Systematic review and meta-analysis of use of serum C-reactive protein levels to predict anastomotic leak after colorectal surgery

Singh, P. P.; Zeng, Irene; Srinivasa, Sanket; Lemanu, Daniel P.; Connolly, Andrew B.; Hill, Andrew G.

doi:10.1002/bjs.9354

Cited by 315 publications

(260 citation statements)

References 45 publications

Supporting

Mentioning

240

Contrasting

Unclassified

Order By: Relevance

“…Our results achieved in young and otherwise healthy endometriosis patients therefore seem comparable with previous studies performed in patients operated for colorectal cancer [25] .…”

Section: Discussionsupporting

confidence: 81%

“…C-reactive protein (CRP) has been shown to be an early indicator of postoperative septic and surgical complications in abdominal and rectal surgery [21][22][23][24] and serial postoperative tests might aid detection of these major complications [25] . The aim of the present study was therefore to evaluate the diagnostic value of daily monitoring of biochemical inflammatory markers (CRP and white blood cell (WBC) count) in the diagnosis of anastomotic leakage or ureteral injury after laparoscopic bowel resection for deep infiltrating endometriosis.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic Value of Serial Measurement of C-Reactive Protein in the Detection of a Surgical Complication after Laparoscopic Bowel Resection for Endometriosis

Riiskjær¹,

Forman²,

Kesmodel

et al. 2016

Gynecol Obstet Invest

View full text Add to dashboard Cite

Aims: The study aimed to assess the diagnostic value of serial monitoring of biochemical inflammatory markers (C-reactive protein (CRP) and white blood cell (WBC) count) in the postoperative diagnosis of anastomotic leakage or ureteral injury after bowel resection for deep infiltrating endometriosis. Methods: This is a review of prospectively collected data from 217 patients who underwent laparoscopic bowel resection for endometriosis from January 2009 to April 2015. Patients with an anastomotic leakage or ureteral injury were identified and classified. Results: The frequency of anastomotic leakage requiring reoperation was 8.3%. The frequency of ureteral injury was 4.6%. Median time to diagnosis was 6 days for anastomotic leakage and 8 days for ureteral injury. The daily mean values of serum CRP were significantly higher in patients with a surgical complication starting at the second postoperative day (POD 2, p = 0.004). WBC was significantly higher (p < 0.05) on POD 2 and 3 in patients with a surgical complication. A decrease in CRP from POD 1 to 3 predicted an uncomplicated course in 92.1% of the cases. Conclusion: A decrease in CRP from POD 1 to 3 was an indicator of uncomplicated subsequent postoperative course. The test is recommended when early discharge after rectal resection for deep infiltrating endometriosis is considered.

show abstract

“…Our results achieved in young and otherwise healthy endometriosis patients therefore seem comparable with previous studies performed in patients operated for colorectal cancer [25] .…”

Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Diagnostic Value of Serial Measurement of C-Reactive Protein in the Detection of a Surgical Complication after Laparoscopic Bowel Resection for Endometriosis

Riiskjær¹,

Forman²,

Kesmodel

et al. 2016

Gynecol Obstet Invest

View full text Add to dashboard Cite

show abstract

“…Some meta-analyses show that the CRP concentration on POD3-5 is a useful negative predictive test rather than a good positive predictor [20,21]. We confirmed this observation in our cohort study.…”

Section: Discussionsupporting

confidence: 81%

Neutrophil to Lymphocyte Ratio and C-Reactive Protein as Two Predictive Tools of Anastomotic Leak in Colorectal Cancer Open Surgery

Mik¹,

Dziki²,

Berut³

et al. 2017

Dig Surg

View full text Add to dashboard Cite

Purpose: To assess the prognostic value of postoperative C-reactive protein (CRP) and neutrophil to lymphocyte ratio (NLR) in the development of anastomotic leak (AL) in patients after surgery for colorectal cancer (CRC). Methods: Patients operated on for CRC between 2010 and 2014 were enrolled into the study. The sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPVs) were calculated for the CRP and NLR measured on the 4th postoperative day (POD). Results: Among 724 patients, AL was diagnosed in 33 (4.6%). The accuracy of CRP in the detection of AL using area under curve was 0.83 with the optimal cut-off value of 180 mg/L, sensitivity 75%, specificity 91%, PPV 52% and NPV 87%. Also, NLR on POD4 was higher in the AL group: 9.03 ± 4.13 vs. 4.45 ± 2.25; p = 0.0012; sensitivity 69%, specificity 78%, PPV 49%, NPV 88% at cut-off point of 6.5. Moreover, CRP and NLR on POD4 were significantly higher in patients who died in the postoperative period: 239 ± 24 mg/L vs. 199 ± 41 mg/L; p = 0.034 and 10.71 ± 2.08 vs. 8.65 ± 4.67; p = 0.029, respectively). Conclusions: CRP and NLR on POD4 possess the ability to predict the development of AL and postoperative mortality after CRC operation. Based on our results, high NPV might be indicative of patients with low risk of AL in their postoperative period.

show abstract

“…Serum CRP levels are influenced by infectious complications such as pneumonia, urinary tract infections, and wound infections [17] . Moreover, a 398 systematic review and meta-analysis reported that the positive/negative predictive values of CRP for AL were 21-23 and 97%, respectively, and concluded that CRP is a useful negative predictor of AL [18] . Based on previous reports, the CRP level may be useful for predicting AL, but it cannot be considered a definite predictor.…”

Section: Discussionmentioning

confidence: 99%

Fecal Volume after Laparoscopic Low Anterior Resection Predicts Anastomotic Leakage

Hidaka

Maeda²,

Nakahara³

et al. 2017

Dig Surg

View full text Add to dashboard Cite

Background/Aim: Anastomotic leakage (AL) is a major complication after laparoscopic low anterior resection (Lap-LAR). Many surgeons encounter AL following severe postoperative diarrhea. However, little is known about the relationship between postoperative fecal volume and AL. This study determined whether postoperative fecal volume can predict AL. Methods: A retrospective assessment was performed with data from 176 patients with rectal cancers who underwent Lap-LAR between April 2011 and August 2015. A transanal tube was routinely placed in all cases. The fecal volume from the transanal tube was measured daily. The total fecal volume for 3 days after surgery was compared between the AL and non-AL groups. Results: AL occurred in 11 patients. There were 3 patients with a fecal volume ≥1,000 mL for 3 days after surgery. AL occurred in these 3 patients. In patients with a fecal volume <1,000 mL, the total fecal volume was significantly greater in the AL group than that in the non-AL group (p = 0.0003). The cut-off value of the total fecal volume in AL was 118 mL. Conclusions: The volume of fecal discharge for 3 days after surgery is associated with the incidence of AL, and a fecal volume ≥118 mL may be a reliable predictor for AL.

show abstract

Systematic review and meta-analysis of use of serum C-reactive protein levels to predict anastomotic leak after colorectal surgery

Abstract: CRP is a useful negative predictive test for the development of anastomotic leakage following colorectal surgery.

Cited by 315 publications

References 45 publications

Diagnostic Value of Serial Measurement of C-Reactive Protein in the Detection of a Surgical Complication after Laparoscopic Bowel Resection for Endometriosis

Diagnostic Value of Serial Measurement of C-Reactive Protein in the Detection of a Surgical Complication after Laparoscopic Bowel Resection for Endometriosis

Neutrophil to Lymphocyte Ratio and C-Reactive Protein as Two Predictive Tools of Anastomotic Leak in Colorectal Cancer Open Surgery

Fecal Volume after Laparoscopic Low Anterior Resection Predicts Anastomotic Leakage

Contact Info

Product

Resources

About