Key result
Serum C-reactive protein (CRP) and CRP ratio cut-off values on post-operative days 2-5 were highly significant for detecting anastomotic leaks (P<0.001).
Why the study?
This study aimed to characterize the time-dependent relationship between serum CRP and anastomotic integrity in the early post-operative period and to develop a systematic use of CRP and computed tomography.
Does the systematic use of serum C-reactive protein concentration and computed tomography detect intestinal anastomotic leaks in patients with left-sided colonic or colorectal anastomosis?
Observational (n=125)
No
Does the systematic use of serum C-reactive protein concentration and computed tomography detect intestinal anastomotic leaks in patients with left-sided colonic or colorectal anastomosis?
p-value: p=<0.001
CRP and CRP ratio cut-off values are sensitive for detecting anastomotic leaks in the early post-operative period, facilitating systematic use of CRP and CT.
May support early CRP monitoring to detect colorectal anastomotic leaks; leaves open whether systematic CRP/CT protocols improve outcomes.
BACKGROUND: This study aimed to characterize the time-dependent relationship between serum C-reactive protein (CRP) and anastomotic integrity in the early post-operative period and to develop a systematic use of CRP and computed tomography. METHODS: Patients aged 18 years or over who had the formation of a left-sided colonic or a colorectal anastomosis, in Royal Sussex County Hospital, were included. The post-operative day (POD) CRP cut-off values were calculated according to receiver operating characteristic analysis to evaluate the sensitivities and specificities of the proposed cut-off parameters. RESULTS: A total of 125 left-sided colonic and colorectal anastomoses were recruited and analysed. When comparing to POD1 CRP cut-off, the calculated CRP ratio cut-off values of all the rest of PODs (2-5) were highly significant in the laparoscopic group and the overall group (P < 0.001). This statistically significant ratio was also demonstrated in the open group at POD2 (P < 0.0001). CONCLUSION: CRP and CRP ratios cut-off values were sensitive to detect an anastomotic leak in the early post-operative period. The cut-off values could facilitate the development of systematic use of CRP and computed tomography.
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Ho et al. (2019) conducted an observational in Left-sided colonic or colorectal anastomosis (n=125). Serum C-reactive protein (CRP) concentration was evaluated on Detection of intestinal anastomotic leaks (p=<0.001). Serum C-reactive protein (CRP) and CRP ratio cut-off values on post-operative days 2-5 were highly significant for detecting anastomotic leaks (P<0.001).
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