Prospective evaluation of clinical and analytical values in the early diagnosis of anastomotic leak after oncological gastric surgery (PROFUGO study).

Authors

Marcos Bruna, Antonio J Serrano, Rocío Pérez-Quintero, Carla Bettonica, Cristina Alegre, María Tudela, Miriam Menéndez, Adrián Herrero, Alessandro Bianchi, Irene Álvarez, Felipe Parreño, Jennifer Triguero, Sergio Rodríguez, Rocío González, Marta de Vega, Ander Bengoechea, Elena Fernández, Mª Asunción Acosta, Silvia Carbonell, Fernando López, Sandra Del Barrio, Ana Senent, Cristina Marín, Helena Salvador, Elizabeth Redondo, Rodolfo Rodríguez, Elisenda Garsot, Claudia Mulas, Diego Antonio Bernal, Teresa Carrascosa, Laura Jiménez, Erick Montilla, Loles Periáñez, Luis Munuera, Jose Luis Romera, María García, Cristina Sancho, Ramón Castañeda, Gabriel Salcedo, Monica Rey, Amparo Roig, Rafael López, Marcelino Martínez-Sober, Dulce Momblán, Sol Bagnaschino, Carlos Díaz, Jean Carlos Trujillo, María Del Campo

Published in

Cirugia espanola. Pages 800372. Sep 01, 2026. Epub Sep 01, 2026.

Abstract

Resective surgery is the cornerstone of gastric cancer treatment, but it carries considerable morbidity and mortality, with anastomotic leak (AL) being the most feared complication. This study aims to describe the prevalence and diagnostic management of AL after oncological gastrectomy, analyzing clinical and laboratory parameters that may facilitate its early diagnosis.
A prospective, multicentre, national study was conducted between 2023 and 2024. 435 patients who underwent surgery for gastric cancer at 43 centres were included. Sociodemographic variables and diagnostic and therapeutic management data were described, comparing the postoperative evolution of clinical and laboratory variables in patients with and without anastomotic leak.
The overall prevalence of AL was 10.5%, with patients exhibiting a significantly higher heart rate from the second postoperative day. In the group of patients with AL, C-reactive protein, procalcitonin, and interleukin-6 showed higher levels from the first postoperative day. Other markers, such as leukocytes and the neutrophil-to-lymphocyte ratio, were also significantly higher in the AL group. The diagnosis of AL was established at a median of 6 days post-surgery, with a resolution rate of 80% using endoscopic therapies, interventional radiology and surgery.
Although the diagnosis of AL is often delayed until the sixth postoperative day, the differences in the values of variables such as C-reactive protein, procalcitonin, and interleukin-6 between patients with and without AL become noticeable earlier. These findings support the creation of predictive models based on the variables studied to diagnose this complication early.

PMID:
42680093
Bibliographic data and abstract were imported from PubMed on 02 Sep 2026.

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