The Value Of Monitoring Interleukin-6,Procalcitonin And C-Reactive Protein In Early Diagnosis Of Anastomotic Leakage After Laparoscopic Middle And High Rectal Cancer Surgery

The value of monitoring interleukin-6,procalcitonin and C-reactive protein in early diagnosis of anastomotic leakage after laparoscopic middle and high rectal cancer surgery.Objective:To investigate the early diagnostic value of interleukin-6(IL-6),procalcitonin(PCT)and C-reactive protein(CRP)in predicting anastomotic leakage after laparoscopic rectal cancer surgery,improve the early diagnosis rate of anastomotic leakage,and provide the basis for its diagnosis and prevention.Methods:This study is a single center retrospective study.60 patients who underwent laparoscopic radical resection of middle and high rectal cancer in the colorectal surgery department of the second hospital of Jilin University from November 2020 to July 2021 were included according to the inclusion criteria and exclusion criteria.The patients were divided into anastomotic leakage group and non-anastomotic leakage group according to whether anastomotic leakage occurred.Clinical data were collected: gender,age,history of hypertension,history of diabetes,the index contents of IL-6,PCT and CRP on the first day before operation and the 1/3/5/7 day after operation.The levels of IL-6,PCT and CRP were compared on the 1st day before operation and the 1/3/5/7 day after operation.The ROC curve was used to evaluate the early predictive value of IL-6,PCT and CRP for postoperative anastomotic leakage.Result:1.Compared with the non-anastomotic leakage group,the operation time and hospital stay in the anastomotic leakage group were significantly longer(P < 0.05),other baseline data showed no significant difference between the two groups(P>0.05);2.The level of IL-6 in the anastomotic leakage group increased significantly on the5 th day after operation(P<0.05).The results of ROC curve showed that the AUC value of IL-6 level on the 5th day after operation was 0.906,and the best critical value was 6.31pg/ml;3.The level of PCT in the leakage group increased significantly on the 3rd day after operation(P<0.05).The results of ROC curve showed that the AUC value of PCT level on the 3rd day after operation was 0.965,and the best critical value was0.3264ng/ml;4.The CRP level in the anastomotic leakage group increased significantly on the 5th day after operation(P<0.05).The ROC curve showed that the AUC value of CRP level on the 5th day after operation was 0.906,and the best critical value was61.8mg/l;5.The combined detection of IL-6 and PCT on the 3rd day after operation predicted anastomotic leakage better than the single index detection(AUC 0.984>0.965).Conclusion:When IL-6>6.31pg/ml on the 5th day after operation,PCT>0.3264ng/ml on the 3rd day after operation and CRP>61.8mg/L on the 5th day after operation,the possibility of anastomotic leakage should be highly vigilant.The combined detection of IL-6 and PCT after operation is of great significance in predicting the occurrence of anastomotic leakage after laparoscopic surgery for middle and high rectal cancer.