Using CRP to predict anastomotic leakage after open and laparoscopic colorectal surgery: is there a difference?

Waterland, Peter; Ng, Jimmy; Jones, Adam; Broadley, Graham; Nicol, Deborah; Patel, Heena; Pandey, Steve

doi:10.1007/s00384-016-2547-0

Cited by 39 publications

(31 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a clean contaminated procedure, POD1 CRP reflects the extent of tissue damage from surgery rather than septic complications, which is supported by the significant differences in CRP between the open group and the laparoscopic group. 24 The CRP ratio in PODs compared to the baseline CRP (POD1) was observed to be a very sensitive indicator to detect an anastomotic leak in the cohort. This ratio, or trajectory, was also found to be useful in the detection of an anastomotic leak in other studies.…”

Section: Discussionmentioning

confidence: 87%

Systematic use of the serum C‐reactive protein concentration and computed tomography for the detection of intestinal anastomotic leaks

Laycock

Kirubakaran

et al. 2019

ANZ Journal of Surgery

View full text Add to dashboard Cite

Background This study aimed to characterize the time‐dependent relationship between serum C‐reactive protein (CRP) and anastomotic integrity in the early post‐operative period and to develop a systematic use of CRP and computed tomography. Methods Patients aged 18 years or over who had the formation of a left‐sided colonic or a colorectal anastomosis, in Royal Sussex County Hospital, were included. The post‐operative day (POD) CRP cut‐off values were calculated according to receiver operating characteristic analysis to evaluate the sensitivities and specificities of the proposed cut‐off parameters. Results A total of 125 left‐sided colonic and colorectal anastomoses were recruited and analysed. When comparing to POD1 CRP cut‐off, the calculated CRP ratio cut‐off values of all the rest of PODs (2–5) were highly significant in the laparoscopic group and the overall group (P < 0.001). This statistically significant ratio was also demonstrated in the open group at POD2 (P < 0.0001). Conclusion CRP and CRP ratios cut‐off values were sensitive to detect an anastomotic leak in the early post‐operative period. The cut‐off values could facilitate the development of systematic use of CRP and computed tomography.

show abstract

Section: Discussionmentioning

confidence: 87%

Systematic use of the serum C‐reactive protein concentration and computed tomography for the detection of intestinal anastomotic leaks

Laycock

Kirubakaran

et al. 2019

ANZ Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…Because vital signs and leukocyte numbers are slow in responding, it is important to identify tools to detect early leakage 36,37 . Early diagnosis is essential to reduce morbidity and mortality 33,[38][39][40] because delayed diagnosis can increase mortality by 18% 37 .…”

Section: Discussionmentioning

confidence: 99%

“…CRP is an acute-phase protein produced by hepatocytes after inflammatory stimulation 18,25 . It is a useful marker to monitor and identify postoperative complications because it has a short half-life 38,40 . This protein has been shown to be as effective and sensitive as a predictor of anastomotic leakage 34,35,[39][40][41] and postoperative infection 15,19,38 .…”

Section: Discussionmentioning

confidence: 99%

Serum C-reactive protein is a useful marker to exclude anastomotic leakage after colorectal surgery

Messias¹,

Botelho

Saad

et al. 2020

Sci Rep

View full text Add to dashboard Cite

Anastomotic leakage is a complication of colorectal surgery. c-reactive protein (cRp) is an acutephase marker that can indicate surgical complications. We determined whether serum cRp levels in patients who had undergone colorectal surgery can be used to exclude the presence of anastomotic leakage and allow safe early discharge. We included 90 patients who underwent colorectal surgery with primary anastomosis. Serum cRp levels were measured retrospectively on postoperative days (poDs) 1-7. Patients with anastomotic leakage (n = 11) were compared to those without leakage (n = 79). We statistically analysed data and plotted receiver operating characteristic curves. the incidence of anastomotic leakage was 12.2%. Diagnoses were made on PODs 3-24. The overall mortality rate was 3.3% (18.2% in the leakage group, 1.3% in the non-leakage group; P < 0.045). CRP levels were most accurate on POD 4, with a cutoff level of 180 mg/L, showing an area under the curve of 0.821 and a negative predictive value of 97.2%. Lower CRP levels after POD 2 and levels <180 mg/L on POD 4 may indicate the absence of anastomotic leakage and may allow safe discharge of patients who had undergone colorectal surgery with primary anastomosis.

show abstract

“…The cut-off value of 140 mg/L on POD3 maximized the sensitivity (78%) and specificity (86%) of serum CRP in assessing the risk of leakage [6]. Serum CRP has been evaluated in other 11 studies [7][8][9][10][11][12][13][14][15][16][17]. In general, the CRP level was raised significantly days before the diagnosis of AL.…”

Section: C-reactive Proteinmentioning

confidence: 99%

“…Negative predictive value (96.7% and 96.7% respectively) Kostan, 2014, [11] CRP: POD4, cutoff value: 99 mg/L, Sensitivity 100%, specilficity 64% Marek, 2015, [12] CRP (POD3, cutoff value: 245.64 mg/l), PCT (POD3, cutoff value:3.83 ng/ml) CRP (sensitivity100%, specilficity 98%), PCT (sensitivity 75%, specilficity 100%) Waterland, 2016, [13] CRP (POD3 and POD4 with cut-off value of 209 and 123.5 mg/ml in laparotomy); CRP (POD2 with cut-off value of 146.5 mg/ml in laparoscopy)…”

Section: Some Uncommon Markers In Drainagementioning

confidence: 99%

The value of biomarkers in early diagnosis of anastomotic leak following colorectal tumor resection: a review of the literature between 2012 and 2017

Ge¹,

Chen²

2017

Oncotarget

View full text Add to dashboard Cite

Anastomotic leakage (AL) is one of the most serious complications of colorectal resection, causing sepsis, reducing overall in-hospital survival and increasing the risk of local and distant recurrences. So, early diagnosis of AL is very important. To improve the early diagnosis of AL following colorectal resection, a number of studies have investigated potential biomarkers to predict AL. In this review, we summarized the biomarkers, which had been shown to be useful in early diagnosis of AL. The results showed that c-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC), cytokines, and so on were hot study biomarkers, which were proved to be reliable predictors of AL. Besides, drainage indexes such as microbiological study, potential of hydrogen (PH), carcinoembryonic antigen (CEA), and so on also helped to indicate early AL. Although there have been many studies on this field, rigorous homogeneous and prospective trials are demanded to explore ideal biomarkers to early diagnose AL.

show abstract

Using CRP to predict anastomotic leakage after open and laparoscopic colorectal surgery: is there a difference?

Abstract: CRP levels are higher after open surgery compared with laparoscopic surgery, both with and without AL. AL generates a significant detectable increase in CRP within 2-4 days after surgery.

Cited by 39 publications

References 26 publications

Systematic use of the serum C‐reactive protein concentration and computed tomography for the detection of intestinal anastomotic leaks

Systematic use of the serum C‐reactive protein concentration and computed tomography for the detection of intestinal anastomotic leaks

Serum C-reactive protein is a useful marker to exclude anastomotic leakage after colorectal surgery

The value of biomarkers in early diagnosis of anastomotic leak following colorectal tumor resection: a review of the literature between 2012 and 2017

Contact Info

Product

Resources

About