Serum C-reactive protein is a useful marker to exclude anastomotic leakage after colorectal surgery

Messias, Bruno Amantini; Botelho, Ricardo Vieira; Saad, Sarhan Sydney; Mocchetti, Erica R.; Turke, Karine Corcione; Waisberg, Jaques

doi:10.1038/s41598-020-58780-3

Cited by 50 publications

(38 citation statements)

References 46 publications

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“…Messias et al reported that postoperative serum CRP levels in patients who undergo colorectal surgery could become a marker for the exclusion of anastomotic leakage [ 25 ]. Additionally, Smith et al reported changes in CRP, WBC count and procalcitonin as potential markers of AL following colorectal surgery [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Preoperative white blood cell count predicts anastomotic leakage in patients with left-sided colorectal cancer

et al. 2021

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To determine whether preoperative white blood cell (WBC) counts reflect risk of anastomotic leak (AL) for patients with colorectal cancer (CRC), we retrospectively examined data from records of 208 consecutive patients who had undergone resections for left-sided CRC, including their clinicopathological parameters and preoperative laboratory data. The diagnostic value of WBC count for AL was evaluated and compared with those of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, lymphocyte-monocyte ratio and platelet count × C-reactive protein level multiplier (P-CRP) value; optimal cut-off values were derived from receiver operating characteristic curves. AL was observed in 11 of the 208 patients (5.3%). Compared with the no-AL group, the AL group had a significantly higher mean WBC count and smoking rate. In multivariate analysis, WBC count and smoking were independent risk factors for AL. Compared with the other tested inflammatory indicators, the cut-off value for WBC (6,200/μL) had the highest sensitivity (81.8%) and negative predictive value (98.4%), as well as the lowest likelihood ratio (0.289). Preoperative WBC count could therefore be a convenient predictor of AL in patients with left-sided CRC.

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Section: Discussionmentioning

confidence: 99%

Preoperative white blood cell count predicts anastomotic leakage in patients with left-sided colorectal cancer

et al. 2021

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“…Hoeller et al ( 23 ) pointed out that CRP had a high predictive value for postoperative surgical site infection after dorsal spondylodesis, with sensitivity of 92.9% and specificity of 78.2%. Messies et al ( 24 ) demonstrated that CRP ≥ 180 mg/L on the 4th day after surgery was an independent risk factor for predicting anastomotic fistula after primary anastomosis in patients with rectal cancer ( P = 0.002), with sensitivity and specificity of 72.3 and 88.9%, respectively. Johnson et al ( 25 ) found that postoperative CRP value was an independent risk factor affecting 1-year tumor-free survival ( P < 0.001) and 1-year overall survival ( P < 0.001) after nephrectomy in patients with local renal cancer.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of C-Reactive Protein for Early Postoperative Complications in Children After Hypospadias Surgery

Tang

et al. 2021

Front. Pediatr.

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Background: This study explored the predictive value of postoperative C-reactive protein in children with hypospadias for postoperative complications and the risk factors.Methods: The clinical and follow-up data of 106 children with hypospadias who were treated with operations at Kunming Children's Hospital in 2020 were, respectively, analyzed. According to the occurrence of postoperative complications, the patients were divided into two groups: 25 patients with postoperative complications were the complications group, and 81 without postoperative complications were the control group. The baseline data, clinical characteristics, laboratory test indexes, and outcome of the two groups were collected. Receiver operating characteristic (ROC) was used to calculate the optimal cutoff value of C-reaction protein (CRP). Logistic regression was used to analyze the risk factors of hypospadias after surgery. A probability value (P) < 0.05 was considered statistically significant.Results: According to the result of the ROC curve, the optimal cutoff value of CRP was 11.7 mg/L. Logistic regression showed that the length of urethral defect, the urethral material, the operative produce, and the postoperative CRP level were related to the occurrence of postoperative complications of patients with DCC. The length of the urethral defect and the CRP level were the independent risk factors of the prognosis of hypospadias patients. The CRP level was related to the occurrence of postoperative complications and fistula.Conclusions: Postoperative CRP level can be used as a reliable marker for predicting the prognosis of hypospadias patients.

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“…Patients with a high BMI or obstructive colon cancer need to be treated more carefully. CRP is a well-known acute-phase biomarker that can indicate surgical complications [26]. It reached a peak level in the plasma after 48 hours.…”

Section: Discussionmentioning

confidence: 99%

Clinical validation of implementing Enhanced Recovery After Surgery protocol in elderly colorectal cancer patients

et al. 2022

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The aim of this study was to evaluate the safety and feasibility of applying enhanced recovery after surgery (ERAS) protocol in elderly colorectal cancer patients. Methods: The medical records of patients who underwent elective colorectal cancer surgery at our institution, from January 2017 to December 2017, were reviewed. Patients were divided into 2 groups: the young group (YG, patients aged 70 and under 70 years) and the old group (OG, patients over 70 years old). Perioperative outcomes and length of hospital stay were compared between both groups. Results: In total, 335 patients were enrolled; 237 were YG and 98 were OG. Despite the poorer baseline characteristics of OG, the perioperative outcomes were similar. Length of hospital stay was not different between the groups (YG, 5 days vs. OG, 5 days; P = 0.320). When comparing the postoperative complications using the comprehensive complication index (CCI), there was no significant difference (YG, 8.0 ± 13.2 vs. OG, 11.7 ± 23.0; P = 0.130). In regression analysis, old age ( > 70 years) was not a risk factor for high CCI in all patients. In multivariate analysis, C-reactive protein (CRP) level on postoperative day (POD) 3 to 4 was the only strong predictive factor for high CCI in elderly patients. Conclusion: Implementing the ERAS protocol in patients aged > 70 years is safe and feasible. High CRP ( ≥ 6.47 mg/dL) on POD 3 to 4 can be used as a safety index to postpone discharge in elderly patients.

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Serum C-reactive protein is a useful marker to exclude anastomotic leakage after colorectal surgery

Cited by 50 publications

References 46 publications

Preoperative white blood cell count predicts anastomotic leakage in patients with left-sided colorectal cancer

Preoperative white blood cell count predicts anastomotic leakage in patients with left-sided colorectal cancer

Predictive Value of C-Reactive Protein for Early Postoperative Complications in Children After Hypospadias Surgery

Clinical validation of implementing Enhanced Recovery After Surgery protocol in elderly colorectal cancer patients

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