C-reactive protein in drainage fluid as a predictor of anastomotic leakage after elective colorectal resection

Kostić, Zoran; Slavković, Damjan; Mijusković, Z; Panišić, Marina; Ignjatović, Miroljub

doi:10.2298/vsp141031017k

Cited by 5 publications

(4 citation statements)

References 35 publications

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“…On top of this observation, Jaju et al (6) proposed that a steady increase of the CRP in the peritoneal fluid better predicted an AL. However, this assumption was not verified by Kostić et al (8).…”

Section: Discussionmentioning

confidence: 85%

CRP in Drain Fluid as a Predictive Marker of Anastomotic Leak in Colorectal Surgery: A Systematic Review of the Literature

Kyrochristou

Spartalis

Anagnostopoulos

et al. 2023

In Vivo

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Section: Discussionmentioning

confidence: 85%

CRP in Drain Fluid as a Predictive Marker of Anastomotic Leak in Colorectal Surgery: A Systematic Review of the Literature

Kyrochristou

Spartalis

Anagnostopoulos

et al. 2023

In Vivo

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“…Incidence of anastomotic leak as per the current study was 14% which is comparable with previous studies. 5,6,7,8,9 The average age of the population was 60.9.1 (Fig. 1) it is evident that the study population includes patients from all age groups.…”

Section: Discussionmentioning

confidence: 94%

“…Un-eventful healing of the intestinal anastomosis remains a challenge after colon and rectal resections. 5 Anastomotic leakage is the most dreaded complication and is a serious obstacle in the successful outcome of colon and rectal anastomotic surgeries. Incidence of anastomotic leak as per the current study was 14% which is comparable with previous studies.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of C-Reactive Protein in Peritoneal Drain Fluid for the Early Detection of Anastomotic Leak

M¹,

Kailasanadhan²

2018

jebmh

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BACKGROUND Anastomotic leakage is the most dreadful complication of colorectal surgeries. It results in sepsis, entero-cutaneous fistula formation, leads to reoperation and permanent stoma and is associated with decreased survival and death. The clinical presentation may not be evident in the initial phase, when a timely intervention may save the life of the patient or could avoid a reoperation or a permanent stoma. The current study is to evaluate the diagnostic efficacy of peritoneal drain fluid CRP to predict anastomotic leakage in elective colorectal surgeries. MATERIALS AND METHODS 50 patients with elective colorectal resection and primary anastomosis were studied. The selected patients were followed up from their preoperative admission in the ward till discharge. Demographic data of the patients, operative details, postoperative events and follow up data were obtained through a standardized case record form and were entered into a data base. In the postoperative period, drain fluid reservoirs were emptied 2 times a day within 12-hour intervals, under aseptic precautions. The evening collection was disposed off. CRP is estimated on postoperative day 3 and day 5. The values obtained were compared between the groups of patients without complications of surgery and in those with anastomotic leakage. RESULTS Clinically evident anastomotic leakage was observed in 7 patients (14%), in 3(6%) following right hemicolectomy and in 2(4%) following anterior resection and 2(4%) following left hemicolectomy. The mean value of CRP on postoperative day 3 was 48.41 in patients without anastomotic leakage and those with anastomotic leakage was 40.36 whereas, the postoperative day 5 CRP was 36.61 in patients without anastomotic leakage and 86.85 in those with leakage. On applying independent sample t test to day 5 CRP, it was found to be significantly elevated with a t value 9.45 and p value 0.001. To find out the cut off value of CRP in diagnosing those with anastomotic leak, an ROC curve was constructed. The area under the curve was 0.997 with a p value 0.001 and a confidence interval between 0.986 and 1.007. And it was found that with a cut off value of CRP 77.59, the sensitivity is 85% and specificity 100% in diagnosing anastomotic leakage. CONCLUSION Serial measurement of the drain fluid CRP can be reliably used in early detection of anastomotic leakage. It was found that CRP value on postoperative day 5 showed a progressive elevation from the day 3 CRP value. The mean CRP value on postoperative day 5 was 86.85 which is statistically significant with a sensitivity of more than 85% and with specificity of 100%.

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“…19 Few other studies support this observation, where different variables were correlated with major anastomotic leaks. [20][21][22] CRP and procalcitonin were shown to be reliable predictors of anastomotic leak on day 3 and 5 with 100% sensitivity, 72% specificity, 100% negative predictive value but the positive predictive value was poor. 23 The role of mechanical bowel preparation and prophylactic antibiotic therapy remains unclear despite few studies suggesting reduced leaks.…”

Section: Discussionmentioning

confidence: 98%

Can analysis of drain fluid biomarkers predict anastomotic leak?

et al. 2021

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Background: Anastomotic leak is a major complication often leading to significant morbidity and mortality. A method to predict leaks in the early postoperative period will help in better management and outcome. Though serum biomarkers like C-reactive protein and procalcitonin levels are often used to predict chances of developing complications, they are nonspecific and suggest mainly ongoing sepsis in general. Detection and assessment of the presence of these biomarkers at the local milieu is an alternate non-invasive option as they are produced at the injury site and increase in anastomotic leaks. If measured serially, can guide to a strong suspicion of a leak before the clinical signs are evident. Methods: Forty-eight patients who underwent intestinal anastomosis for various indications were included. Serial measurement of drain fluid C-reactive protein and procalcitonin were measured on postoperative days 3, 5 and 7.Results: 7 patients developed leaks with two deaths. CRP and procalcitonin levels were higher on all days in comparison with the no leak group. CRP had the highest sensitivity on day 5 with 85.71% and 97.56% specificity on day7. The sensitivity and specificity of procalcitonin were 71.43% and 97.56% on day 5 and day 7. Accuracy was 93.7% for CRP and 87.5% for procalcitonin on the seventh day.Conclusions: Serial analysis of drain fluid CRP and procalcitonin showed persistently increased levels in patients with an anastomotic leak. Correlation of the levels in patients with anastomotic leak suggests the possibility of their utility in the early detection of leaks.

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C-reactive protein in drainage fluid as a predictor of anastomotic leakage after elective colorectal resection

Abstract: Serial measurement of CRP in drainage fluid can reliably be used in the detection of AL in patients with colorectal resection. The most significant values obtained on the PODs 5 and 7 were positively correlated with the values registered in

Cited by 5 publications

References 35 publications

CRP in Drain Fluid as a Predictive Marker of Anastomotic Leak in Colorectal Surgery: A Systematic Review of the Literature

CRP in Drain Fluid as a Predictive Marker of Anastomotic Leak in Colorectal Surgery: A Systematic Review of the Literature

Evaluation of C-Reactive Protein in Peritoneal Drain Fluid for the Early Detection of Anastomotic Leak

Can analysis of drain fluid biomarkers predict anastomotic leak?

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