Systematic use of the serum C-reactive protein concentration and computed tomography for the detection of intestinal anastomotic leaks
Author(s)
Ho, Yiu Ming
Laycock, Juliet
Kirubakaran, Arangan
Hussain, Labib
Clark, Jeremy
Griffith University Author(s)
Year published
2019
Metadata
Show full item recordAbstract
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 ...
View more >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.
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View more >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.
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Journal Title
ANZ Journal of Surgery
Note
This publication has been entered into Griffith Research Online as an Advanced Online Version.
Subject
Clinical sciences
C-reactive protein
colonic anastomosis