Monitoring c-reactive protein after laparoscopic colorectal surgery excludes infectious complications and allows for safe and early discharge

Abstract

Monitoring CRP level in laparoscopic colorectal surgery demonstrated a high diagnostic accuracy for infectious complications, thus allowing for safe and early discharge.

Meta-analysis of the predictive value of C-reactive protein for infectious complications in abdominal surgery

“…Although no single inflammatory marker can definitively exclude an anastomotic leak, routine measurement of CRP concentration with use of the suggested cut‐off levels may allow safe discharge. As shown recently in a large series of laparoscopic colonic resections, clinical signs of postoperative infectious complications are rarely apparent before POD 6.…”

“…Measurement of CRP levels is widely available and well established in routine clinical practice, unlike procalcitonin or IL‐6, other recently described markers of systemic inflammation. The predictive value of postoperative CRP levels to rule out infectious complications after colorectal, bariatric, gastro‐oesophageal and pancreatic surgery has been assessed previously.…”

Fecal Volume after Laparoscopic Low Anterior Resection Predicts Anastomotic Leakage

“…However, one paper reported no differences in CRP levels between the AL and non-AL groups after total colectomy for familial adenomatous polyposis [16] . Serum CRP levels are influenced by infectious complications such as pneumonia, urinary tract infections, and wound infections [17] . Moreover, a 398 systematic review and meta-analysis reported that the positive/negative predictive values of CRP for AL were 21-23 and 97%, respectively, and concluded that CRP is a useful negative predictor of AL [18] .…”

Diagnostic Accuracy of Inflammatory Markers As Early Predictors of Infection After Elective Colorectal Surgery

“…This fact enhances the interest of absolute values over tendencies, as it has already been stated in previous works having explored the interest of thresholds and that of decrements. 25,26 It is well established that most postoperative infections become clinically evident beyond POD 5, with advanced IAI. CRP was more accurate than PCT, as it was the case in several previous smaller series.…”