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Polymerase chain reaction for Enterococcus faecalis in drain fluid: the first screening test for symptomatic colorectal anastomotic leakage

The Appeal-study: Analysis of Parameters Predictive for Evident Anastomotic Leakage

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Polymerase chain reaction for Enterococcus faecalis in drain fluid: the first screening test for symptomatic colorectal anastomotic leakage

The Appeal-study: Analysis of Parameters Predictive for Evident Anastomotic Leakage

Rechten: Alle rechten voorbehouden

Samenvatting

Purpose
With current diagnostic methods, the majority of patients with symptomatic colorectal anastomotic leakage (CAL) is identified approximately 1 week after operation. The aim of this study is to determine whether real-time polymerase chain reaction (RT-PCR) for detection of Escherichia coli and Enterococcus faecalis on drain fluid can serve as a screening test for CAL in the early postoperative phase.
Methods
All patients included in this multicenter prospective observational study underwent left-sided colorectal resection for both malignant and benign diseases with construction of an anastomosis. In all patients, an intra-abdominal drain was placed during operation. During the first five postoperative days, drain fluid was processed for RT-PCR. The quantitative results of the RT-PCR on days 2 to 5 were compared to the results of day 1 in order to detect concentration changes.
Results
In total, 243 patients, with both benign and malignant diseases, were included of whom 19 (7.8 %) developed symptomatic CAL. An increase in E. coli concentration was found in significantly more patients with CAL on day 4 and 5 [p = 0.0004; diagnostic odds ratio (DOR) 7.9]. For E. faecalis, this result was found for days 2, 3, and 4 (p 

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OrganisatieHogeschool Leiden
AfdelingFaculteit Techniek
LectoraatInnovatieve Moleculaire Diagnostiek
Gepubliceerd inInternational Journal of Colorectal Disease Springer Nature, Vol. 29, Pagina's: 15-21
Jaar2014
TypeArtikel
DOI10.1007/s00384-013-1776-8
TaalEngels

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