Early detection of infectious complications using C-reactive protein and the procalcitonin levels after laparoscopic colorectal resection: a prospective cohort study

Abstract

Purpose The predictive values of the C-reactive protein (CRP) and procalcitonin (PCT) levels for postoperative infectious complications were investigated in patients who underwent elective laparoscopic resection of colorectal cancer. Methods A total of 154 consecutive patients who underwent elective laparoscopic resection for colorectal cancer (CRC) were prospectively studied. The CRP and PCT levels on the first postoperative day (POD1) and the fourth postoperative day (POD4) were measured. Any correlations between the CRP and PCT levels on POD1 and POD4 with the occurrence of infectious complications were examined. Results Infectious complications occurred in 18 (11.7%) patients. CRP on POD1 and CRP and PCT on POD4 were significantly higher in patients who developed infectious complications than in those who did not. The areas under the receiver operating characteristic curves of CRP on POD1 and CRP and PCT on POD4 were 0.597, 0.763 and 0.768, respectively. The cutoff values of CRP and PCT levels on POD4 were 14.33 mg/dl and 0,264 ng/ml, respectively. Whereas the positive predictive value of an elevated CRP level was high, the negative predictive value of an elevated PCT was high. Conclusion The CRP and PCT levels on POD4 are both considered to be useful for the early detection of infectious complications after laparoscopic resection of CRC.

Nomogram to predict postoperative infectious complications after surgery for colorectal cancer: a retrospective cohort study in China

“…0%) developed ICs after surgery for CRC, which is comparable to multiple previous studies[24][25][26][27]. Furthermore, chronic pulmonary diseases, diabetes mellitus, preoperative and/or intraoperative blood transfusion, and longer operation time were identified as independent risk factors for ICs.…”

Procalcitonin is one of the predictive factors of dehiscence of the colorectal anastomosis

“…In their study of 154 patients, Tatsuoka et al found that PCT 4th POD has higher specificity and sensitivity than CRP values in patients with dehiscence of colorectal anastomosis. 24 Besides, Takakura et al in their study confirmed PCT as an important prognostic marker of anastomotic leakage in patients operated on for colorectal cancer. 25 In this study, which included 118 patients operated on colorectal cancer, it was found that all patients with anastomotic leakage had a significant increase in PCT values on the second and fourth day compared to patients without anastomotic leakage.…”

Evaluation of the use of inflammatory biomarkers in the early detection of anastomotic leakage after esophagectomy: A retrospective analysis

“…The lack of a clear understanding of the pathophysiology behind AL led to the diversification of the investigated potential biomarkers across broad categories such as those of inflammation, ischemia, and tissue repair [ 11 ]. Although none of the examined biomarkers proved to be the gold standard, CRP shows promising results in contemporary literature [ 12 , 13 ].…”