Fecal Calprotectin as a Marker for Postoperative l'eri-ileitis after Sphincter-preserving Total Colectomy in Ulcerative Colitis Patients
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The study aimed to evaluate fecal calprotectin (K .) its it autrAer Ira- the raaconu• of surgical twatment of cases of ulcerative colitis WC resistant to medical treatment and as applicability as a follow-up diagnostic modality and for predicting postopetatice (PO) relative, &trolled patients were evaluated clinically using Ilarycy-Bradshatv Activity Index far 1/C mud anderwem i.olomiscopy and mucosa, biopsy. The study comprised 10 volunteerv as control ,group. Study participants (Patients cc: controls) supplied fresh fecal samples that were processed to obtain clear extract supernatant which was EL/SA assayed for PC -concentrations. Patients gaVe 4 fecal samples, preoperative !SOL prior to hospital discharge (SI) and 6 (S3) and 12 months (53) postothanthy. The .vtudy contprised 35 patients had active disease with a mean UCA1 score of 7.94±3.3 and mean preliminary colonoscopic score of 2.2.6. All patients underwent preliminary lapamscopy and 10 cases lardei -wcat iapart,AciT6 - lotal colect, nly. read mucosa stripping and *preen?l anastomosis, while in 25 patients the .‘aine praccifitre l'ets applied through laparotomy. Prior to discharge (SI), 24 patients had no complaints and their UCAI was zero: while 11 patients were still complaining with a total meem PO lICAI of 0.7-0.6 and received Medical Irealinent: at 6-months PO, 6 patients had complaining with a total score of 0.6±2 and at 12 months 1'0,2 patients still complaining with a total IICAI of 0.742.4. Postoperative calonowopv and biopAr Alumni *nye I K in 2 patients who underwent total pl000-COICCMIlly PICOpet Jam' i•oncrotration was significantly higher compared to its levels in control .subjects and in patients follow-up samples that showed significantly higher PC to control levels with non-significant di fkrence itchetween. There was a positive significant correlation between theopemave H colleen:rations and di.vease activity judged by preoperative UCAI and colonoscopic grading. Using the receiver operating rhameteristic (ROC) curve analysis judged by the area under the curve (A (IC) ha the speed icily of estimation of PC prior to discharge as a predictor pr ro recurrent mildly Conlin' red to PO colomrscopy wyealed a nonsignificant difference between both n•parted A (IC (A IIC=0.839 Ai. 0.580 respectively? and defined it cutoff point of 355 pearl as the most specific cutoff point for preopertany kr as predictor,fm. the possibility of recurrent ulceration. It could be concluded that estimation of PC is a reliable specific non-invasive inodality for follow-up of patients with UC who underwent total colectomy and ileo-rectal anastmnosis at can predict .P0 recurrence using a cutoff- potht of preopemtive PC at 355 pg/m1 as differentiating point for identifying those at higher risk for relapse. Kew words: Fecal Calproteetin, uleemtive colitis, surgical treatment, recurrence.