Assessment of Systemic Inflammatory Response Index as a Predictor of Anastomotic Leakage after Colorectal Cancer Surgery

Background: In the field of colorectal cancer (CRC) surgery, anastomotic leakage (AL) is one of the most potentially fatal postoperative complications, contributing to morbidity, mortality, and delayed adjuvant therapy. Systemic Inflammatory Response Index (SIRI) is a novel marker that reflects systemic inflammation. The main goal is to evaluate the role of systemic SIRI in prediction of anastomotic leakage in patients with colorectal cancer whom underwent radical surgical resection and anastomosis.Methods: A prospective cohort study included 40 patients undergoing radical colorectal cancer resection and anastomosis in Surgical Oncology department, Suez Canal University Hospital in Ismailia. Preoperative SIRI values were calculated from complete blood counts with differential. The optimal cut-off value of SIRI and other inflammatory markers was determined by receiver operating characteristic (ROC) curve analysis.Results: The study demonstrated AL incidence of 15%, it was significantly increased with elevated levels of preoperative SIRI (p-value 0.006). A cutoff value of [5897.6] yielded sensitivity of 66.7% and specificity of 100%. Univariate analysis showed that C-reactive protein (CRP) > 15 and SIRI > 5897.6 have the highest odds ratio for detection of risk for AL measuring 13.8 and 66 respectively. Multivariate regression confirmed SIRI as an independent predictor of AL.Conclusion: Preoperative SIRI is a reliable, independent, inexpensive and available predictor of AL following CRC surgery, offering high specificity of 100% and moderate sensitivity of 66.7%. The combined use of SIRI and CRP may therefore improve preoperative risk stratification and guide perioperative management.