Microwave biosensor for amylase detection in drainage fluid to monitor anastomotic leakage

Anastomotic leakage (AL) is a serious complication following colorectal cancer surgery, resulting in increased morbidity, extended hospital stays, and higher mortality rates. Current methods for AL monitoring are often delayed, non-specific, and unsuitable for long-term point-of-care (POC) applications, highlighting the need for cost-effective, portable biosensors. Amylase, a promising biomarker present in peritoneal fluid, offers hope for early and long-term detection of AL. In this study, we present a miniaturized microwave biosensor capable of quasi-continuous (e.g. hourly) monitoring of amylase concentrations from postoperative day 1 and for a long time. The sensor detects clinically relevant amylase concentrations (>1000 U/L) within an hour, enabling early and prolonged monitoring of AL. High specificity was achieved using an amylopectin coating that reacts selectively with amylase, even in complex samples such as simulated peritoneal fluid (SPF). We validated the performance of our miniaturized, portable microwave sensor against the EnzChek™ Ultra Amylase Assay Kit, confirming its accuracy and reliability. This low-cost, portable biosensor provides a proof-of-concept for a practical, highly specific POC solution for real-time AL monitoring, supporting both early diagnosis and long-term postoperative care.