Significant elevation of carcinoembryonic antigen levels in abdominal drains after colorectal surgery may indicate early anastomotic dehiscence

Background Anastomotic leak after colorectal surgery is a severe complication leading to major postoperative morbidity and mortality. Leaks typically present on the 5th to 6th postoperative days; however, early anastomotic dehiscence occurs occasionally. This study evaluated carcinoembryonic antigen (CEA) levels in abdominal drains after colorectal resection to assess its potential as an early marker to predict anastomotic leaks. Methods This prospective study included 105 patients undergoing elective colorectal surgery. Fluids from the patients' abdominal drain system were sampled daily for up to 3 days after surgery and evaluated for CEA levels. Results Early anastomotic dehiscence occurred in 3 patients (2.8%) and was associated with a significant elevation of CEA in drain fluids (above 1,000 ng/mL). However, in patients who developed late leaks (7 patients, 6.7%) no significant elevation of CEA was observed. Conclusions Significant elevation of CEA levels in abdominal drains in the early postoperative period may indicate early anastomotic dehiscence.