Bacteriological Concentration of Peritoneal Drainage Fluid Could Make an Early Diagnosis of Anastomotic Leakage Following Rectal Resection

Purpose: To investigate that the bacteriological concentration and pH value in peritoneal drainage fluid might serve as indicators of early diagnosis of anastomotic leakage following rectal resection. Methods: We prospectively analyzed consecutive patients who were treated for rectal diseases with anastomotic stoma at the department of general surgery, the affiliated hospital of Nanjing University Medical School between August 2018 and December 2020. The bacteriological concentration and the pH levels in peritoneal drainage fluid were tested on the first, fourth, seventh days postoperatively. Results: A total of 300 consecutive patients underwent rectal resection were tested. 21 patients present with AL and the overall AL rate was 7%. The bacteriological concentration in peritoneal drainage fluid of AL group was significantly higher than that in non-AL group. The AUC value was 0.98 according to the ROC curve. The best cut-off value was 1143/uL and the sensitivity and specificity were 100% and 93.19% respectively. There was no difference of pH value between the AL and non-AL groups. Conclusion: According the results of present study, a high bacteriological concentration in peritoneal drainage fluid is a good marker for predicting and diagnosing AL following rectal resection. The best cut-off value is1143/uL and the sensitivity and specificity are 100% and 93.19% respectively.