Increased Serum Levels of C‐Reactive Protein Precede Anastomotic Leakage in Colorectal Surgery

Edelhauser

International Orthopaedics (SICOT)

et al. 2011

Purpose The purpose of this study was to investigate (a) whether pre-operative serum CRP is a predictor of survival in patients with high-grade osteosarcoma, (b) whether postoperative infection is a predictor of survival in these patients and (c) whether CRP is a predictor of postoperative infection, and especially deep prosthetic infection. Methods In this retrospective single-centre study, preoperative serum CRP levels in 79 patients (37 females, 42 males; average age, 18 years; mean follow-up, 46 months) undergoing resection of an osteosarcoma were correlated with clinical data and survival. Results The mean pre-operative serum CRP level of all 79 patients was 0.53 mg/dl (SD, 1.27 mg/dl). Patients dying of their underlying disease had significantly higher CRP levels compared to patients surviving throughout the follow-up period (1.09 mg/dl ± 2.02 mg/dl versus 0.32 mg/dl ± 0.75 mg/dl, respectively; p=0.015). CRP levels were significantly correlated with survival (Pearson's correlation coefficient= −0.25; p =0.026) and histological subtype (Pearson's correlation coefficient=−0.42; p<0.001), but not with sex, age, histological response, tumour size or metastatic disease. In uni-and multivariate survival analysis, age, response to chemotherapy and serum CRP were associated with disease-specific survival. Patients with a CRP level over 1 mg/dl had a significantly lower diseasespecific five-year survival of 36.7% compared to 73.8% in patients with normal CRP values (p=0.020). Infection was not correlated with disease-specific survival. Pre-operative serum CRP levels were not correlated with post-operative infection or deep prosthetic infection. Conclusions Pre-operative serum CRP seems to be an independent predictor of survival in patients with highgrade osteosarcoma. Further studies are needed to confirm these results on a large-scale basis.

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pre-operative serum C-reactive protein as independent prognostic factor for survival but not infection in patients with high-grade osteosarcoma

Edelhauser

International Orthopaedics (SICOT)

et al. 2011

Asian Pacific Journal of Cancer Prevention

“…These results have never been reported before and seem to suggest that the early and sustained decrease of postoperative pelvic pH value may be used as a predictor of AL in patients underwent rectal surgery. Thus, the pretty marker is superior to the others, such as C-creative protein (CRP), which is a hot marker that has been studied repeatedly in present day (Welsch et al, 2007; Matthiessen et al, 2008; Ortega-Deballon et al, 2010;Woeste et al, 2010). The high level CRP in patients with AL may be caused by other infections including respiratory, urinary tract and surgical wound infections, which should be excluded; however the low pH value of pelvic draining in patients with AL is not necessary to exclude those infectious complications.…”

mentioning

confidence: 99%

Acidic Pelvic Drainage as a Predictive Factor For Anastomotic Leakage after Surgery for Patients with Rectal Cancer

Liu

Huang²,

Xu³

et al. 2013

considerable extra cost, increased in-hospital morbidity and mortality, impaired pelvic organ function (Eriksen et al., 2005; Law et al., 2007; Lee et al., 2008;Riss et al., 2011). Although there are multiple risk factors, such as being male, advanced age, severe obesity, lower tumor site (less than 4cm from the anal verge) and the reduction of TSGF in POD5, which are associated with anastomotic leakage have been reported in our previous study (Yang in individual patients on account of the absence of a early stage.The diagnosis of AL should be as early as possible for the sake of reducing its associated morbidity and mortality (Doeksen et al., 2007). Many studies on anterior resections regarding AL come from multi-center and different surgeons. A variety of factors predisposing to AL have been reported in the previous investigations. However, lack of data about the risk factors and incidence associated with AL from a single-institute of one team of doctors. Liu Yang et al 5442In addition, a great deal previous studies are repetitive works and duplicated effforts because of the limited power of innovative thinking. The pathophysiological processes and considering that interstitial acidic pH notion that extracellular acidosis may intensify the acute and extending its functional lifespan (Trevani et al., 1999; Martínez et al., 2006). The acidic microenvironments developing and the pelvic draining is becoming acidic, which is the main theoretical foundation for the present research. This study aimed to evaluate the utility of sequential postoperative pelvic drainage determinations of of AL after anterior resection of rectal cancer, which has not been reported ever before. Materials and MethodsBetween January 2004 and December 2011, 753 consecutive patients with rectal cancer underwent anterior resection with double stapling anastomosis for primary Jiangsu Cancer Hospital of Nanjing Medical University & Jiangsu Institute of Cancer Research, Nanjing, China. The medical notes of all patients were reviewed in detail.of TNM stage, histologically proven adenocarcinoma, open and laparoscopic surgery with pelvic drainage, all patients with 12 postoperative determinations of pH value, and antibiotics using for 7 PODs. Exclusion criteria were of TNM stage, colon cancer, hand-sewn anastomosis and perioperatively abdominopelvic implants that might be affect pH value, ongoing infection before surgery or an acquired infection in the postoperative period other the distance from the anal verge, as determined by rigid sigmoidoscopy. Total mesorectal excision was adopted as the standard surgical technique according to tumor location. The Ethics Committee of Science approved data collection in the register.All the patients were assigned to one of two groups according to the presence or absence of AL: with AL (Group AL, n=57), without AL (Group nAL, n=696). The two groups were compared according to the following characteristics: median age, gender, physical status (ASA score), the alcohol and tobacco abuse, tumor site, TNM stage, pre...

“…Systemic indicators include pain tympanic abdomen, temperature, tachycardia, hypotension and low urine output. More specific indicators include intramucosal pH [6], intraperitoneal cytokines [7] and elevated serum C-reactive protein [8]. However, these are unreliable.…”

Section: Introductionmentioning

confidence: 99%

Surgical wound monitoring by MRI with a metamaterial-based implanted local coil

et al. 2018

Abstract. An implantable sensor for monitoring surgical wounds after bowel reconstruction is proposed. The sensor consists of a coupled pair of 8-element magneto-inductive ring resonators, designed for mounting on a biofragmentable anastomosis ring to give a local increase in signal-to-noise ratio near an annular wound during 1 H magnetic resonance imaging. Operation on an anti-symmetric spatial mode is used to avoid coupling to the B 1 field during excitation, and a single wired connection is used for MRI signal output. The electrical response and field-of-view are estimated theoretically. Prototypes are constructed from flexible elements designed for operation at 1.5 T, electrical responses are characterized and local SNR enhancement is confirmed using agar gel phantoms.