An early detector of anastomosis leakage following colorectal cancer surgery in intensive care

Colorectal cancer, comprising 10% of global cancer cases, often leads to anastomosis leakage (AL), a significant post-operative complication. Previous research on AL has highlighted the inflammatory response as a common risk factor and a potential diagnostic tool. This study aimed to investigate the inflammatory markers linked to AL and their prospective use as predictors of AL. This retrospective study was conducted in the intensive care unit of a state hospital in Ankara, Turkey. AL was detected through computed tomography and clinical evaluation (e.g., peritonitis and clinical deterioration). Inflammatory markers, including C-reactive protein and neutrophil-to-lymphocyte ratio (NLR), were examined in this study. A total of 410 patients were included in this study, among whom AL was observed in 26 cases (6.3%). The pre-operative levels of inflammatory markers did not differ between AL-positive and AL-negative groups, whereas the post-operative levels significantly differed between the groups (P < 0.05), particularly regarding post-operative NLR levels (P < 0.001). The predictive power of the difference in NLR was more prominent than the other inflammatory markers. In addition, the area under the curve of the NLR difference was sufficient to effectively predict AL. As the manifestation of AL signs and symptoms often occur in the later stages of inflammation, the early detection of inflammatory marker changes could signal the pre-emptive development of AL and enhance its management. In summation, the findings of this study further established the clinical potential of inflammatory markers for the early detection of AL, albeit requiring validation and support from additional prospective studies.