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Mediastinal Microdialysis in the Diagnosis of Early Anastomotic Leakage after Resection for cancer of the esophagus and GE junction

Authors
  • Ellebæk, Mark
  • Qvist, Niels
  • Fristrup, Claus
  • Mortensen, Michael Bau1, 2
  • 1 Department of Surgery
  • 2 Odense University Hospital
Type
Published Article
Journal
The American Journal of Surgery
Publisher
Elsevier
Publication Date
Jan 01, 2014
Accepted Date
Sep 29, 2013
Identifiers
DOI: 10.1016/j.amjsurg.2013.09.026
Source
Elsevier
Keywords
License
Unknown

Abstract

BackgroundAnastomotic leakage after gastroesophageal resection for cancer is a serious complication. The aim was to evaluate mediastinal microdialysis (MM) in the detection of anastomotic leakage prior to clinical symptoms MethodsSixty patients were included. Samples were collected every 4 hours in the first eight postoperative days and analysed for several metabolites. ResultsForty-four patients had an uncomplicated postoperative recovery, 7 developed anastomotic related complications and 5 major non-anastomotic related complications. Six patients were excluded (early catheter malfunction and re-operation).Logistic regression model on several metabolites demonstrated a 100 % sensitivity, specificity, 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 anastomotic leakage. ConclusionThe diagnosis of anastomotic related complications prior to clinical symptoms seemed possible by MM, but the diagnosis should be based on an interpretation of several metabolic events. Summery“Mediastinal microdialysis seemed able to detect preclinical anastomotic leakages, but the interpretation should be based on several metabolic events”

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