C reactive protein as a predictor of anastomotic leakage in colorectal surgery. Comparison between open and laparoscopic surgery
Anastomotic leak (AL) is a serious complication in colorectal surgery due to its increase in morbidity and mortality. The aim of this prospective non-randomised study is to determine whether C-reactive Protein (CRP) is useful as a predictor of AL in patients undergoing open versus laparoscopic surge...
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| Veröffentlicht in: | Cirugia Española 2017-11, Vol.95 (9), p.529-535 |
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| creator | Ramos Fernández, María Rivas Ruiz, Francisco Fernández López, Alberto Loinaz Segurola, Carmelo Fernández Cebrián, José María de la Portilla de Juan, Fernando |
| description | Anastomotic leak (AL) is a serious complication in colorectal surgery due to its increase in morbidity and mortality. The aim of this prospective non-randomised study is to determine whether C-reactive Protein (CRP) is useful as a predictor of AL in patients undergoing open versus laparoscopic surgery.
A total of 168 patients undergoing elective colorectal surgery were included. CRP was measured daily during the first 5postoperative days. Complications, specially AL, were analysed.
Following an open approach 32 patients (45.7%) presented complications, 15 (18.7%) in the laparoscopic group and 12 (29.4%) in the converted group (P=0.153). Following open surgery 9 patients experienced AL, 5 were detected in the laparoscopic group and none in those converted (P=0.153). There were significant differences in CRP values between the 3 groups (P=0.03). ROC Curves showed AUC for the open and laparoscopic approach of 0.731 and 0.760 respectively. On day 4 the AUC was 0.867 for the open group and 0.914 for the laparoscopic group. Cut-off points on day 4 were: Open: 159.2mg/L; sensitivity 75%, specificity 89% and NPP 96% (P |
| doi_str_mv | 10.1016/j.ciresp.2017.08.003 |
| format | Article |
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A total of 168 patients undergoing elective colorectal surgery were included. CRP was measured daily during the first 5postoperative days. Complications, specially AL, were analysed.
Following an open approach 32 patients (45.7%) presented complications, 15 (18.7%) in the laparoscopic group and 12 (29.4%) in the converted group (P=0.153). Following open surgery 9 patients experienced AL, 5 were detected in the laparoscopic group and none in those converted (P=0.153). There were significant differences in CRP values between the 3 groups (P=0.03). ROC Curves showed AUC for the open and laparoscopic approach of 0.731 and 0.760 respectively. On day 4 the AUC was 0.867 for the open group and 0.914 for the laparoscopic group. Cut-off points on day 4 were: Open: 159.2mg/L; sensitivity 75%, specificity 89% and NPP 96% (P<0.001). Following laparoscopic surgery the cut-off point was 67.3%; sensitivity 100%, specificity 89.5% and NPP 100% (P=0.016).
CRP on day 4 is useful to diagnose AL. Different cut-off values should be taken into account depending on the approach used.</description><identifier>EISSN: 1578-147X</identifier><identifier>DOI: 10.1016/j.ciresp.2017.08.003</identifier><identifier>PMID: 29061337</identifier><language>eng ; spa</language><publisher>Spain</publisher><subject>Aged ; Anastomotic Leak - blood ; Anastomotic Leak - diagnosis ; C-Reactive Protein - analysis ; Colonic Diseases - surgery ; Digestive System Surgical Procedures - methods ; Female ; Humans ; Laparoscopy ; Male ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Rectal Diseases - surgery</subject><ispartof>Cirugia Española, 2017-11, Vol.95 (9), p.529-535</ispartof><rights>Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29061337$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ramos Fernández, María</creatorcontrib><creatorcontrib>Rivas Ruiz, Francisco</creatorcontrib><creatorcontrib>Fernández López, Alberto</creatorcontrib><creatorcontrib>Loinaz Segurola, Carmelo</creatorcontrib><creatorcontrib>Fernández Cebrián, José María</creatorcontrib><creatorcontrib>de la Portilla de Juan, Fernando</creatorcontrib><title>C reactive protein as a predictor of anastomotic leakage in colorectal surgery. Comparison between open and laparoscopic surgery</title><title>Cirugia Española</title><addtitle>Cir Esp</addtitle><description>Anastomotic leak (AL) is a serious complication in colorectal surgery due to its increase in morbidity and mortality. The aim of this prospective non-randomised study is to determine whether C-reactive Protein (CRP) is useful as a predictor of AL in patients undergoing open versus laparoscopic surgery.
A total of 168 patients undergoing elective colorectal surgery were included. CRP was measured daily during the first 5postoperative days. Complications, specially AL, were analysed.
Following an open approach 32 patients (45.7%) presented complications, 15 (18.7%) in the laparoscopic group and 12 (29.4%) in the converted group (P=0.153). Following open surgery 9 patients experienced AL, 5 were detected in the laparoscopic group and none in those converted (P=0.153). There were significant differences in CRP values between the 3 groups (P=0.03). ROC Curves showed AUC for the open and laparoscopic approach of 0.731 and 0.760 respectively. On day 4 the AUC was 0.867 for the open group and 0.914 for the laparoscopic group. Cut-off points on day 4 were: Open: 159.2mg/L; sensitivity 75%, specificity 89% and NPP 96% (P<0.001). Following laparoscopic surgery the cut-off point was 67.3%; sensitivity 100%, specificity 89.5% and NPP 100% (P=0.016).
CRP on day 4 is useful to diagnose AL. Different cut-off values should be taken into account depending on the approach used.</description><subject>Aged</subject><subject>Anastomotic Leak - blood</subject><subject>Anastomotic Leak - diagnosis</subject><subject>C-Reactive Protein - analysis</subject><subject>Colonic Diseases - surgery</subject><subject>Digestive System Surgical Procedures - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Rectal Diseases - surgery</subject><issn>1578-147X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1kE9LxDAQxYMg7rr6DURy9NKaNGnaHmXxHyx4UfBWJtnpkrVtapIqe_OjG3CdwxuG-b0HM4RccZZzxtXtPjfWY5jygvEqZ3XOmDghS15WdcZl9b4g5yHsGStKwYszsigaprgQ1ZL8rKlHMNF-IZ28i2hHCoFCGnBrTXSeuo7CCCG6wUVraI_wATukCTSudx5NhJ6G2e_QH3K6dsME3gY3Uo3xG3GkbkoC45b2kFYuGDelnKPjgpx20Ae8PPYVeXu4f10_ZZuXx-f13SabuOQx01yXldaq5so0HatA1oXQ2EjWaA0SUSAzsu5UpRpdF6VplGJdKlFpJVGLFbn5y01Xfs4YYjvYYLDvYUQ3h5Y3ZclUzaRM6PURnfWA23bydgB_aP-_Jn4BXApx9A</recordid><startdate>201711</startdate><enddate>201711</enddate><creator>Ramos Fernández, María</creator><creator>Rivas Ruiz, Francisco</creator><creator>Fernández López, Alberto</creator><creator>Loinaz Segurola, Carmelo</creator><creator>Fernández Cebrián, José María</creator><creator>de la Portilla de Juan, Fernando</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>201711</creationdate><title>C reactive protein as a predictor of anastomotic leakage in colorectal surgery. Comparison between open and laparoscopic surgery</title><author>Ramos Fernández, María ; Rivas Ruiz, Francisco ; Fernández López, Alberto ; Loinaz Segurola, Carmelo ; Fernández Cebrián, José María ; de la Portilla de Juan, Fernando</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p141t-b1b57bb6816c9f07a4823be9409bba4ee3e0c48f6769b825c9660ffff37b64eb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng ; spa</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Anastomotic Leak - blood</topic><topic>Anastomotic Leak - diagnosis</topic><topic>C-Reactive Protein - analysis</topic><topic>Colonic Diseases - surgery</topic><topic>Digestive System Surgical Procedures - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Rectal Diseases - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ramos Fernández, María</creatorcontrib><creatorcontrib>Rivas Ruiz, Francisco</creatorcontrib><creatorcontrib>Fernández López, Alberto</creatorcontrib><creatorcontrib>Loinaz Segurola, Carmelo</creatorcontrib><creatorcontrib>Fernández Cebrián, José María</creatorcontrib><creatorcontrib>de la Portilla de Juan, Fernando</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Cirugia Española</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ramos Fernández, María</au><au>Rivas Ruiz, Francisco</au><au>Fernández López, Alberto</au><au>Loinaz Segurola, Carmelo</au><au>Fernández Cebrián, José María</au><au>de la Portilla de Juan, Fernando</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>C reactive protein as a predictor of anastomotic leakage in colorectal surgery. Comparison between open and laparoscopic surgery</atitle><jtitle>Cirugia Española</jtitle><addtitle>Cir Esp</addtitle><date>2017-11</date><risdate>2017</risdate><volume>95</volume><issue>9</issue><spage>529</spage><epage>535</epage><pages>529-535</pages><eissn>1578-147X</eissn><abstract>Anastomotic leak (AL) is a serious complication in colorectal surgery due to its increase in morbidity and mortality. The aim of this prospective non-randomised study is to determine whether C-reactive Protein (CRP) is useful as a predictor of AL in patients undergoing open versus laparoscopic surgery.
A total of 168 patients undergoing elective colorectal surgery were included. CRP was measured daily during the first 5postoperative days. Complications, specially AL, were analysed.
Following an open approach 32 patients (45.7%) presented complications, 15 (18.7%) in the laparoscopic group and 12 (29.4%) in the converted group (P=0.153). Following open surgery 9 patients experienced AL, 5 were detected in the laparoscopic group and none in those converted (P=0.153). There were significant differences in CRP values between the 3 groups (P=0.03). ROC Curves showed AUC for the open and laparoscopic approach of 0.731 and 0.760 respectively. On day 4 the AUC was 0.867 for the open group and 0.914 for the laparoscopic group. Cut-off points on day 4 were: Open: 159.2mg/L; sensitivity 75%, specificity 89% and NPP 96% (P<0.001). Following laparoscopic surgery the cut-off point was 67.3%; sensitivity 100%, specificity 89.5% and NPP 100% (P=0.016).
CRP on day 4 is useful to diagnose AL. Different cut-off values should be taken into account depending on the approach used.</abstract><cop>Spain</cop><pmid>29061337</pmid><doi>10.1016/j.ciresp.2017.08.003</doi><tpages>7</tpages></addata></record> |
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| ispartof | Cirugia Española, 2017-11, Vol.95 (9), p.529-535 |
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| language | eng ; spa |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Aged Anastomotic Leak - blood Anastomotic Leak - diagnosis C-Reactive Protein - analysis Colonic Diseases - surgery Digestive System Surgical Procedures - methods Female Humans Laparoscopy Male Middle Aged Predictive Value of Tests Prospective Studies Rectal Diseases - surgery |
| title | C reactive protein as a predictor of anastomotic leakage in colorectal surgery. Comparison between open and laparoscopic surgery |
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