Safe and Early Discharge After Colorectal Surgery Due to C-Reactive Protein

Warschkow, René; Beutner, Ulrich; Steffen, Thomas; Müller, Sascha; Schmied, Bruno M.; Güller, Ulrich; Tarantino, Ignazio

doi:10.1097/sla.0b013e31825b60f0

Cited by 157 publications

(123 citation statements)

References 29 publications

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“…Apart from increased morbidity and mortality rates it results in longer in-hospital stay, higher costs and even increased cancer recurrence rates [3,4]. Early diagnosis and treatment are paramount to improve these outcomes [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Gender, Age and BMI on Postoperative C-Reactive Protein Levels After Major Abdominal Surgery

et al. 2014

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Section: Introductionmentioning

confidence: 99%

The Effect of Gender, Age and BMI on Postoperative C-Reactive Protein Levels After Major Abdominal Surgery

et al. 2014

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“…Infective complications were categorised as described elsewhere and summarised here briefly [8]. Wound (superficial surgical site) infection was defined as the presence of pus either spontaneously discharging from the wound or requiring drainage.…”

Section: Methodsmentioning

confidence: 99%

“…Recent evidence suggests that the postoperative systemic inflammatory response, measure by C-reactive protein (CRP), is important in both short and long term outcomes of colorectal patients and that it may be a causal factor in development of postoperative complications [6][7][8][9][10]. A recent comprehensive review has suggested that CRP concentrations exceeding 150mg/L on postoperative days 3 to 5 should alert clinicians to the possible development of postoperative complications, including anastomotic leakage, precluding early discharge [11].…”

Section: Introductionmentioning

confidence: 99%

The relationship between systemic inflammation and stoma formation following anterior resection for rectal cancer: A cross-sectional study

Khor

McSorley

Horgan

et al. 2017

International Journal of Surgery

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Tel: 0141 211 4000Running title: Inflammation and permanent stoma rate Disclosure: no conflicts of interest, no financial support/interests Keywords: colorectal cancer, stoma, stress response, morbidity 2 Abstract IntroductionThere is evidence that temporary defunctioning stoma formation in patients undergoing anterior resection reduces the risk of anastomotic leakage. The aim of the present study was to investigate the relationship between stoma formation, the postoperative systemic inflammatory response and complications following anterior resection for rectal cancer. ResultsOf the 167 patients, the majority were male (61%) and over 65 years old (56%) with node negative disease (60%). 36 patients (22%) underwent preoperative neoadjuvant treatment. 100 patients (60%) had a stoma formed at the time of surgery. Stoma formation was significantly associated with male sex (69% vs. 50%, p=0.017), neoadjuvant chemoradiotherapy (30% vs 9%, p=0.001) and open surgery (71% vs. 55%, p=0.040). Of those 100 patients who had a stoma formed, 80 had it reversed. Permanent stoma was significantly associated with increasing age (p=0.011), exceeding the established CRP threshold of 150mg/L on postoperative day 4 (67% vs 37%, p=0.039), higher incidence of 3 postoperative complications (76% vs 47%, p=0.035), anastomotic leakage (24% vs 2%, p=0.003) and higher Clavien Dindo score (p=0.036). ConclusionsThere was no significant association between stoma formation during anterior resection and the postoperative systemic inflammatory response. However, in these patients both the postoperative systemic inflammatory response and complications were associated with permanent stoma.  Both inflammatory response and complications were associated with permanent stoma.5

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“…Most studies focus on the forecast of serious infections or leakage after intestinal surgery [19,20,21,22,23,24,25]. Some authors define the third and fourth day after surgery as a cutoff point [21,22,24]. Other authors could show no predictive value for an early diagnosis of bowel leak or inflamed disease [19,20,23,25].…”

Section: Discussionmentioning

confidence: 99%

“…According to Riss et al [18], preoperatively increased CRP values in patients with Crohn's disease seem to be associated with a negative outcome. Most studies focus on the forecast of serious infections or leakage after intestinal surgery [19,20,21,22,23,24,25]. Some authors define the third and fourth day after surgery as a cutoff point [21,22,24].…”

Section: Discussionmentioning

confidence: 99%

Value of Clinical and Laboratory Inflammation Factors in the Postoperative Period after Laparoscopic Urogynecological Surgery

Noé

Anapolski²,

Soltész³

et al. 2014

Gynecol Obstet Invest

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Background/Aims: Leukocytes and C-reactive protein (CRP) levels are often used to detect infections. The aim of this study was to evaluate the diagnostic and screening validity of leukocytes and CRP levels as well as body temperature >38° C to predict infections after laparoscopic sacrocolpopexy. Methods: The study included 287 patients suffering from genital prolapse higher than POP-Q I. In addition to the sacrocolpopexy, a laparoscopic supracervical hysterectomy was performed in cases of preexisting uterus (n = 171). Leukocytes and CRP levels were analyzed preoperatively and 4 days after surgery. Early and late onset of infections was documented. Results: Urinary tract infection was identified as the most frequent early postoperative complication (11.4%). Early wound infections were found in 2.8% of the patients (8/287). Late onset of infections was found in 1% of patients (3/287). Areas under ROC curves were low for both leukocytes (0.52, 95% CI: 0.37-0.66) and CRP levels (0.60, 95% CI: 0.44-0.77). Conclusion: Our findings question the benefit of routine determination of leukocytes and CRP levels 4 days after surgery. The sensitivity and specificity of leukocytes and CRP levels are probably more significant after normalization of the initial tissue response (days 8-10).

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Safe and Early Discharge After Colorectal Surgery Due to C-Reactive Protein

Cited by 157 publications

References 29 publications

The Effect of Gender, Age and BMI on Postoperative C-Reactive Protein Levels After Major Abdominal Surgery

The Effect of Gender, Age and BMI on Postoperative C-Reactive Protein Levels After Major Abdominal Surgery

The relationship between systemic inflammation and stoma formation following anterior resection for rectal cancer: A cross-sectional study

Value of Clinical and Laboratory Inflammation Factors in the Postoperative Period after Laparoscopic Urogynecological Surgery

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