masterThesis
Procalcitonina como marcador temprano en la detección de fuga anastomótica intestinal, en un hospital universitario en Bogotá
Autor
Benítez Navarrete, Elkin Eduardo
Mosquera González, Maria Fernanda
Martinez Rojas, Valeria
Beltrán García, Tatiana Carolina
Institución
Resumen
Introduction: Anastomotic leakage is a complication of intestinal anastomosis with an incidence of 2-7% in the experience centers (1). For achieve an early detection, have been proposed serological markers such as procalcitonin (2). Methods: Retrospective cohort, patients taken to colorectal surgery with intestinal anastomosis, the objective is to estimate the association of procalcitonin (≥2ng/dL) as an early inflammatory marker and anastomotic leak, in the fourth level hospital Coloproctology Service, between September 2017 and January 2019. Results: Cohort of 237 patients, 51% women (18-89 years), with comorbidities in 81%, including immunosuppression, colon cancer was the most operated pathology (53.1%). The laparoscopic approach the most applied 60.34%, the most performed colorectal anastomosis (47.26%). Ileocolonic anastomosis showed a higher frequency 43.75% of leak. The anastomotic leak is associated with positive serum procalcitonin at 3 days postoperatively (X2: 8.68, gl: 1, p value <0.05). Patients with positive procalcitonin have a 4.28-fold risk of presenting anastomotic leak, compared with those with negative procalcitonin at 3 days postoperatively, this crude association is statistically significant 95% CI (1.34-14.16), p < 0.05 Conclusion: Anastomotic leakage is a source of morbidity in patients with intestinal anastomosis. It is necessary to guarantee an early diagnosis to prevent local abscesses and secondary peritonitis, the objective is to provide adequate, timely treatment and reduce the associated mortality, these results contribute to achieve this goal, we recommend including procalcitonin in the postoperative protocol given the association reported by this study .