C-reactive protein level on postoperative day 3 as a predictor of anastomotic leakage after elective right-sided colectomy

• Published in: Surgery Today Vol. 52; no. 2; pp. 337 - 343
• Main Authors: Masuda, Toshiro, Takamori, Hiroshi, Ogawa, Katsuhiro, Shimizu, Kenji, Karashima, Ryuichi, Nitta, Hidetoshi, Matsumoto, Katsutaka, Okino, Tetsuya, Baba, Hideo
• Format: Journal Article
• Language: English
• Published: Singapore Springer Science and Business Media LLC 01.02.2022; Springer Singapore
• Subjects: Aged; Aged, 80 and over; Anastomotic Leak; Anastomotic Leak - diagnosis; Anastomotic Leak - etiology; Biomarkers; Biomarkers - blood; C-Reactive Protein; Colectomy; Colectomy - adverse effects; Colectomy - methods; Elective Surgical Procedures; Elective Surgical Procedures - adverse effects; Elective Surgical Procedures - methods; Female; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Postoperative Complications; Postoperative Complications - diagnostic imaging; Postoperative Complications - etiology; Postoperative Period; Retrospective Studies; ROC Curve; Surgery; Surgical Oncology; Time Factors; CRP; Anastomotic leakage; Ileocecal resection; Ileocolic anastomosis; Right hemicolectomy
• ISSN: 0941-1291; 1436-2813; 1436-2813
• DOI: 10.1007/s00595-021-02351-0

Purpose To investigate the factors predictive of anastomotic leakage in patients undergoing elective right-sided colectomy. Methods The subjects of this retrospective study were 247 patients who underwent elective right hemicolectomy or ileocecal resection with ileocolic anastomosis between April 2012 and March 2019, at our institution. Results Anastomotic leakage occurred in 9 of the 247 patients (3.6%) and was diagnosed on median postoperative day (POD) 7 (range POD 3–12). There were no significant differences in the background factors or preoperative laboratory data between the patients with anastomotic leakage (anastomotic leakage group) and those without anastomotic leakage (no anastomotic leakage group). Open surgery was significantly more common than laparoscopic surgery ( P  = 0.027), and end-to-side anastomosis was less common ( P  = 0.025) in the anastomotic leakage group. The C-reactive protein (CRP) level in the anastomotic leakage group was higher than that in the no anastomotic leakage group on PODs 3 ( P  < 0.001) and 5 ( P  < 0.001). ROC curve analysis revealed that anastomotic leakage was significantly more frequent in patients with a serum CRP level ≥ 11.8 mg/dL [area under the curve (AUC) 0.83]. Conclusion A serum CRP level ≥ 11.8 mg/dL on POD 3 was predictive of anastomotic leakage being detected on median POD 7.