A Prospective Observational Study on the Role of Serum C Reactive Protein in the Early Detection of Leaks in Colorectal Anastomosis
Creators
- 1. Post Graduate, Department of General Surgery, Andhra Medical College, Visakhapatnam
- 2. Professor and HOD, Department of General Surgery, Andhra Medical College, Visakhapatnam
- 3. Assistant Professor, Department of General Surgery, Andhra Medical College, Visakhapatnam
- 4. Associate Professor, Department of General Surgery Andhra Medical College, Visakhapatnam
Description
Introduction: Advancements in surgery have led to a point where the modern surgeon no longer looks upon a colorectal malignancy as an unconquerable obstacle. Unfortunately, despite rapid advances in surgery and neo-adjuvant chemoradiation, the spectre of anastomotic leaks continues to cast a dark veil even in the best equipped facilities. Several studies have shown the role of Serum C-Reactive protein as a useful marker of anastomotic healing with consistently high negative predictive values, as early as post-operative day 4 onwards. Methods: This study is conducted in prospective observational pattern for a period of 18 months from March 2022 to September 2023 in a tertiary care hospital. The study population included 60 participants who were planned for colorectal surgeries. 57 participants were eligible for analysis after considering inclusion and exclusion criteria and their preoperative and postoperative 4th day C – reactive protein values were identified and they were followed for a period of 15 days for anastomotic leak. Results: The cut-off values of the 4th day CRP with highest area under the ROC is calculated and found to be 166 mg/L. Elevated CRP on the 4th day above 166mg/L is a sensitive and specific marker for the early detection of leaks in colorectal anastomosis. Conclusion: The subjects who underwent colorectal anastomosis can be safely discharged on 4th post-operative day if the C Reactive Protein values are below the cutoff value of 166mg/L without any significant risk of anastomotic leaks.
Abstract (English)
Introduction: Advancements in surgery have led to a point where the modern surgeon no longer looks upon a colorectal malignancy as an unconquerable obstacle. Unfortunately, despite rapid advances in surgery and neo-adjuvant chemoradiation, the spectre of anastomotic leaks continues to cast a dark veil even in the best equipped facilities. Several studies have shown the role of Serum C-Reactive protein as a useful marker of anastomotic healing with consistently high negative predictive values, as early as post-operative day 4 onwards. Methods: This study is conducted in prospective observational pattern for a period of 18 months from March 2022 to September 2023 in a tertiary care hospital. The study population included 60 participants who were planned for colorectal surgeries. 57 participants were eligible for analysis after considering inclusion and exclusion criteria and their preoperative and postoperative 4th day C – reactive protein values were identified and they were followed for a period of 15 days for anastomotic leak. Results: The cut-off values of the 4th day CRP with highest area under the ROC is calculated and found to be 166 mg/L. Elevated CRP on the 4th day above 166mg/L is a sensitive and specific marker for the early detection of leaks in colorectal anastomosis. Conclusion: The subjects who underwent colorectal anastomosis can be safely discharged on 4th post-operative day if the C Reactive Protein values are below the cutoff value of 166mg/L without any significant risk of anastomotic leaks.
Files
IJPCR,Vol16,Issue4,Article138.pdf
Files
(611.8 kB)
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Additional details
Dates
- Accepted
-
2024-03-26
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue4,Article138.pdf
- Development Status
- Active
References
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