{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:45:33Z","timestamp":1790725533025,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,8,2]],"date-time":"2019-08-02T00:00:00Z","timestamp":1564704000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005940","name":"Dansk Kr\u00e6ftforsknings Fond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005940","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007403","name":"Dagmar Marshalls Fond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007403","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004196","name":"Odense Universitetshospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Anastomotic leakage (AL) is a common and serious complication following sphincter\u2010preserving surgery for rectal cancer. Early detection and intervention can improve clinical outcomes. The aim of this prospective cohort study was to compare intraperitoneal microdialysis with a clinical scoring system for early detection of AL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A microdialysis catheter was anchored near the anastomosis at low anterior resection (LAR) for rectal cancer. Peritoneal fluid samples were analysed (lactate, pyruvate, glucose and glycerol concentration) 4\u2010hourly and compared with a daily clinical leak score (DULK\u00a0=\u00a0Dutch leakage). At day 7 a pelvic CT with rectal contrast enema was performed to establish if there had been a radiological leak.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In this two\u2010centre study, 129 patients [median age 65 (26\u201382) years; 60.5% male] underwent LAR. The leak rate was 27% (grade A, <jats:italic>n<\/jats:italic>\u00a0=\u00a011; grade B, <jats:italic>n<\/jats:italic>\u00a0=\u00a012; grade C, <jats:italic>n<\/jats:italic>\u00a0=\u00a012). Receiver operator characteristic analysis demonstrated a lactate cut\u2010off value of 9.8\u00a0m<jats:sc>m<\/jats:sc> and had 77% sensitivity, 82% specificity, 78% accuracy, a positive predictive value (PPV) of 58, a negative predictive value (NPV) of 88 (CI 79\u201394) and an area under the curve (AUC) of 0.9 for AL. This compared with a clinical score \u2265\u00a04, which had 57% sensitivity, 79% specificity, 71% accuracy, a PPV of 46, a NPV of 82 and an AUC of 0.7 for AL. The mean day for a positive test when using delta lactate \u2265\u00a06.3\u00a0m<jats:sc>m<\/jats:sc> was 1.6 days and for leak score \u2265\u00a04 it was 3.3\u00a0days (NS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>When AL occurs, intraperitoneal lactate concentration increases over time, and at a certain cut\u2010off has a higher sensitivity, specificity, accuracy, PPV and NPV than a clinical scoring system.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14781","type":"journal-article","created":{"date-parts":[[2019,7,18]],"date-time":"2019-07-18T14:42:56Z","timestamp":1563460976000},"page":"1387-1396","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Detection of early anastomotic leakage by intraperitoneal microdialysis after low anterior resection for rectal cancer: a prospective cohort study"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6550-7505","authenticated-orcid":false,"given":"M. B.","family":"Elleb\u00e6k","sequence":"first","affiliation":[{"name":"Department of Surgery Odense University Hospital Odense Denmark"},{"name":"OPEN, Odense Patient data Explorative Network Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. B.","family":"Rahr","sequence":"additional","affiliation":[{"name":"Department of Surgery Vejle Hospital Vejle Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Boye","sequence":"additional","affiliation":[{"name":"Department of Radiology Svendborg Hospital Svendborg Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Fristrup","sequence":"additional","affiliation":[{"name":"Department of Surgery Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Qvist","sequence":"additional","affiliation":[{"name":"Department of Surgery Odense University Hospital Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,2]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"1676","article-title":"Virtual ileostomy following TME and primary sphincter\u2010saving reconstruction for rectal cancer","volume":"54","author":"Sacchi M","year":"2007","journal-title":"Hepatogastroenterology"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-007-9023-4"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181dae4ed"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800570208"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0007-1323.2001.01829.x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2009.10.012"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2008.04.009"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9354"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-003-0498-8"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-008-0487-z"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-006-0708-x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365520310004065"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4586"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/145749690909800304"},{"key":"e_1_2_9_16_1","first-page":"1","article-title":"Peritoneal microdialysis as a tool for detecting anastomotic leakage in patients after left\u2010side colon and rectal resection. 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