Clinical Gastroenterology Journal

PROCOLE (Prognostic Colorectal Leakage): A New Prognostic Index to Predict the Risk of Anastomotic Leak in Colorectal Cancer Surgery

Abstract

Pina D, Simo R, Machado R, Sebastian A, Calpena R

Objective: To develop a prognostic index to predict the risk of developing anastomotic leakage after colorectal cancer surgery, this has been named PROCOLE (prognostic colorectal leakage). Methods: A systematic review of the literature of observational studies has been performed to identify risk factors and then, a meta-analysis of each factor has been done. The factors that are statistically significant are weighted according to the value of the effect size. The prognostic index has been validated by an observational, longitudinal, retrospective, case-control data collection. Results: The predictive ability of the PROCOLE is made from the data obtained from the sample of cases and controls, resulting in an area under the curve (AUC) of 0.82 with a confidence interval of 95% of the AUC [0.75, 0.89]. Conclusions: The PROCOLE score predicts the risk of developing anastomotic leakage and may be useful to assist operative decision-making such as the implementation of a protective stoma.