Laparoscopic colorectal resection for deep infiltrating endometriosis: can we reliably predict anastomotic leakage and major postoperative complications in the early postoperative period?

C-reactive Protein for Predicting Early Postoperative Complications in Patients Undergoing Laparoscopic Shaving for Deep Infiltrating Endometriosis

“…However, given the high negative predictive value, a CRP value under the threshold might comfort for a discharge at this time. Basing on our data and in agreement with other Authors [25], an isolated increase of CRP seems to be not enough for predicting postoperative complications on postoperative day 3.…”

“…Consistently, our CRP cut-off value appears also lower than those proposed by two previous studies assessing patients with colorectal endometriosis [13,25,26]. Differently from us, this latter included only patients undergoing laparoscopic full thickness bowel resection and assessed predictive value of CRP for the diagnosis of overall major complications or only septic complications.…”

“…Although CRP failed to confirm its promising value as diagnostic marker for stage III/IV endometriosis, [14] its value as a predictor of postoperative complications is still being evaluated in the Literature. In particular, most of studies has assessed heterogeneous cohorts of patients who underwent laparoscopic or open colorectal surgery for various indications [18][19][20][21][22][23][24], while to our knowledge, only few studies have been focused on women with endometriosis, mainly considering patients who underwent segmental and/or discoid colorectal resection [13,17,25,26].…”

“…CRP monitoring was performed from postoperative day 3 and then every 48 hours in accordance with other Authors [20]. In fact, even if CRP monitoring may be started the day after surgery [16,17,21], CRP values on or before postoperative day 2 seem to be more affected by the inflammatory reaction induced by surgery [19,25]. Indeed CRP values reach a peak after 48 hours from surgery [19].…”

“…In fact an increase in its levels may precede the clinical manifestations of postoperative complications [16][17][18][19]. In particular, CRP has shown interesting results in emergency and elective colorectal surgery for various indications [20][21][22][23][24], also including endometriosis [13,17,25,26]. However, to our knowledge, no study has ever evaluated its value in predicting early complications after laparoscopic shaving of the bowel for endometriotic nodules.…”