Denizhan KILIÇ, Erhan KIZILKAYA
Annals of Clinical and Analytical Medicine - 2026;17(10):1111-1116
Aim: This study evaluated associations of perioperative laboratory parameters, inflammatory and nutritional indices, and their changes over time with anastomotic leakage after colorectal surgery. Methods: Patients undergoing colorectal surgery between January 2020 and April 2026 were retrospectively evaluated; 28 without anastomosis were excluded, leaving 183 patients with primary anastomosis. We analyzed preoperative, postoperative day 1 (POD1), and postoperative day 3 (POD3) hematological and biochemical parameters and derived indices (NLR, PLR, LMR, SII, SIRI, CAR, and PNI), as well as POD1-to-POD3 changes, by anastomotic leakage status. Results: Anastomotic leakage occurred in 21 patients (11.5%) and was associated with a longer mean (SD) hospital stay (23.43 [20.53] vs. 11.14 [6.06] days; P < .001). Preoperative parameters did not differ significantly between patients with and without anastomotic leakage. On POD1, leukocyte ( P = .018) and neutrophil ( P = .032) levels were higher in the leakage group, while on POD3, leukocyte, neutrophil, CRP, NLR, SII, SIRI, and CAR were significantly elevated (all P < .05). POD1-to-POD3 changes were not associated with leakage. POD3 CRP remained associated with anastomotic leakage after adjustment for age, sex, and tumor diameter (adjusted OR=1.010; 95% CI: 1.003-1.016; P = .002). Conclusion: POD3 inflammatory markers were associated with anastomotic leakage, and the association with CRP persisted after adjustment for age, sex, and tumor diameter. Changes from POD1 to POD3 were not significantly associated with leakage. Clinical predictive performance was not evaluated.
