C-reactive protein level on postoperative day 3 as a predictor of anastomotic leakage after elective right-sided colectomy

Masuda, Toshiro; Ogawa, Katsuhiro; Shimizu, Kenji; Karashima, Ryuichi; Nitta, Hidetoshi; Matsumoto, Kazuya; Okino, Tetsuya; Baba, Hideo

doi:10.1007/s00595-021-02351-0

Cited by 3 publications

(2 citation statements)

References 21 publications

(39 reference statements)

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“…From 1945 citations, 23 studies (15 retrospective cohorts and 8 prospective cohorts) were included with a total of 7147 patients [32, 46–68]. Study and patient characteristics are presented in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Using preoperative C‐reactive protein levels to predict anastomotic leaks and other complications after elective colorectal surgery: A systematic review and meta‐analysis

McKechnie,

Cloutier,

Archer

et al. 2024

Colorectal Disease

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AimWhile postoperative C‐reactive protein (CRP) is used routinely as an early indicator of anastomotic leak (AL), preoperative CRP remains to be established as a potential predictor of AL for elective colorectal surgery. The aim of this systematic review and meta‐analysis is to examine the association between preoperative CRP and postoperative complications including AL.MethodMEDLINE, EMBASE, Web of Science, PubMed, Cochrane Library and CINAHL databases were searched. Studies with reported preoperative CRP values and short‐term surgical outcomes after elective colorectal surgery were included. An inverse variance random effects meta‐analysis was performed for all meta‐analysed outcomes to determine if patients with or without complications and AL differed in their preoperative CRP levels. Risk of bias was assessed with MINORS and certainty of evidence with GRADE.ResultsFrom 1945 citations, 23 studies evaluating 7147 patients were included. Patients experiencing postoperative infective complications had significantly greater preoperative CRP values [eight studies, n = 2421 patients, mean difference (MD) 8.0, 95% CI 3.77–12.23, p < 0.01]. A significant interaction was observed with subgroup analysis based on whether patients were undergoing surgery for inflammatory bowel disease (X2 = 8.99, p < 0.01). Preoperative CRP values were not significantly different between patients experiencing and not experiencing AL (seven studies, n = 3317, MD 2.15, 95% CI −2.35 to 6.66, p = 0.35), nor were they different between patients experiencing and not experiencing overall postoperative morbidity (nine studies, n = 2958, MD 4.54, 95% CI −2.55 to 11.62, p = 0.31) after elective colorectal surgery.ConclusionHigher preoperative CRP levels are associated with increased rates of overall infective complications, but not with AL alone or with overall morbidity in patients undergoing elective colorectal surgery.

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Section: Resultsmentioning

confidence: 99%

Using preoperative C‐reactive protein levels to predict anastomotic leaks and other complications after elective colorectal surgery: A systematic review and meta‐analysis

McKechnie,

Cloutier,

Archer

et al. 2024

Colorectal Disease

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“…al. 20 , que incluyó 247 pacientes sometidos a hemicolec-Figura 1. Curva de características operativas del receptor para la precisión diagnóstica de la concentración de proteína C reactiva en la predicción de fuga anastomótica posoperatoria.…”

Section: Discussionunclassified

Proteína C reactiva y su progresión en el tiempo para la detección de las fugas anastomóticas

Borráez-Segura¹,

Anduquia-Garay²,

Gómez-Raigosa³

et al. 2023

Rev Colomb Cir

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Introducción. Las fugas anastomóticas son una complicación común y crítica en cirugía gastrointestinal, por lo que su identificación y tratamiento temprano son necesarios para evitar resultados adversos. El uso convencional con un valor límite de la proteína C reactiva ha demostrado una utilidad limitada. El objetivo de este estudio fue determinar la utilidad de la medición seriada de la proteína C reactiva en la detección de fugas anastomóticas. Métodos. Revisión prospectiva de base de datos retrospectiva de pacientes sometidos a cirugía abdominal mayor con al menos una anastomosis intestinal. Se midió la proteína C reactiva al tercer y quinto día posoperatorio. Las complicaciones se categorizaron según la clasificación de Clavien-Dindo. La precisión diagnóstica fue evaluada por el área bajo la curva. Resultados. Se incluyeron 157 pacientes, el 52 % mujeres. La edad promedio fue de 63,7 años. El mayor número de cirugías correspondió a gastrectomía (36,3 %), resección anterior de recto (15,3 %) y hemicolectomía derecha (13,4 %). El 25,5 % tuvieron alguna complicación postoperatoria y el 32,5 % (n=13) presentaron fuga en la anastomosis. El aumento de la proteína C reactiva tuvo un área bajo la curva de 0,918 con un punto de corte de aumento en 1,3 mg/L, sensibilidad de 92,3 % (IC95% 78 – 100) y una especificidad de 92,4 % (IC95% 88 – 96). Conclusiones. El aumento de 1,3 mg/L en la proteína C reactiva entre el día de la cirugía y el quinto día fue un predictor preciso de fugas anastomóticas en pacientes con cirugía abdominal mayor.

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Diagnostic Modalities for Early Detection of Anastomotic Leak After Colorectal Surgery

Yung,

Daroch,

Parikh

et al. 2024

Journal of Surgical Research

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C-reactive protein level on postoperative day 3 as a predictor of anastomotic leakage after elective right-sided colectomy

Cited by 3 publications

References 21 publications

Using preoperative C‐reactive protein levels to predict anastomotic leaks and other complications after elective colorectal surgery: A systematic review and meta‐analysis

Using preoperative C‐reactive protein levels to predict anastomotic leaks and other complications after elective colorectal surgery: A systematic review and meta‐analysis

Proteína C reactiva y su progresión en el tiempo para la detección de las fugas anastomóticas

Diagnostic Modalities for Early Detection of Anastomotic Leak After Colorectal Surgery

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