Inflammatory markers for the early detection of post-operative infection: The same threshold for rectal and colic surgery?

Vauclair, E.; Moreno-Lopez, Nathan; Orry, David; Fournel, Isabelle; Rat, Patrick; Ortega‐Deballon, Pablo; Facy, Olivier

doi:10.1016/j.jviscsurg.2020.10.012

Cited by 1 publication

(3 citation statements)

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“…12 Interestingly, the results of these studies had certain discrepancies, which may be related to the different objects, surgical approaches and endpoints. Vauclair et al 9 have reported that patients undergoing rectal resection were more prone to intra-abdominal septic complications than those who underwent colectomy. Facy et al 12 also discussed whether the same cut-off values should be used in laparoscopy and laparotomy.…”

Section: Discussionmentioning

confidence: 99%

“…A number of studies have investigated the predictive accuracy of PCT, CRP and WBC in predicting AL after colorectal surgery 5–8 . Nevertheless, due to the different anatomical positions of the colon and rectum, different anastomotic positions, the application of neoadjuvant therapy in rectal cancer, and the different proportions of laparoscopic surgery, the degree and rates of AL were different in various studies, and the value of CRP and PCT in predicting AL of various studies has been controversial 9–12 …”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7][8] Nevertheless, due to the different anatomical positions of the colon and rectum, different anastomotic positions, the application of neoadjuvant therapy in rectal cancer, and the different proportions of laparoscopic surgery, the degree and rates of AL were different in various studies, and the value of CRP and PCT in predicting AL of various studies has been controversial. [9][10][11][12] Therefore, we aimed to explore the predictive value of PCT, CRP and WBC in predicting infectious complications, in particular, AL after laparoscopic rectal surgery; and compare their accuracy to further promote the safe development of enhanced recovery after surgery (ERAS) in the field of laparoscopic rectal cancer surgery. Retrospective data collection included age, sex, body mass index (BMI), history of smoking, history of drinking, neoadjuvant therapy, American Society of Anesthesiology (ASA), duration of surgery, tumour node metastasis (TNM) stages according to the American Joint Committee on Cancer (AJCC) eighth edition staging system, 13 serum WBC, PCT and CRP levels, postoperative infectious complications, and duration of postoperative hospital stay.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of C‐reactive protein and procalcitonin in the early diagnosis of infections after laparoscopic rectal cancer surgery

Yang

Huang

et al. 2022

ANZ Journal of Surgery

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Background: We aimed to examine the diagnostic accuracy of postoperative procalcitonin (PCT) and C-reactive protein (CRP) in the detection of infectious complications in patients after laparoscopic rectal cancer surgery, as opposed to all colorectal surgery. Methods: Between December 2018 and December 2020, 204 patients who underwent laparoscopic rectal cancer surgery were enrolled retrospectively. The PCT, CRP and white blood cell (WBC) count were measured before surgery and on postoperative days (PODs) 3 and 5. Diagnostic accuracy was determined by the area under the receiver operating characteristic curve (AUC). Net Reclassification Index (NRI) was used to calculate the ability to correct reclassification. Results: Infectious complications occurred in 36 patients (17.6%), including 17 cases of anastomotic leakage (AL) (8.3%). The AUCs of PCT and CRP in predicting infectious complications on POD 3 were 0.690 and 0.731, respectively, which were better than those on POD 5 (AUC 0.666 and 0.697, respectively). PCT with an optimal cutoff value of 1.10 ng/mL (AUC 0.792, specificity 78.6%, negative predictive value [NPV] 96.6%), CRP with an optimal cutoff value of 109.5 mg/L (AUC 0.760, specificity 78.6%, NPV 96.1%) on POD 3 had superior diagnostic accuracy in predicting AL, both better than WBC (AUC 0.627). The AUC of combining PCT and CRP on POD 3 in predicting AL was 0.851, with a specificity of 79.7% and NPV of 97.4%, and the NRI was estimated to be 7.0%. Conclusions: Both PCT and CRP on POD 3 are excellent negative predictors for early monitoring of infectious complications, especially AL, in patients undergoing laparoscopic rectal cancer surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%