Key result
Post-operative serum CRP levels below /L and /L on days 2 and 4, respectively, effectively excluded anastomosis leakage with 96% sensitivity.
Why the study?
Anastomotic leak is a common complication of colorectal surgery, and C-reactive protein may be valuable for early diagnosis and exclusion to help shorten hospitalization.
Does postoperative C-reactive protein measurement predict the exclusion of anastomosis leakage in patients undergoing elective colorectal surgery?
Observational (n=315)
No
Does postoperative C-reactive protein measurement predict the exclusion of anastomosis leakage in patients undergoing elective colorectal surgery?
Postoperative serum CRP levels below 44 mg/L on day 2 and 27.2 mg/L on day 4 can serve as highly sensitive markers to exclude anastomotic leakage and potentially shorten hospitalization after colorectal surgery.
Answers are grounded in this paper and cite their sources.
May support CRP thresholds to exclude leakage after colorectal surgery; leaves open need for prospective validation before changing discharge practice.
Background: Anastomotic leak (AL) is one of the common complications of colorectal surgeries. In COVID-19 pandemic, shortening the hospitalization period seems valuable in reducing postoperative complications Objectives:. C-reactive protein is valuable in early diagnosis and also exclusion of AL. Method: This study was a survey of laboratory tests. The patients were enrolled with the elective of colorectal surgery between 2017 and 2019. We measured the symptoms of Anastomotic leak such as high-level C-reactive protein, leukocytosis, body temperature, and ileus by passing five days from the surgery. Moreover, we evaluated the value of C-reactive protein to exclude Anastomosis leakage within 5 postoperative days. Results: three hundred and fifteen patients were enrolled in this study. The mean age of the patients was 56.2 years old. Anastomotic leak was detected in 26 patients. C-reactive protein levels in the second day, third day, fourth day, and fifth day were significant for the Anastomotic leak (P-value <0.05). In postoperative days 2 and 4, CPR levels below 44 mg/L and 27.2 mg/L were found to be significant for the exclusion of anastomosis leakage. Conclusion: Postoperative serum CRP, especially on postoperative days 2 and 4 with cut off value of 44 mg/L and 27.2 mg/L in the absence of ileus, fever, leukocytosis, and normal abdominal examination, could be considered as a highly sensitive adjutant to exclude AL and shorten the hospitalization period.
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Amoli et al. (2021) conducted an observational in Elective colorectal surgery with primary anastomosis (n=315). Postoperative C-reactive protein (CRP) levels vs. Patients without anastomosis leakage was evaluated on Anastomosis leakage (p=<0.001). Post-operative serum CRP levels below /L and /L on days 2 and 4, respectively, effectively excluded anastomosis leakage with 96% sensitivity.
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