Mediastinal microdialysis in the diagnosis of early anastomotic leakage after resection for cancer of the esophagus and gastroesophageal junction - 14/08/14
, Niels Qvist, M.D., D.M.Sc., Claus Fristrup, M.D., Ph.D., Michael B. Mortensen, M.D., Ph.D., D.M.Sc.Abstract |
Background |
Anastomotic leakage (AL) after gastroesophageal resection for cancer is a serious complication. The aim was to evaluate mediastinal microdialysis in the detection of AL before clinical symptoms.
Methods |
Sixty patients were included. Samples were collected every 4 hours in the 1st 8 postoperative days and analyzed for several metabolites.
Results |
Forty-four patients had an uncomplicated postoperative recovery, 7 developed anastomotic-related complications, and 5 developed major nonanastomotic-related complications. Six patients were excluded (early catheter malfunction and reoperation). Logistic regression model on several metabolites demonstrated a 100% sensitivity, specificity, and positive and negative predictive values regarding the diagnosis of anastomotic complications within postoperative day 7. However, as independent markers, none of the measured metabolites were able to predict AL.
Conclusion |
The diagnosis of anastomotic-related complications before clinical symptoms seemed possible by mediastinal microdialysis, but the diagnosis should be based on an interpretation of several metabolic events.
Le texte complet de cet article est disponible en PDF.Keywords : Mediastinal microdialysis, Anastomotic leakage, Esophageal cancer, Lactate/glucose ratio, Lactate/pyruvate ratio
Plan
| The authors declare no conflicts of interest. |
|
| This project is supported by Fehr Foundation. |
Vol 208 - N° 3
P. 397-405 - septembre 2014 Retour au numéro
Article précédent
- Comparison of long-term results between laparoscopy-assisted gastrectomy and open gastrectomy with D2 lymphadenectomy for advanced gastric cancer
- Cheng Fang, Jin Hua, Jipeng Li, Jianyong Zhen, Fei Wang, Qingchuan Zhao, Jianbo Shuang, Jianjun Du
- Pain and its effects on physical activity and quality of life before operation in patients undergoing elective inguinal and ventral hernia repair
- Lucia Chung, Patrick J. O'Dwyer
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?