Peritoneal microdialysis as a tool for detecting anastomotic leakage in patients after left-side colon and rectal resection. A systematic review

Mark Bremholm Ellebaeka, Freek Daams, Kjell Jansson, Peter Matthiessen, Cyril Cosse, Claus Fristrup, Signe Bremholm Ellebaek, Jonas Emil Sabroe, Niels Qvist

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Objective: The objective was to evaluate peritoneal microdialysis in the detection of clinical anastomotic leakage after left-sided colon and rectal resection through a systematic review. Methods: A systematic review (PRISMA guidelines) based on a systematic search through PubMed, Cochrane Library, and EMBASE (1 February 2017) was performed. Methodological index of non-randomised studies score was selected to assess the methodological quality. Patient demographics and raw data for intraperitoneal microdialysis concentrations of glucose, lactate, glycerol and pyruvate for 5 d postoperative were obtained from the respective study groups. Results: Ten studies with a total of 128 patients were included. Thirty (23 patients developed clinical anastomotic leakage. The area under the curve for intraperitoneal lactate concentration was significant higher in patients with anastomotic leakage (58.2; 95% CI 39.2, 77.2) compared with the no leakage group (41.0; 95% CI 35.2, 46.1; p = .007). Receiver operating characteristic curve analysis of the maximum measured lactate concentration demonstrated 25% sensitivity, 88% specificity and 74% accuracy for AL at a cut-off value of 9.8 mmol/L. The odds ratio for a 5 mmol/L increase in lactate in relation to the risk of AL was 2.9 (CI 1.1, 8.0). Conclusions: Increased intraperitoneal lactate concentration within the first 5 d postoperative was significantly associated with clinical anastomotic leakage, but with low predictive values. The microdialysis method is not yet ready for clinical implication before large prospective studies have defined cut off values for a biologic marker in the setting of a clear definitions of leakage.
OriginalsprogEngelsk
BogserieScandinavian Journal of Gastroenterology
Vol/bind53
Udgave nummer12
Sider (fra-til)1625-1632
ISSN0036-5521
DOI
StatusUdgivet - 2. dec. 2018

Fingeraftryk

Anastomotic Leak
Microdialysis
Lactic Acid
Colon
Pyruvic Acid
PubMed
ROC Curve
Libraries
Area Under Curve
Odds Ratio
Prospective Studies
Guidelines

Citer dette

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title = "Peritoneal microdialysis as a tool for detecting anastomotic leakage in patients after left-side colon and rectal resection. A systematic review",
abstract = "Objective: The objective was to evaluate peritoneal microdialysis in the detection of clinical anastomotic leakage after left-sided colon and rectal resection through a systematic review. Methods: A systematic review (PRISMA guidelines) based on a systematic search through PubMed, Cochrane Library, and EMBASE (1 February 2017) was performed. Methodological index of non-randomised studies score was selected to assess the methodological quality. Patient demographics and raw data for intraperitoneal microdialysis concentrations of glucose, lactate, glycerol and pyruvate for 5 d postoperative were obtained from the respective study groups. Results: Ten studies with a total of 128 patients were included. Thirty (23 patients developed clinical anastomotic leakage. The area under the curve for intraperitoneal lactate concentration was significant higher in patients with anastomotic leakage (58.2; 95{\%} CI 39.2, 77.2) compared with the no leakage group (41.0; 95{\%} CI 35.2, 46.1; p = .007). Receiver operating characteristic curve analysis of the maximum measured lactate concentration demonstrated 25{\%} sensitivity, 88{\%} specificity and 74{\%} accuracy for AL at a cut-off value of 9.8 mmol/L. The odds ratio for a 5 mmol/L increase in lactate in relation to the risk of AL was 2.9 (CI 1.1, 8.0). Conclusions: Increased intraperitoneal lactate concentration within the first 5 d postoperative was significantly associated with clinical anastomotic leakage, but with low predictive values. The microdialysis method is not yet ready for clinical implication before large prospective studies have defined cut off values for a biologic marker in the setting of a clear definitions of leakage.",
keywords = "Peritoneal microdialysis, anastomotic leakage, colorectal resection, lactate",
author = "Ellebaeka, {Mark Bremholm} and Freek Daams and Kjell Jansson and Peter Matthiessen and Cyril Cosse and Claus Fristrup and Ellebaek, {Signe Bremholm} and Sabroe, {Jonas Emil} and Niels Qvist",
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day = "2",
doi = "10.1080/00365521.2018.1533033",
language = "English",
volume = "53",
pages = "1625--1632",
journal = "Scandinavian Journal of Gastroenterology. Supplement",
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Peritoneal microdialysis as a tool for detecting anastomotic leakage in patients after left-side colon and rectal resection. A systematic review. / Ellebaeka, Mark Bremholm; Daams, Freek; Jansson, Kjell; Matthiessen, Peter; Cosse, Cyril; Fristrup, Claus; Ellebaek, Signe Bremholm; Sabroe, Jonas Emil; Qvist, Niels.

I: Scandinavian Journal of Gastroenterology, Bind 53, Nr. 12, 02.12.2018, s. 1625-1632.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Peritoneal microdialysis as a tool for detecting anastomotic leakage in patients after left-side colon and rectal resection. A systematic review

AU - Ellebaeka, Mark Bremholm

AU - Daams, Freek

AU - Jansson, Kjell

AU - Matthiessen, Peter

AU - Cosse, Cyril

AU - Fristrup, Claus

AU - Ellebaek, Signe Bremholm

AU - Sabroe, Jonas Emil

AU - Qvist, Niels

PY - 2018/12/2

Y1 - 2018/12/2

N2 - Objective: The objective was to evaluate peritoneal microdialysis in the detection of clinical anastomotic leakage after left-sided colon and rectal resection through a systematic review. Methods: A systematic review (PRISMA guidelines) based on a systematic search through PubMed, Cochrane Library, and EMBASE (1 February 2017) was performed. Methodological index of non-randomised studies score was selected to assess the methodological quality. Patient demographics and raw data for intraperitoneal microdialysis concentrations of glucose, lactate, glycerol and pyruvate for 5 d postoperative were obtained from the respective study groups. Results: Ten studies with a total of 128 patients were included. Thirty (23 patients developed clinical anastomotic leakage. The area under the curve for intraperitoneal lactate concentration was significant higher in patients with anastomotic leakage (58.2; 95% CI 39.2, 77.2) compared with the no leakage group (41.0; 95% CI 35.2, 46.1; p = .007). Receiver operating characteristic curve analysis of the maximum measured lactate concentration demonstrated 25% sensitivity, 88% specificity and 74% accuracy for AL at a cut-off value of 9.8 mmol/L. The odds ratio for a 5 mmol/L increase in lactate in relation to the risk of AL was 2.9 (CI 1.1, 8.0). Conclusions: Increased intraperitoneal lactate concentration within the first 5 d postoperative was significantly associated with clinical anastomotic leakage, but with low predictive values. The microdialysis method is not yet ready for clinical implication before large prospective studies have defined cut off values for a biologic marker in the setting of a clear definitions of leakage.

AB - Objective: The objective was to evaluate peritoneal microdialysis in the detection of clinical anastomotic leakage after left-sided colon and rectal resection through a systematic review. Methods: A systematic review (PRISMA guidelines) based on a systematic search through PubMed, Cochrane Library, and EMBASE (1 February 2017) was performed. Methodological index of non-randomised studies score was selected to assess the methodological quality. Patient demographics and raw data for intraperitoneal microdialysis concentrations of glucose, lactate, glycerol and pyruvate for 5 d postoperative were obtained from the respective study groups. Results: Ten studies with a total of 128 patients were included. Thirty (23 patients developed clinical anastomotic leakage. The area under the curve for intraperitoneal lactate concentration was significant higher in patients with anastomotic leakage (58.2; 95% CI 39.2, 77.2) compared with the no leakage group (41.0; 95% CI 35.2, 46.1; p = .007). Receiver operating characteristic curve analysis of the maximum measured lactate concentration demonstrated 25% sensitivity, 88% specificity and 74% accuracy for AL at a cut-off value of 9.8 mmol/L. The odds ratio for a 5 mmol/L increase in lactate in relation to the risk of AL was 2.9 (CI 1.1, 8.0). Conclusions: Increased intraperitoneal lactate concentration within the first 5 d postoperative was significantly associated with clinical anastomotic leakage, but with low predictive values. The microdialysis method is not yet ready for clinical implication before large prospective studies have defined cut off values for a biologic marker in the setting of a clear definitions of leakage.

KW - Peritoneal microdialysis

KW - anastomotic leakage

KW - colorectal resection

KW - lactate

U2 - 10.1080/00365521.2018.1533033

DO - 10.1080/00365521.2018.1533033

M3 - Journal article

VL - 53

SP - 1625

EP - 1632

JO - Scandinavian Journal of Gastroenterology. Supplement

JF - Scandinavian Journal of Gastroenterology. Supplement

SN - 0085-5928

IS - 12

ER -