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Hyponatremia could identify patients with intrabdominal sepsis and anastomotic leak after colorectal surgery: a systematic review of the literature

  • Ahmad Alsaleh
  • Gianluca Pellino
  • Natasha Christodoulides
  • George Malietzis
  • Christos KontovounisiosEmail author
Review Article
  • 12 Downloads

Abstract

Anastomotic leak (AL) is a serious post-operative complication in colorectal surgery. It can lead to devastating morbidity and mortality. Clinicians usually depend on a combination of clinical, biochemical and radiological findings to diagnose this problem. In our article, we tried to look if electrolyte disturbances could be indicators for intra-abdominal sepsis due to AL. Systematic review of the literature identifies a potential correlation between electrolyte alterations and AL in digestive surgery. The following databases were searched: PubMed, EMBASE and MIDLINE. The review adhered to the PRISMA statement for systematic review. Our literature search did not identify any articles linking any electrolyte disturbances—except for hyponatremia—to AL. Pathophysiology of these electrolyte disturbances does not seem to be linked to AL, except for hyponatremia which might be explained. Our review included 442 patients with intra-abdominal sepsis and 1133 controls. The mean specificity of hyponatremia being associated with intra-abdominal sepsis is 86%, whereas mean sensitivity is 28%. Hyponatremia seems to be a significant and clinically relevant marker for of intra-abdominal sepsis and AL.

Keywords

Anastomotic leak Hyponatremia Electrolyte disturbance Colorectal surgery Complication 

Notes

Acknowledgements

The authors wish to thank the Royal Marsden Hospital Biomedical Research Council (BRC) for their support.

Funding

All Authors have no source of funding.

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest.

Research involving human participants and/or animals

This article did not involve human participants and/or animals.

Informed consent

No procedures were conducted by the authors on patients; there was no need of informed consent. This review was in agreement with the Good Clinical Practice.

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Copyright information

© Italian Society of Surgery (SIC) 2019

Authors and Affiliations

  1. 1.Department of Colorectal SurgeryChelsea and Westminster HospitalLondonUK
  2. 2.Department of Medical, Surgical, Neurological, Metabolic and Ageing SciencesUniversitá della Campania “Luigi VanvitelliNaplesItaly
  3. 3.Department of Surgery and CancerImperial CollegeLondonUK

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