Background. Early diagnosis of anastomotic leakage (AL) after rectal surgery can reduce the adverse effects of AL, thereby reducing morbidity and mortality. Currently, there are no accepted indicators or effective scoring systems that can clearly identify patients at risk of anastomotic leakage. Methods. A prospective study with assessment of the diagnostic accuracy of oxidative stress level (CAT, SOD, MDA) in serum and drain fluid compared to white blood cell count (WBC), C-reactive protein (CRP), and neutrophil percentage (NEUT) in prediction of AL in patients undergoing elective rectal surgery with anastomosis. Results. Most of the oxidative stress indicators we detected are of considerable significance in the diagnosis of anastomotic leakage. The level of MDA on postoperative day (POD)3 (areas under the curve (AUC): 0.831) and POD5 (AUC: 0.837) in the serum and on POD3 (AUC: 0.845) in the drain fluid showed the same excellent diagnostic accuracy as the level of CRP on the POD3 (AUC: 0.847) and POD5 (AUC: 0.896). Conclusions. The overall level of oxidative stress in serum and drain fluid is a reliable indicator for the early diagnosis of anastomotic leakage after rectal surgery. More specifically, among the redox indicators analyzed, MDA has almost the same predictive value as CRP, which provides another useful biomarker for the early diagnosis of anastomotic leakage.

中文翻译：

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氧化应激水平作为直肠手术后吻合口漏的预测指标

背景。直肠手术后吻合口漏（AL）的早期诊断可以减少AL的不良反应，从而降低发病率和死亡率。目前，没有公认的指标或有效的评分系统可以清楚地识别有吻合口漏风险的患者。方法。一项前瞻性研究，评估血清和引流液中氧化应激水平（CAT、SOD、MDA）与白细胞计数（WBC）、C反应蛋白（CRP）和中性粒细胞百分比（NEUT）相比的诊断准确性择期直肠吻合术患者 AL 的预测。结果. 我们检测到的大部分氧化应激指标对吻合口漏的诊断具有相当的意义。术后第 3 天（POD）3（曲线下面积（AUC）：0.831）和 POD5（AUC：0.837）血清和引流液 POD3（AUC：0.845）水平显示出同样出色的诊断准确性作为 POD3 (AUC: 0.847) 和 POD5 (AUC: 0.896) 上的 CRP 水平。结论。血清和引流液中氧化应激的总体水平是早期诊断直肠​​术后吻合口漏的可靠指标。更具体地说，在所分析的氧化还原指标中，MDA的预测价值与CRP几乎相同，为吻合口漏的早期诊断提供了另一个有用的生物标志物。