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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 ISSN 0253-4886. [ 🗎 Public]. [ (✓) hoa:511 ]

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Official URL: https://doi.org/10.1159/000488007

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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:
DateEvent
February 2019Published
15 June 2018Available
22 May 2018Accepted
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 (Creative Commons)
Copyright Holders: The Author(s)
Date of first compliant deposit: 9 August 2018
Date of first compliant Open Access: 9 August 2018

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