AI Article Synopsis
- The study evaluates the effectiveness of early contrast-enhanced CT scans performed on postoperative days 2-3 for detecting anastomotic leakage (AL) in patients who had undergone colorectal surgery (CRS) and had elevated CRP levels.
- Out of 661 patients, 141 were included, revealing an overall AL rate of 7.4%, with the early CT scan achieving an accuracy of 83.7% in diagnosing AL.
- While the results indicate that early CT can help detect AL, its accuracy varies by anastomosis type and is not flawless for early diagnosis.
Article Abstract
Purpose: After colorectal surgery (CRS), the early detection and treatment of anastomotic leakage (AL) is critical. We aimed to evaluate the efficacy of early contrast-enhanced computed tomography (CT) (postoperative day [POD] 2-3) after elective colorectal surgery for the diagnosis of AL for patients with elevated CRP levels at POD 2-3.
Method: From 2017 to 2022, all patients who underwent elective CRS with an anastomosis and CRP > 150 mg/ml on POD 2-3 underwent enhanced CT during the 24 h following the CRP evaluation and were included in this retrospective, single-center study. The primary endpoint was the diagnostic value of the early CT scan for the detection of AL. The secondary endpoints were the diagnostic value of the early CT scan for the detection of grade C AL according to the type of resection and anastomosis and the quality of the opacification.
Results: A total of 661 patients underwent elective CRS with anastomosis with an overall AL rate of 7.4%. Among the 661 patients, 141 were finally included in the study. The accuracy of early CT for the diagnosis of AL was 83.7%. For grade C AL, the accuracy was 81.6%. Among patients who had an ileocolic anastomosis, the accuracy was 88.2%, among those who had colorectal or ileorectal anastomosis, the accuracy was 83.0%, and among those who had a coloanal, the accuracy was 66.7%. In cases of good opacification by CT, the accuracy was 84.0%.
Conclusion: Early CT does not show perfect accuracy for an early diagnosis of AL.
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| http://dx.doi.org/10.1007/s00384-023-04571-x | DOI Listing |
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