Slovenská chirurgia 2/2023

Monitoring prognostic factors of dehiscence of anastomosis in ischemic terrain

Introduction: Dehiscence of anastomosis after colorectal surgery is serious life-threatening complication, which extends hospital stay and increases the costs of treatment. Current diagnostic tools are non-specific, what can cause delayed diagnosis, which linkes to worse outcomes of treatment. Material and methods: 54 adult patients were collected in clinical prospective study (N=54), all of them have been hospitalised and treated in I. surgical clinic and LF UPJS with colorectal carcinoma. The patients were divided into three groups: group B – patients without anastomotic leak, group D with anastomotic leak and control group C – patients after surgery without resection. We measured concentration of lactate, pyruvate, glucose and counted ratio lactate/pyruvate. Significant elevation of of lactate and ratio lactate/pyruvate were observed in group B during second postoperative day compare to group B (lactate p = 0,032, ratio lactate/pyruvate p = 0,002). Second lactate level graduation and elevated ratio lactate/pyruvate was observed after fifth postoperative day in the group D. Conclusion: Determination of lactate and ratio lactate/pyruvate allows early identification of high-risk surgical patients with anastomotic leak two days after surgery.

Keywords: dehiscence of anastomosis, lactat, lactat/pyruvate, spectrophotometry