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Non-invasive detection of anastomotic leakage following esophageal and pancreatic surgery by urinary analysis
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Plat, Victor D., Gaal, Nora van, Covington, James A., Neal, Matthew, Meij, Tim G. J. de , Peet, Donald L. van der, Zonderhuis, Babs, Kazemier, Geert, Boer, Nanne K. H. de and Daams, Freek (2019) Non-invasive detection of anastomotic leakage following esophageal and pancreatic surgery by urinary analysis. Digestive Surgery, 36 (2). pp. 173-180. doi:10.1159/000488007
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WRAP-non-invasive-detection-anastomotic-leakage-urinary-Covington-2018.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution Non-commercial No Derivatives 4.0. Download (437Kb) | Preview |
Official URL: https://doi.org/10.1159/000488007
Abstract
Background
Esophagectomy or pancreaticoduodenectomy is the standard surgical approach for patients with tumors of the esophagus or pancreatic head. Postoperative mortality is strongly correlated with the occurrence of anastomotic leakage (AL). Delay in diagnosis leads to delay in treatment, which ratifies the need for development of novel and accurate non-invasive diagnostic tests for detection of AL. Urinary volatile organic compounds (VOCs) reflect the metabolic status of an individual, which is associated with a systemic immunological response. The aim of this study was to determine the diagnostic accuracy of urinary VOCs to detect AL after esophagectomy or pancreaticoduodenectomy.
Methods
In the present study, urinary VOCs of 63 patients after esophagectomy (n = 31) or pancreaticoduodenectomy (n = 32) were analyzed by means of field asymmetric ion mobility spectrometry. AL was defined according to international study groups.
Results
AL was observed in 15 patients (24%). Urinary VOCs of patients with AL after pancreaticoduodenectomy could be distinguished from uncomplicated controls, area under the curve 0.85 (95% CI 0.76-0.93), sensitivity 76%, and specificity 77%. However, this was not observed following esophagectomy, area under the curve 0.51 (95% CI 0.37-0.65).
Conclusion
In our study population AL following pancreaticoduodenectomy could be discriminated from uncomplicated controls by means of urinary VOC analysis, NTC03203434.
| Item Type: | Journal Article | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Subjects: | R Medicine > RD Surgery | ||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Engineering > Engineering | ||||||||
| SWORD Depositor: | Library Publications Router | ||||||||
| Library of Congress Subject Headings (LCSH): | Pancreas -- Surgery, Esophagus -- Surgery, Organic compounds, Biofragmentable anastomosis rings, Ion mobility spectroscopy | ||||||||
| Journal or Publication Title: | Digestive Surgery | ||||||||
| Publisher: | S. Karger AG | ||||||||
| ISSN: | 0253-4886 | ||||||||
| Official Date: | February 2019 | ||||||||
| Dates: |
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| Volume: | 36 | ||||||||
| Number: | 2 | ||||||||
| Page Range: | pp. 173-180 | ||||||||
| DOI: | 10.1159/000488007 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Open Access | ||||||||
| Copyright Holders: | The Author(s) |
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