Elevated serum C reactiveprotein as apredictive factor for anastomotic dehiscence in colorectal surgery: P038

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Aim:To demonstrate the utility of serial serum determinations of postoperative C-reactiveprotein (CRP) and white blood cells (WBC) in the identification of increased risk of anastomotic dehiscence (AD) after colorectal surgery.Method:A retrospective study of 173 patients operated on between January 2008 and October 2009, who underwent surgery for colorectal disease with anastomosis. Patients with AD (Group A, n = 24) were compared to patients without dehiscence (Group B, n = 149). Patients withprevious or acquired unrelated postoperative infections were excluded. Meanpre-and postoperative values of CRP and WBC were compared.Results:The diagnosis of AD was made between the 4th and 11th post-operative day (POD; mean: 7th POD).The daily average values of serum CRP were significantly higher in group A from the 2nd POD and remained significantly elevated until the diagnosis of dehiscence (P = 0.003). A cut-off value of 140 mg/l on the 3rd POD maximized the sensitivity (78%) and specificity (86%) of serum CRP in assessing the risk of dehiscence. Comparison of postoperative serum WBC values didn't show any significant differences between the two groups until the 6th POD.Conclusion:Early and persistent elevation of CRP, associated with a value > 140 mg/l on POD 3 after colorectal surgery with anastomosis, is apredictor of AD.

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