Key result
High peritoneal fluid lactate and lactate/pyruvate ratio identify anastomotic leak 2 days after colorectal surgery.
Why the study?
Anastomotic leak after colorectal surgery is a serious complication that significantly affects morbidity and mortality, and earlier detection methods are needed.
Does the analysis of lactate and pyruvate in peritoneal fluid detect anastomotic leak early in adult patients undergoing colorectal surgery?
Observational (n=54)
Open-label
No
Does the analysis of lactate and pyruvate in peritoneal fluid detect anastomotic leak early in adult patients undergoing colorectal surgery?
Absolute Event Rate: 17.6% vs 7.96%
p-value: p=<0.001
High levels of lactate and the lactate/pyruvate ratio in peritoneal fluid may allow for the early identification of anastomotic leak as early as 2 days after colorectal surgery.
May support early anastomotic leak detection via peritoneal lactate after colorectal surgery; hypothesis-generating and requires prospective validation before practice change.
Background Anastomotic leak (AL) represents serious complications of colorectal surgery and significantly influences patients’ morbidity and mortality. We investigated whether the analysis of lactate and pyruvate in the peritoneal fluid can help detect AL earlier than the current non-specific biochemical examination. Methods Fifty-four adult patients (median age: 52 years) with colorectal carcinoma were enrolled in this prospective study. Patients were divided into the following three groups: group B – patients without AL after resection, group D – patients with AL after resection, and control group C – patients after palliative surgery without resection. We measured the concentration of lactate and pyruvate and calculated the lactate/pyruvate ratio in the peritoneal fluid of patients for the first 7 days after surgery. Results The most significant difference was recorded between groups D and C (P < 0.001). Statistically significant differences were observed in the concentration of lactate between group B and group D over 7 days, except on the first postoperative day (P < 0.001). Upon comparison of groups B and D and groups C and D, the lactate/pyruvate ratio showed the most significant difference on the second postoperative day (P = 0.002). Conclusion High levels of lactate and lactate/pyruvate ratio allows early identification of AL as early as 2 days after surgery.
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Lakyová et al. (2025) conducted an observational in Colorectal carcinoma (n=54). Elevated lactate and lactate/pyruvate ratio in peritoneal fluid vs. Normal lactate levels (patients without anastomotic leak) was evaluated on Lactate concentration in peritoneal fluid (p=<0.001). High levels of lactate (median 17.6 mmol/L vs 7.96 mmol/L) and lactate/pyruvate ratio in peritoneal fluid allow early identification of anastomotic leak as early as 2 days after colorectal surgery.
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