Early Detection and Monitoring of Anastomotic Leaks via Naked Eye‐Readable, Non‐Electronic Macromolecular Network Sensors

Author:

Jessernig Alexander12,Anthis Alexandre H.C.12,Vonna Emilie1,Rosendorf Jachym34,Liska Vaclav34,Widmer Jeannette5,Schlegel Andrea A.6,Herrmann Inge K.1278ORCID

Affiliation:

1. Nanoparticle Systems Engineering Laboratory Institute of Energy and Process Engineering (IEPE) Department of Mechanical and Process Engineering (D‐MAVT) ETH Zurich Sonneggstrasse 3 Zurich 8092 Switzerland

2. Particles‐Biology Interactions Laboratory Department of Materials Meet Life Swiss Federal Laboratories for Materials Science and Technology (Empa) Lerchenfeldstrasse 5 St. Gallen 9014 Switzerland

3. Department of Surgery Faculty of Medicine in Pilsen Charles University Alej Svobody 923/80 Pilsen 32300 Czech Republic

4. Biomedical Center Faculty of Medicine in Pilsen Charles University Alej Svobody 1655/76 Pilsen 32300 Czech Republic

5. Department of Surgery and Transplantation Swiss HPB Centre University Hospital Zurich Zürich 8091 Switzerland

6. Transplantation Center Digestive Disease and Surgery Institute and Department of Immunity and Inflammation Lerner Research Institute Cleveland Clinic 9620 Carnegie Ave Cleveland OH 44106 USA

7. The Ingenuity Lab University Hospital Balgrist Balgrist Campus Forchstrasse 340 Zurich 8008 Switzerland

8. Faculty of Medicine University of Zurich Rämistrasse 74 Zürich 8006 Switzerland

Abstract

AbstractAnastomotic leakage (AL) is the leaking of non‐sterile gastrointestinal contents into a patient's abdominal cavity. AL is one of the most dreaded complications following gastrointestinal surgery, with mortality rates reaching up to 27%. The current diagnostic methods for anastomotic leaks are limited in sensitivity and specificity. Since the timing of detection directly impacts patient outcomes, developing new, fast, and simple methods for early leak detection is crucial. Here, a naked eye‐readable, electronic‐free macromolecular network drain fluid sensor is introduced for continuous monitoring and early detection of AL at the patient's bedside. The sensor array comprises three different macromolecular network sensing elements, each tailored for selectivity toward the three major digestive enzymes found in the drainage fluid during a developing AL. Upon digestion of the macromolecular network structure by the respective digestive enzymes, the sensor produces an optical shift discernible to the naked eye. The diagnostic efficacy and clinical applicability of these sensors are demonstrated using clinical samples from 32 patients, yielding a Receiver Operating Characteristic Area Under the Curve (ROC AUC) of 1.0. This work has the potential to significantly contribute to improved patient outcomes through continuous monitoring and early, low‐cost, and reliable AL detection.

Funder

Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung

Publisher

Wiley

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