybakov
Keyword(s):  
Colorectal Surgery ◽  
Anastomotic Leakage ◽  
Fluorescence Imaging ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Randomized Study ◽  
Colorectal Anastomosis ◽  
Original Data ◽  
Fluorescence Angiography ◽  
Rectal Cancer Surgery

AIM: to evaluate of efficacy of fluorescence angiography (FA) in reducing the anastomotic leakage (AL) rate after colorectal surgery in meta-analysis.SEARCH STRATEGY: PubMed were searched up to May 2019 for studies comparing fluorescence imaging with standard approach. The primary outcome measure was colorectal anastomotic leakage (AL) rate. The Newcastle-Ottawa scale was used for quality assessment. A meta-analysis with random-effects model was performed to calculate odds ratios (ORs) from the original data.RESULTS: Two thousand four hundred and sixty-six patients from 7 non-randomized studies and 1 randomized study were included. Fluorescence imaging significantly reduced the AL rate in patients after colorectal surgery (OR 0.58; 95%CI 0.39-0.85; p=0.006) and after rectal cancer surgery (OR 0.28; 95%CI, 0.14-0.55; p=0.0002). A limitation of this meta-analysis is the inclusion of only one randomized study.CONCLUSION: Fluorescence angiography with indocyanine green is a method of preventing of leakage of colorectal anastomosis. The results of randomized clinical trials are needed to confirm the effectiveness of this technique.

Calcification of the Aorta-Iliac Trajectory as a Risk Factor for Anastomotic Leakage in Colorectal Surgery: Individual Patient Data Meta-Analysis and Systematic Review

2021 ◽  
Vol 39 ◽  
Author(s):  
Vincent Edomskis ◽  
◽  
Pim Edomskis ◽  
Anand Menon ◽  
Roy Dwarkasing ◽  
...  
Keyword(s):  
Risk Factor ◽  
Colorectal Surgery ◽  
Anastomotic Leakage ◽  
Vascular Calcification ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Patient Data ◽  
Arterial Calcification ◽  
Scoring Methods ◽  
Scoring Method

Objective: The purpose of this review is to evaluate the relevance of vascular calcification as a potential risk factor for anastomotic leakage in colorectal surgery. Method: The Embase, Medline, PubMed, and Cochrane databases and Google Scholar were systematically searched. Studies that assessed calcification of the aorta-iliac trajectory in patients who underwent colorectal surgery were included. An independent patient data meta-analysis was performed as follows: based on the heterogeneity of the study population, a “random-effects model” or “fixed-effects model” was used to perform a multivariable logistic regression and calculate pooled Odds Ratios (OR) and 95% confidence intervals (CI). Heterogeneity was assessed using the Q-test and I2-test. Results: From a total of 457 articles retrieved, eight fell within the scope of the review, with a total of 2010 patients. Anastomotic leakage was found at a mean rate of 11.1% (SD 4.9%). In these eight studies, four different calcification scoring methods were used, which made a single structured meta-analysis not feasible. Therefore, an independent patient data meta-analysis on the most frequently used calcification scoring method was performed, including three studies with a total of 396 patients. After multivariable analyses, no significant association was found between anastomotic leakage and the amount of calcification in the aorta-iliac trajectory. The remaining three scoring methods were evaluated. In four of the five studies, vascular calcification was associated with anastomotic leakage after colorectal surgery. Conclusion: In contrast to previous studies, an individual patient data meta-analysis found no association between calcification and anastomotic leakage in colorectal surgery after multivariable analysis that considered a single calcification measurement method. In addition, this study demonstrated several scoring methods for arterial calcification and the need for a standardized technique. Therefore, the authors would recommend prospective studies using a calcification scoring method that includes grade of stenosis due to its potential to preoperatively improve perfusion by endovascular treatment.

scholarly journals Validation of a score for the early diagnosis of anastomotic leakage following elective colorectal surgery

2015 ◽  
Vol 152 (1) ◽  
pp. 5-10 ◽  
Author(s):  
G. Martin ◽  
A. Dupré ◽  
A. Mulliez ◽  
F. Prunel ◽  
K. Slim ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Early Diagnosis ◽  
Anastomotic Leakage ◽  
Elective Colorectal Surgery

scholarly journals Oxidative Stress Level as a Predictor of Anastomotic Leakage after Rectal Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Jiajun Luo ◽  
Hongxue Wu ◽  
Yu Yang ◽  
Yue Jiang ◽  
Jingwen Yuan ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Early Diagnosis ◽  
Diagnostic Accuracy ◽  
Anastomotic Leakage ◽  
Stress Level ◽  
Rectal Surgery ◽  
Scoring Systems ◽  
Oxidative Stress Level ◽  
Patients At Risk ◽  
Drain Fluid

Background. Early diagnosis of anastomotic leakage (AL) after rectal surgery can reduce the adverse effects of AL, thereby reducing morbidity and mortality. Currently, there are no accepted indicators or effective scoring systems that can clearly identify patients at risk of anastomotic leakage. Methods. A prospective study with assessment of the diagnostic accuracy of oxidative stress level (CAT, SOD, MDA) in serum and drain fluid compared to white blood cell count (WBC), C-reactive protein (CRP), and neutrophil percentage (NEUT) in prediction of AL in patients undergoing elective rectal surgery with anastomosis. Results. Most of the oxidative stress indicators we detected are of considerable significance in the diagnosis of anastomotic leakage. The level of MDA on postoperative day (POD)3 (areas under the curve (AUC): 0.831) and POD5 (AUC: 0.837) in the serum and on POD3 (AUC: 0.845) in the drain fluid showed the same excellent diagnostic accuracy as the level of CRP on the POD3 (AUC: 0.847) and POD5 (AUC: 0.896). Conclusions. The overall level of oxidative stress in serum and drain fluid is a reliable indicator for the early diagnosis of anastomotic leakage after rectal surgery. More specifically, among the redox indicators analyzed, MDA has almost the same predictive value as CRP, which provides another useful biomarker for the early diagnosis of anastomotic leakage.

Anastomotic leakage after colorectal surgery: diagnostic accuracy of CT

2015 ◽  
Vol 25 (12) ◽  
pp. 3543-3551 ◽  
Author(s):  
Paul Kauv ◽  
Samir Benadjaoud ◽  
Emmanuel Curis ◽  
Isabelle Boulay-Coletta ◽  
Jerome Loriau ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Diagnostic Accuracy ◽  
Anastomotic Leakage

scholarly journals Utility of C-reactive protein in the early diagnosis of anastomotic leakage in colorectal surgery

2019 ◽  
Vol 86 (5) ◽  
Author(s):  
Guillermo R. Guevara-Morales ◽  
Marco A. Regalado-Torres ◽  
Eduardo Cantarell-Castillo ◽  
Ricardo Castro-Salas ◽  
Rebeca Maldonado-Barrón ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Early Diagnosis ◽  
Anastomotic Leakage ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Potential Diagnostic Value of Circulating miRNA for Multiple Myeloma: A Meta-Analysis.

2020 ◽  
Author(s):  
Wen-Ting Zhang ◽  
Shuai-Shuai Gao ◽  
Yan-Jun Wang ◽  
Guo-Xun Zhang
Keyword(s):  
Multiple Myeloma ◽  
Early Diagnosis ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Cochrane Library ◽  
Circulating Mirna

Abstract Multiple myeloma (MM) is the second incurable hematological malignancy. In recent years, due to the rise of microRNA (miRNA), many scholars have participated in the study of its value in the diagnosis of MM, and have obtained good but inconsistent results. Therefore, in order to determine the role of miRNA in the early diagnosis of MM, we searched for related studies including PubMed, Web of Science, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang Database as of July 20, 2020 to conduct this meta-analysis. To improve the accuracy, the quality assessment of Diagnostic Accuracy Study 2 (QUADAS-2) was used. We also applied random effects models to summarize sensitivity and specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and area under the curve (AUC) to measure diagnostic values, and subgroup analysis used to discover potential sources of heterogeneity. Finally, we collected 32 studies from 15 articles that included a total of 2053 MM patients and 1118 healthy controls. The overall sensitivity, specificity, PLR, NLR, DOR and AUC were 0.81, 0.85, 5.5, 0.22, 25 and 0.90, respectively. Subgroup analysis shows that the down-regulation of microRNA clusters with larger samples size of plasma type could carry out a better diagnostic accuracy of MM patients. In addition, publication bias was not found. In conclusion, circulating miRNA could be a potential non-invasive biomarker for early diagnosis of MM. However, multi-center, more rigorous, and larger-scale studies are needed to verify our conclusions.

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