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  1. Article ; Online: A national database analysis of the evolution of outcomes of surgery for anal melanoma.

    Emile, Sameh H / Horesh, Nir / Garoufalia, Zoe / Gefen, Rachel / Dourado, Justin / Wexner, Steven D

    Journal of surgical oncology

    2024  

    Abstract: Background: This study assessed trends in treatment and outcomes of anal melanomas over a 17-year period.: Methods: NCDB was searched for patients with anal melanoma (2004-2020). Receiver-operating characteristic curve analysis was used to determine ... ...

    Abstract Background: This study assessed trends in treatment and outcomes of anal melanomas over a 17-year period.
    Methods: NCDB was searched for patients with anal melanoma (2004-2020). Receiver-operating characteristic curve analysis was used to determine cutoff year marking increased overall survival (OS) of anal melanoma. Characteristics, treatments, and outcomes in consecutive time periods were compared.
    Results: A total of 815 patients (mean age: 67.2 years; 59.4% female) were included: 354 in Period 1 (2004-2012) and 461 in Period 2 (2013-2020). Period 2 included fewer abdominoperineal resections (18% vs. 28%, p = 0.002), more local tumor excisions (61.1% vs. 55%, p = 0.002), more often immunotherapy (odds ratio [OR]: 3.41, 95% confidence interval [CI]: 2.22-5.22, p < 0.001) and less often chemotherapy (OR: 0.516, 95% CI: 0.352-0.755, p < 0.001) administered and longer median OS (25.2 vs. 19.8 months, p = 0.006). Independent predictors of worse OS were older age (hazard ratio [HR]: 1.02, p = 0.012), higher Charlson score (HR: 2.32, p = 0.02), and greater number of positive lymph nodes (HR: 1.15, p < 0.001); conversely private insurance (HR: 0.385, p = 0.008) was predictive of increased OS.
    Conclusions: Anal melanoma patients diagnosed between 2013 and 2020 underwent fewer abdominoperineal resections and more local excisions than patients diagnosed between 2004 and 2013. Increased immunotherapy and longer median OS were noted in period two. Age and private insurance were significant predictors of OS, remaining constant across time periods.
    Language English
    Publishing date 2024-03-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 82063-5
    ISSN 1096-9098 ; 0022-4790
    ISSN (online) 1096-9098
    ISSN 0022-4790
    DOI 10.1002/jso.27631
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    Zs.A 706: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Prognostic Significance of Lymphocyte-to-Monocyte and Platelet-to-Lymphocyte Ratio in Rectal Cancer: A Systematic Review, Meta-analysis, and Meta-regression.

    Hamid, Hytham K S / Emile, Sameh H / Davis, George N

    Diseases of the colon and rectum

    2021  Volume 65, Issue 2, Page(s) 178–187

    Abstract: Background: The low lymphocyte-to-monocyte ratio and high platelet-to-lymphocyte ratio have been reported to be poor prognostic indicators in various solid tumors, but the prognostic significance in rectal cancer remains controversial.: Objectives: ... ...

    Abstract Background: The low lymphocyte-to-monocyte ratio and high platelet-to-lymphocyte ratio have been reported to be poor prognostic indicators in various solid tumors, but the prognostic significance in rectal cancer remains controversial.
    Objectives: We sought to determine the prognostic value of the lymphocyte-to-monocyte ratio and the platelet-to-lymphocyte ratio following curative-intent surgery for rectal cancer.
    Data sources: Following PRISMA guidelines (PROSPERO, ID: CRD42020190880), PubMed and Embase databases were searched through January 2021 including 3 other registered medical databases.
    Study selection: Studies evaluating the impact of pretreatment lymphocyte-to-monocyte ratio and platelet-to-lymphocyte ratio on overall or disease-free survival in patients undergoing curative rectal cancer resection were selected.
    Main outcomes measures: The main outcome measures were overall and disease-free survival.
    Results: A total of 23 studies (6683 patients) were included; lymphocyte-to-monocyte ratio and platelet-to-lymphocyte ratio were evaluated in 14 and 16 studies. A low lymphocyte-to-monocyte ratio was associated with poorer overall survival (HR, 1.57; 95% CI, 1.29-1.90; p < 0.001) and disease-free survival (HR, 1.29; 95% CI, 1.13-1.46; p < 0.001). However, when the analysis was limited to patients treated with surgery alone or to those with stage I to III tumors, lymphocyte-to-monocyte ratio was not a predictor of overall survival and disease-free survival. The platelet-to-lymphocyte ratio did not predict for overall or disease-free survival, regardless of the treatment modality, studied population, tumor stage, or cutoff value. Finally, a low lymphocyte-to-monocyte ratio, but not a high platelet-to-lymphocyte ratio, was inversely correlated with complete pathologic response rate.
    Limitations: The retrospective nature of most included studies was a limitation.
    Conclusions: Pretreatment lymphocyte-to-monocyte ratio, but not platelet-to-lymphocyte ratio, correlates with tumor response to neoadjuvant chemoradiotherapy and poorer prognosis after curative-intent surgery for rectal cancer, and it potentially represents a simple and reliable biomarker that could help optimize individualized clinical decision-making in high-risk patients.
    Registration: https://www.crd.york.ac.uk/prospero/; ID: CRD42020190880.
    MeSH term(s) Humans ; Lymphocyte Count ; Monocytes ; Platelet Count ; Predictive Value of Tests ; Prognosis ; Rectal Neoplasms/blood ; Rectal Neoplasms/mortality ; Rectal Neoplasms/surgery
    Language English
    Publishing date 2021-11-10
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Systematic Review
    ZDB-ID 212581-x
    ISSN 1530-0358 ; 0012-3706
    ISSN (online) 1530-0358
    ISSN 0012-3706
    DOI 10.1097/DCR.0000000000002291
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    Uk I Zs.237: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Immunotherapy in Stage III-IV Colon Cancer: A Propensity Score-Matched Analysis of the National Cancer Database.

    Horesh, Nir / Emile, Sameh H / Garoufalia, Zoe / Gefen, Rachel / Zhou, Peige / Nagarajan, Arun / Wexner, Steven D

    Journal of immunotherapy (Hagerstown, Md. : 1997)

    2024  

    Abstract: Summary: Immunotherapy for the systemic treatment of cancer offers new treatment possibilities for advanced malignancies. Despite promising initial results, evidence on efficacy of immunotherapy for colon cancer is lacking. Thus, we aimed to assess ... ...

    Abstract Summary: Immunotherapy for the systemic treatment of cancer offers new treatment possibilities for advanced malignancies. Despite promising initial results, evidence on efficacy of immunotherapy for colon cancer is lacking. Thus, we aimed to assess short-term and long-term outcomes of immunotherapy in patients with advanced colon cancer. A US National Cancer Database was searched for patients with stage III-IV colonic adenocarcinoma between 2010 and 2019. Propensity score matching was used to classify the cohort into 2 groups: patients who received immunotherapy and controls. Main outcome measures were primary outcome was overall survival (OS). A total of 23,778 patients with stage III-IV colonic adenocarcinoma were treated with immunotherapy during the study period compared to 114,753 controls. Immunotherapy treated patients were younger (median age 61 vs. 67 y; P<0.001), more often male (57.3% vs. 50.7%, P<0.001), had more private insurance (44.1% vs. 33.7%; P<0.001), had more left-sided tumors (49.5% vs. 39.1%; P<0.001) and liver metastasis (80.2% vs. 61.7%; P<0.001) than controls. Immunotherapy patients received more standard chemotherapy (49.8% vs. 41.6%; P<0.001). After propensity-score matching, mean OS was significantly shorter in the immunotherapy group compared with controls (34.7 vs. 36.2 mo; P=0.008). Cox regression analysis demonstrated that immunotherapy was associated with increased risk for mortality (HR: 1.1; 95% CI: 1.02-1.18; P=0.005). Patients who received immunotherapy had lower 90-day mortality rates compared with controls (2.3% vs. 3.6%; P=0.004), but the groups had equivalent 30-day mortality rates (0.7% vs. 0.8%; P=0.76). Immunotherapy showed no improvement in OS in patients with stage III-IV colon cancer.
    Language English
    Publishing date 2024-04-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1064067-8
    ISSN 1537-4513 ; 1053-8550 ; 1524-9557
    ISSN (online) 1537-4513
    ISSN 1053-8550 ; 1524-9557
    DOI 10.1097/CJI.0000000000000520
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    Zs.A 1778: Show issues Location:
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  4. Article: Surgery in the COVID-19 Era: A Narrative Review.

    Koroye, Oyintonbra F / Adejumo, Adeyinka / Emile, Sameh H / Ukoima, Hudson S / Fente, Beleudanyo G

    Journal of the West African College of Surgeons

    2022  Volume 10, Issue 3, Page(s) 1–7

    Abstract: The coronavirus disease 2019 (COVID-19) pandemic affected the delivery of surgical care and services. This review article aims to appraise the impact of COVID-19 on surgical care. The authors discuss the literature on surgery and COVID-19 under the ... ...

    Abstract The coronavirus disease 2019 (COVID-19) pandemic affected the delivery of surgical care and services. This review article aims to appraise the impact of COVID-19 on surgical care. The authors discuss the literature on surgery and COVID-19 under the following themes: emergency case triaging, elective surgery triaging, operating on a COVID-19-positive patient, surgical smoke, management of scarce resources, and restarting elective surgery. Most of the large surgical societies recommended and most surgical departments all over the world implemented the cancellation of elective surgeries, while emergency surgeries proceeded as usual. Elective surgeries were triaged taking into consideration the COVID-19 infection rate in the locality, availability of resources, and the need for intensive care unit beds and ventilators. A COVID-19-positive patient should not be denied surgery if indicated, and the recommended precautions and use of personal protective equipment should be adhered to. The generation of surgical smoke occurs in both laparoscopic and open surgeries, and it has not been shown to contain this novel virus. Smoke generation should be minimized and laid down guidelines followed. Laparoscopic surgery seems to have an advantage over open surgery in this regard. In resuming elective surgeries, the local infection rates, bed occupancy rate, and availability of resources should be taken into cognizance. We should learn from this pandemic so as to be prepared for future occurrences, which is a significant possibility.
    Language English
    Publishing date 2022-05-04
    Publishing country India
    Document type Journal Article ; Review
    ISSN 2276-6944
    ISSN 2276-6944
    DOI 10.4103/jwas.jwas_20_21
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  5. Article: The "terminal line": a novel sign for the identification of distal mesorectum end during TME for rectal cancer.

    Ghareeb, Waleed M / Wang, Xiaojie / Zhao, Xiaozhen / Xie, Meirong / Emile, Sameh H / Shawki, Sherief / Chi, Pan

    Gastroenterology report

    2022  Volume 10, Page(s) goac050

    Abstract: Background: Although the clinical importance of complete, intact total mesorectal excision (TME) is the widely accepted standard for decreasing local recurrence of rectal cancer, the residual mesorectum still represents a significant component of ... ...

    Abstract Background: Although the clinical importance of complete, intact total mesorectal excision (TME) is the widely accepted standard for decreasing local recurrence of rectal cancer, the residual mesorectum still represents a significant component of resection margin involvement. This study aimed to use a visible intraoperative sign to detect the distal mesorectal end to ensure complete inclusion of the mesorectum and avoid unnecessary over-dissection.
    Methods: The distal mesorectum end was investigated retrospectively through a review of 124 operative videos at the Union Hospital of Fujian Medical University (Fujian, China) and Cleveland Clinic (Ohio, USA) by two independent surgeons who were blinded to each other. Furthermore, 28 cadavers and 44 post-operative specimens were prospectively examined by hematoxylin and eosin (H&E) staining and Masson's staining to validate and confirm the findings of the retrospective part. Univariate and multivariate analyses were carried out to detect the independent factors that can affect the visualization of the distal mesorectal end.
    Results: The terminal line (TL) is the distal mesorectal end of the transabdominal and transanal TME (taTME) and appears as a remarkable pearly white fascial structure extending posteriorly from 2 to 10 o'clock. Histopathological examination revealed that the fascia propria of the rectum merges with the presacral fascia at the TL, beyond which the mesorectum ends, with no further downward extension. In the retrospective observation, the TL was seen in 56.6% of transabdominal TME and 56.0% of taTME operations. Surgical approach and tumor distance from the anal verge were the independent variables that directly influenced the detection of the TL (
    Conclusion: The TL is a visible sign where the transabdominal TME should end and the taTME should begin. Recognition of the mesorectal end may impact the certainty of complete mesorectum inclusion. Further clinical trials are needed to confirm the preliminary findings.
    Language English
    Publishing date 2022-09-21
    Publishing country England
    Document type Journal Article
    ZDB-ID 2710871-5
    ISSN 2052-0034
    ISSN 2052-0034
    DOI 10.1093/gastro/goac050
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  6. Article ; Online: Multicenter validation of the PREDICT score for prediction of local recurrence after total mesorectal excision of rectal cancer.

    Emile, Sameh H / Madbouly, Khaled M / Elfeki, Hossam / Shalaby, Mostafa / Sakr, Ahmad / Zuhdy, Mohammad / Metwally, Islam H / Abdelkhalek, Mohamed

    Journal of surgical oncology

    2022  Volume 126, Issue 4, Page(s) 772–780

    Abstract: Background: Total mesorectal excision (TME) is the gold standard treatment for rectal cancer. Although TME has managed to decrease the rates of local recurrence after rectal cancer resection, local recurrence is still recorded at varying rates. The ... ...

    Abstract Background: Total mesorectal excision (TME) is the gold standard treatment for rectal cancer. Although TME has managed to decrease the rates of local recurrence after rectal cancer resection, local recurrence is still recorded at varying rates. The present study aimed to validate the PREDICT score in the prediction of local recurrence of rectal cancer after TME with curative intent.
    Methods: This was a retrospective multicenter study on patients with nonmetastatic low or middle rectal cancer who underwent TME. The total PREDICT score was calculated for every patient and related to the onset of local recurrence. According to the final score, patients were allocated to one of three risk groups: low, moderate, and high, and the rates of local recurrence in each group were calculated and compared.
    Results: The present study included 262 patients (50.4% males) with a mean age of 47.1 years. The overall local recurrence rate was 12.6%. 29.4% of patients were in the low-risk group, 63.7% in the moderate-risk group, and 6.9% in the high-risk group. The local recurrence rate was 3.9% (95% confidence interval [CI]: 0.8-10.9) in the low-risk group, 13.2% (95% CI: 8.4-19.3) in the moderate risk group, and 44.4% (95% CI: 21.5-69.2) in the high-risk group (p < 0.0001). The sensitivity of the PREDICT score was 72.7%, the specificity was 88.1%, and the accuracy was 86.3%.
    Conclusions: The PREDICT score had good diagnostic accuracy in the prediction of local recurrence after TME and a good discriminatory ability in the differentiation between patients at different risks to develop local recurrence.
    MeSH term(s) Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/pathology ; Rectal Neoplasms/pathology ; Rectum/surgery ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2022-06-07
    Publishing country United States
    Document type Journal Article ; Multicenter Study
    ZDB-ID 82063-5
    ISSN 1096-9098 ; 0022-4790
    ISSN (online) 1096-9098
    ISSN 0022-4790
    DOI 10.1002/jso.26978
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    Zs.A 706: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  7. Article ; Online: Helicobacter pylori, Sleeve Gastrectomy, and Gastroesophageal Reflux Disease; Is there a Relation?

    Emile, Sameh H / Elshobaky, Ayman / Elbanna, Hosam G / Elkashef, Wagdi / Abdel-Razik, Mohamed A

    Obesity surgery

    2020  Volume 30, Issue 8, Page(s) 3037–3045

    Abstract: Purpose: Sleeve gastrectomy (SG) is an effective bariatric procedure, yet can be associated with complications as gastroesophageal reflux disease (GERD). The present study aimed to investigate the prevalence of Helicobacter pylori (H. pylori) in SG ... ...

    Abstract Purpose: Sleeve gastrectomy (SG) is an effective bariatric procedure, yet can be associated with complications as gastroesophageal reflux disease (GERD). The present study aimed to investigate the prevalence of Helicobacter pylori (H. pylori) in SG specimens, its relation with GERD, and its impact on postoperative outcomes.
    Methods: All SG specimens received in the pathology laboratory were reviewed. The prevalence of H. pylori in SG specimens was recorded. Patients with H. pylori infection who received triple therapy were compared with patients without H pylori in terms of baseline characteristics, preoperative GERD and its outcome postoperatively, development of new-onset GERD, staple line complications, and weight loss.
    Results: The records of 176 patients were reviewed; 69 (39.2%) were positively tested on H. pylori infection. Patients with H. pylori had higher body mass index (BMI) (RR = 1.51), greater incidence of preoperative GERD (RR = 1.67), and complained more of dyspepsia (RR = 1.87). Eradication of H. pylori was achieved in 67 (97.1%) of 69 patients. Postoperative improvement in GERD symptoms (44.4% Vs 19%, p = 0.036) and dyspepsia (85.7% Vs 51.7%, p = 0.007) was higher in patients with H. pylori with confirmed eradication of infection than patients without H. pylori. Both groups had similar operation time, postoperative BMI, excess weight loss, staple line complications, and new-onset GERD.
    Conclusions: More than one-third of patients with morbid obesity had H. pylori infection. Morbidly obese patients with H. pylori infection may be more prone to develop GERD symptoms; yet after eradication of the infection, they may also experience better improvement in symptoms after SG.
    MeSH term(s) Gastrectomy ; Gastroesophageal Reflux/epidemiology ; Gastroesophageal Reflux/etiology ; Gastroesophageal Reflux/surgery ; Helicobacter pylori ; Humans ; Obesity, Morbid/surgery ; Weight Loss
    Language English
    Publishing date 2020-05-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1070827-3
    ISSN 1708-0428 ; 0960-8923
    ISSN (online) 1708-0428
    ISSN 0960-8923
    DOI 10.1007/s11695-020-04648-4
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    Zs.A 3381: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  8. Article ; Online: Analysis of Emergency Department Visits and Unplanned Readmission After Bariatric Surgery: An Experience From a Tertiary Referral Center.

    Makki, Hayder / Mahdy, Tarek / Emile, Sameh H / Nofal, Heba / Asaad, Yaser / Abdulateef, Omar / Rasheed, Marwan / Madyan, Amr

    Surgical laparoscopy, endoscopy & percutaneous techniques

    2021  Volume 32, Issue 1, Page(s) 107–113

    Abstract: Background: Bariatric surgery is the most effective treatment of morbid obesity. As the number of bariatric procedures performed has increased, visits to the emergency department (ED) and readmissions have subsequently increased. The present study aimed ...

    Abstract Background: Bariatric surgery is the most effective treatment of morbid obesity. As the number of bariatric procedures performed has increased, visits to the emergency department (ED) and readmissions have subsequently increased. The present study aimed to assess the rates and indications for of ED visits and readmission after bariatric surgery and to identify the predictors of hospital readmission.
    Patients and methods: This was a retrospective cohort study on patients who underwent bariatric surgery from January 2018 to April 2020. The percentage of ED visits and unplanned readmission was estimated and the indications and management of each were analyzed. The association of age, sex, body mass index, and type of procedure with readmission was assessed.
    Results: Of 582 patients who underwent bariatric surgery in the study period, 204 (35%) required ED visits, and 42 (7.2%) required readmission. The mean age of patients was 33 years, and the mean body mass index was 43 kg/m2. The most common indication for ED visits was abdominal pain (41.2%). In all, 64.8% of ED visits and 43% of readmissions were unrelated to bariatric surgery complications. A total of 94.1% of patients who required ED visits and 71.4% of readmitted patients were managed conservatively. The most common procedure followed by readmission was laparoscopic sleeve gastrectomy (50%) then one-anastomosis gastric bypass (21.4%). Age, sex, body mass index, and procedure type were not significantly associated with higher readmission.
    Conclusions: The rates of ED visits and readmission in our cohort were 35% and 7.2%, respectively. Most cases of ED visits were not related to adverse effects of bariatric surgery and the majority of which were managed conservatively.
    MeSH term(s) Adult ; Bariatric Surgery/adverse effects ; Emergency Service, Hospital ; Gastric Bypass ; Humans ; Obesity, Morbid/surgery ; Patient Readmission ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Retrospective Studies ; Tertiary Care Centers
    Language English
    Publishing date 2021-10-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1475108-2
    ISSN 1534-4908 ; 1530-4515 ; 1051-7200
    ISSN (online) 1534-4908
    ISSN 1530-4515 ; 1051-7200
    DOI 10.1097/SLE.0000000000001011
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  9. Article ; Online: Laparoscopic Sleeve Gastrectomy Then and Now: An Updated Systematic Review of the Progress and Short-term Outcomes Over the Last 5 Years.

    Emile, Sameh H / Elfeki, Hossam / Elalfy, Khaled / Abdallah, Emad

    Surgical laparoscopy, endoscopy & percutaneous techniques

    2017  Volume 27, Issue 5, Page(s) 307–317

    Abstract: Introduction and aim: Laparoscopic sleeve gastrectomy (LSG) is considered one of the most popular bariatric surgeries of the present time. This review aimed to evaluate the progress and short-term outcomes of LSG over the last 5 years.: Methods: The ... ...

    Abstract Introduction and aim: Laparoscopic sleeve gastrectomy (LSG) is considered one of the most popular bariatric surgeries of the present time. This review aimed to evaluate the progress and short-term outcomes of LSG over the last 5 years.
    Methods: The systematic review of electronic databases revealed 27 relevant articles, which were carefully assessed. The data extracted from the studies were analyzed and compared with data reported by a previous review published in 2010.
    Results: A total of 5218 patients were included in this review with a mean age of 41.1. The average preoperative body mass index (43.8±8) significantly dropped at 12 months to 30.7±3.9. The average percentage of excess weight loss at 1 year was 67.3. The mean rates of remission of diabetes mellitus, hypertension, and dyslipidemia were 81.9%, 66.5%, and 64.1%, respectively. The mean complication rate across the studies was 8.7% and the average mortality rate was 0.3%. A significant drop in postoperative body mass index, higher percentage of excess weight loss, and significantly lower overall complication rate were observed in comparison with the previous systematic review.
    Conclusions: LSG continues to achieve satisfactory weight loss and improvement of obesity-related comorbidities with acceptably low morbidity and mortality rates.
    Language English
    Publishing date 2017-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1475108-2
    ISSN 1534-4908 ; 1530-4515 ; 1051-7200
    ISSN (online) 1534-4908
    ISSN 1530-4515 ; 1051-7200
    DOI 10.1097/SLE.0000000000000418
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  10. Article ; Online: Role of the triad of procalcitonin, C-reactive protein, and white blood cell count in the prediction of anastomotic leak following colorectal resections.

    El Zaher, Haidi Abd / Ghareeb, Waleed M / Fouad, Ahmed M / Madbouly, Khaled / Fathy, Hamada / Vedin, Tomas / Edelhamre, Marcus / Emile, Sameh H / Faisal, Mohammed

    World journal of surgical oncology

    2022  Volume 20, Issue 1, Page(s) 33

    Abstract: Purpose: The enhanced recovery after surgery (ERAS) program expedites patient recovery after major surgery. This study aimed to investigate the role of the triad of procalcitonin (PCT), C-reactive protein (CRP), and white blood cells (WBC) trajectories ... ...

    Abstract Purpose: The enhanced recovery after surgery (ERAS) program expedites patient recovery after major surgery. This study aimed to investigate the role of the triad of procalcitonin (PCT), C-reactive protein (CRP), and white blood cells (WBC) trajectories as a predictive biomarker for the anastomotic leak (AL) after colorectal surgery.
    Method: Patients who had colorectal anastomosis were prospectively included. Postoperative clinical and laboratory parameters and outcomes were collected and analyzed. The 5-day trajectories of PCT, CRP, and WBC were evaluated. Based on the trajectory of the three biomarkers, we compared patients with and without AL as detected during the first 30 days after surgery using the area under receiver operator characteristic curves (AUC) for logistic estimation.
    Results: This study included 205 patients, of whom 56% were men and 43.9% were women with a mean age of 56.4 ± 13.1 years. Twenty-two patients (10.7%) had AL; 77.3% underwent surgery, and 22.7% were treated with drainage and antibiotics. Procalcitonin was the best predictor for AL compared to CRP and WBC at three days postoperatively (AUC: 0.84, 0.76, 0.66, respectively). On day 5, a cutoff value of 4.93 ng/mL for PCT had the highest sensitivity, specificity, and negative predictive value. The predictive power of PCT was substantially improved when combined with either CRP or WBC, or both (AUC: 0.92, 0.92, 0.93, respectively).
    Conclusion: The 5-day trajectories of combined CRP, PCT, and WBC had a better predictive power for AL than the isolated daily measurements. Combining the three parameters may be a reliable predictor of early patient discharge, which would be highly beneficial to ERAS programs.
    MeSH term(s) Adult ; Aged ; Anastomotic Leak/diagnosis ; Anastomotic Leak/etiology ; Biomarkers ; C-Reactive Protein/analysis ; Colorectal Neoplasms/surgery ; Female ; Humans ; Leukocyte Count ; Male ; Middle Aged ; Procalcitonin
    Chemical Substances Biomarkers ; Procalcitonin ; C-Reactive Protein (9007-41-4)
    Language English
    Publishing date 2022-02-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 2118383-1
    ISSN 1477-7819 ; 1477-7819
    ISSN (online) 1477-7819
    ISSN 1477-7819
    DOI 10.1186/s12957-022-02506-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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