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Subject Area

Surgery

Article Type

Original Study

Abstract

Objectives: This study aimed to evaluate the value of drain fluid amylase (DAM) levels as a predictive biomarker for early detection of AL in proximal and distal gastrointestinal anastomosis.

Background: Anastomotic leakage is a critical complication following bowel surgery, leading to significant morbidity, mortality. AL is defined as leaking of luminal contents into peritoneal cavity. Early detection affect greatly the management.

Patient and Methods: A prospective observational study was conducted on 33 of 300 patients who underwent GI anastomosis at Menoufia University Hospitals from March 2023 to March 2024. The 33 patients have a relatively high suspicious to have anastomotic leakage we included them to evaluate level of amylase in drain fluid and confirm diagnosis clinically and radiological. We used this technique to evaluate if we can use amylase level in drain fluid as an early predictor for AL.

Results: The study found that 63.6% of participants were males and 36.4% were females, with a mean age of 48.76 ± 12.52 years and a mean BMI of 26.70 ± 3.03 kg/m². Emergent surgeries accounted for 51.5% of cases, while elective surgeries made up 48.5%. The incidence of AL was 30.3%, with a higher incidence in emergent procedures (41.2%) compared to elective procedures (18.7%). DAM levels showed high sensitivity and specificity for predicting AL.

Conclusions: This study supports the use of DAM measurement as a simple, cost-effective, and reliable method to predict AL, allowing for early intervention.

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