Ricerc@Sapienza

Anastomotic leakage is one of the most severe complications of surgical operations involving resections of the gastro-intestinal (GI) tract. Early diagnosis may play a pivotal role in the reduction of morbidity and mortality in the post-operative course. In the last few years, in addition to the most used biomarkers, such as C-Reactive Protein (CRP) and Procalcitonin (PCT), presepsin dosage has been described as a relevant and early inflammatory biomarker.
The aim of this study is to monitor and to identify the possible predictive role of presepsin in the early diagnosis of intestinal anastomotic leakage. Indeed, presepsin (sCD14-ST) is a soluble fragment of the multifunctional glycoprotein CD14, localized mainly on the membrane surface of monocytes/macrophages. It is one of the triggers of the inflammatory cascade also involved in the innate immunity, and early elevated in those patients diagnosed with sepsis. Interestingly, a recent study of M. Cikot assumed that presepsin may contribute significantly to the early detection of anastomotic leakage.
This one would be an Italian, prospective, monocentric study. Data collection and analysis will be carried out by the Department of General Surgery AOU Sant'Andrea of Rome.
All patients over 18 years of age undergoing emergency surgery for major abdominal surgery which resulted in bowel resection with anastomosis will be enrolled, after obtaining informed consent and approval of the Ethics Committee of the AOU of Sant'Andrea, in the current study.
In the postoperative course, in addition to the complete monitoring of the patient's clinical condition (vital signs, routine blood tests, eventual radiological imaging), blood samples will be taken to search for inflammatory values (White Blood Cell count, PCR , PCT) and for the assay of the soluble subtype of the presepsin molecule (sCD4-ST) on the 1st, 3rd and 5th postoperative day.