Early detection of anastomotic leakage after esophagectomy using drain amylase levels

BACKGROUND: Early diagnosis of anastomotic leakage (AL) after esophagectomy is essential to minimize postoperative complications. In this study, we hypothesized that drain amylase levels may be useful for early AL detection, and measuring drain amylase levels could reduce severe postoperative AL incidence. We, therefore, analyzed the usefulness of measuring drain fluid amylase levels after esophagectomy, in esophageal cancer patients.

METHODS: From January 2016 to March 2020, 134 patients with esophageal cancer who underwent surgical resection with esophagogastric anastomosis in the cervical region were included. The patients were divided into a group whose cervical drain fluid amylase levels were not measured (No-AMY Group) and a group whose cervical drain fluid amylase levels were measured daily until postoperative day (POD) 7 (AMY Group). The incidence of severe AL was compared between groups. In the AMY Group, we also investigated the association between AL and drain amylase levels.

RESULTS: Drain amylase levels were significantly higher in AL-positive cases than in AL-negative cases (P < 0.001). Receiver operating characteristic curve analysis revealed the drain amylase level cut-off value for AL diagnosis was 1800 U/L on POD 2 (Area under the curve = 0.835; P = 0.027). The incidence of ≥ grade III AL was significantly lower in the AMY Group than in the No-AMY Group (2 vs. 10%, P = 0.047).

CONCLUSIONS: Cervical drain fluid amylase levels can be a useful screening method for early detection of AL after esophagectomy for esophageal cancer and may help reduce incidence of severe postoperative AL.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:18

Enthalten in:

Esophagus : official journal of the Japan Esophageal Society - 18(2021), 3 vom: 27. Juli, Seite 522-528

Sprache:

Englisch

Beteiligte Personen:

Matsumoto, Tomohiro [VerfasserIn]
Kikuchi, Hirotoshi [VerfasserIn]
Haneda, Ryoma [VerfasserIn]
Soneda, Wataru [VerfasserIn]
Hirotsu, Amane [VerfasserIn]
Kawata, Sanshiro [VerfasserIn]
Hiramatsu, Yoshihiro [VerfasserIn]
Kamiya, Kinji [VerfasserIn]
Shibata, Yosuke [VerfasserIn]
Okada, Eisaku [VerfasserIn]
Takeuchi, Hiroya [VerfasserIn]

Links:

Volltext

Themen:

Amylase
Amylases
Anastomotic leakage
EC 3.2.1.-
Esophageal cancer
Journal Article

Anmerkungen:

Date Completed 25.03.2022

Date Revised 25.03.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s10388-021-00827-z

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM321989147