Anastomic leak in colorectal cancer surgery. Development of a diagnostic index (DIACOLE)

作者：Rojas Machado Silvia Angelica; Romero Manuel; Arroyo Antonio^*; Rojas Machado Adaly; Lopez Jeronimo; Calpena Rafael

来源：International Journal of Surgery, 2016, 27: 92-98.

DOI：10.1016/j.ijsu.2016.01.089

• Colorectal cancer
• Diagnostic score
• Anastomotic leakage
• Meta-analysis

Background: We have obtained a diagnostic score (DIACOLE) in order to detect anastomotic leakage in the postoperative period of colorectal cancer surgery.
Methods: Systematic review to identify any symptoms and clinical or analytical signs associated with anastomotic leakage after colorectal cancer surgery and a meta-analysis of each of these factors. The DIACOLE score encompasses all factors that reached statistical significance in their respective meta-analyses. The value of each factor in the score was determined depending the Napierian logarithm of the odds ratios. The index was validated using collected data at our institution.
Results: We identified 13 potential signs and symptoms of anastomotic leakage to elaborate the DIACOLE score. The predictive power of the DIACOLE was validated in a case-control study, resulting in an Area Under Curve (AUC) of 0.911 and a 95% confidence interval. These values were considered indicative of a very good diagnostic score.
Conclusions: If DIACOLE score is > 3.065, a blood count and re-evaluating the score daily are recommended. If the DIACOLE > 5.436, a radiological test is advised. We have developed free software to obtain DIACOLE value.

• 出版日期2016-3