It is usually diagnosed between 7 to 12 days postoperatively. Serum procalcitonin was taken before surgery and at day three (72 hours). Demographic and surgical data were obtained. Mortality following AL after colorectal and esophageal surgeries are 30% and 30-60% respectively ( 4, 5) 70 patients undergoing colorectal surgery were prospectively analyzed in a single-center tertiary teaching hospital. The incidence is high in esophagectomy and colorectal surgeries and was reported as 10% and 2-19% respectively ( 2, 3). The incidence of AL following intestinal surgeries is 2-20% ( 1). Keywords: C-reactive protein, procalcitonin, anastomotic leak IntroductionĪnastomotic leak (AL) is the most dreadful complication, which can occur following all intestinal anastomotic surgeries. Patients with raised CRP need careful evaluation to rule out anastomotic leak before deciding on early discharge. Serum procalcitonin, haemoglobin, total protein and albumin measured were not sensitive enough to detect the anastomotic leak early.Ĭonclusion: Measuring CRP on the third postoperative day can predict anastomotic leak with a cut off value of 44.32mg/dl. The cut off value for WBC count measured perioperatively in detecting anastomotic leak was 9470 cell/mm3 with sensitivity of 72.73%, specificity of 56.45% and accuracy of 59.74%. Wound infection rate was 23.81%.The cut off value of CRP on third postoperative day in detecting anastomotic leak was 44.322 mg/dl with sensitivity of 72.73%, specificity of 66.13% and accuracy of 59.52%. Anastomotic leak rate was 26.19% (22/84) and 3/22 patients died in anastomotic leak group. Results: Eighty-four patients were included in the study. postoperative day to assess for anastomotic leak, wound infection and other septic foci. Other parameters such as hemoglobin, total protein, albumin and WBC counts were noted perioperatively. Serial estimation of serum procalcitonin and C-reactive protein was done on the first five postoperative days. Material and Methods: A single centre prospective cohort study was done on patients undergoing elective gastrointestinal surgery with anastomosis. The present study was carried out to detect anastomotic leak early in the postoperative period using serial estimation of procalcitonin (PCT) and C-reactive protein (CRP). Objective: Anastomotic leak can adversely affect the outcome of surgery especially if detected late. Serial estimation of serum C-reactive protein and procalcitonin for early detection of anastomotic leak after elective intestinal surgeries-prospective cohort studyĭevarajan Jebin Aaron 1, Amaranathan Anandhi 1, Gubbi Shamanaa Sreenath 1, Sathasivam Sureshkumar 1, Oseen Hajilal Shaikh 1, Vairrappan Balasubramaniyan 2, Vikram Kate 1ġDepartment of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IndiaĢDepartment of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India Abstract