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2018, Number 5

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Cir Cir 2018; 86 (5)

Utility of C-reactive protein in the early diagnosis of anastomotic leakage in colorectal surgery

Guevara-Morales GR, Regalado-Torres MA, Cantarell-Castillo E, Castro-Salas R, Maldonado-Barrón R, Castellanos-Juárez JC

Language: Spanish
References: 18
Page: 432-436
PDF size: 288.73 Kb.


ABSTRACT

Introduction: The anastomotic leakage (AL) in colorectal surgery is a complication feared by the increase in morbidity and mortality. The rate of AF is reported from 1 to 25%. Making the diagnosis early is difficult. Objective: To determine the diagnostic performance of the C reactive protein (CRP) in a cohort of patients undergoing elective colorectal surgery with anastomosis. Method: A prospective, comparative study was conducted in 138 patients undergoing elective anastomosis with colorectal surgery, analyzing the serum values of CRP on postoperative days 1, 3, 5 and 7, as well as leukocytes and other abdominal sepsis data. Results: The AL rate was 6.5%, the CRP values were significantly higher in the group of patients with AF on the 3rd postoperative day; with a cut-off point of 18.5 mg/dl on the third postoperative day, it obtained sensitivity 81%, specificity 91%, positive predictive value 45%, negative predictive value 98%. Conclusion: Measurement of CRP on the third postoperative day in patients undergoing elective colorectal surgery with primary or secondary anastomosis allows the identification of septic complications including leakage of anastomosis.


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