ArticleInternational journal of colorectal disease2017
Inflammatory markers as early predictors of infection after colorectal surgery: the same cut-off values in laparoscopy and laparotomy?
Article in International journal of colorectal disease, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- A systematic review on biomarkers implemented to measure surgical stress response in patients undergoing colorectal surgery.International journal of colorectal disease · 2025Pooled it
- Meta-analysis of the Diagnostic Accuracy of C-Reactive Protein for Infectious Complications in Laparoscopic Versus Open Colorectal Surgery.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020Pooled it
- Systematic review and consensus definitions for the Standardised Endpoints in Perioperative Medicine (StEP) initiative: infection and sepsis.British journal of anaesthesia · 2019Pooled it
- Effect of prucalopride to improve time to gut function recovery following elective colorectal surgery: randomized clinical trial.The British journal of surgery · 2022Trial
- Robotic surgery may lead to reduced postoperative inflammatory stress in colon cancer: a propensity score-matched analysis.Annals of coloproctology · 2024Article
- Interleukin-6 on postoperative day three as an early predictor of infections following laparoscopic gastric cancer resection.BMC surgery · 2024Article
- Management of Intra-Abdominal Infections: The Role of Procalcitonin.Antibiotics (Basel, Switzerland) · 2023Review
- CT scan for early diagnosis of anastomotic leak after colorectal surgery: is rectal contrast useful?Techniques in coloproctology · 2023Article
- Use of a standardized discharge checklist with daily post-operative C-reactive protein monitoring does not impact readmission rates after colon and rectal surgery.International journal of colorectal disease · 2021Article
- Early detection of infectious complications using C-reactive protein and the procalcitonin levels after laparoscopic colorectal resection: a prospective cohort study.Surgery today · 2021Article
- Cumulative C-reactive Protein in the Perioperative Period as a Novel Marker for Oncological Outcome in Patients with Colorectal Cancer Undergoing Curative Resection.Journal of the anus, rectum and colon · 2021Article
- Composite Inflammatory Indicators as Early Predictor of Intra-abdominal Infections after General Surgery.Journal of inflammation research · 2021Article
- Predictive value of inflammatory markers for postoperative recovery following colorectal surgery.International journal of colorectal disease · 2020Article
- Procalcitonin Levels in Post TACE Infection.Cancer management and research · 2020Article
- Near-infrared fluorescence image-guidance in anastomotic colorectal cancer surgery and its relation to serum markers of anastomotic leakage: a clinical pilot study.Surgical endoscopy · 2019Article
- Use of inflammatory markers in the early detection of infectious complications after laparoscopic colorectal cancer surgery with the ERAS protocol.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2018Article
- Procalcitonin and C-reactive protein as early markers of anastomotic leak after laparoscopic colorectal surgery within an enhanced recovery after surgery (ERAS) program.Surgical endoscopy · 2018Article
- Fever and systemic inflammatory response syndrome after retrograde intrarenal surgery: Risk factors and predictive model.The Kaohsiung journal of medical sciences · 2018Article
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeC-reactive protein and procalcitonin are reliable early predictors of infection after colorectal surgery. However, the inflammatory response is lower after laparoscopy as compared to open surgery. This study analyzed whether a different cutoff value of inflammatory markers should be chosen according to the surgical approach.
methodsA prospective, observational study included consecutive patients undergoing elective colorectal surgery in three academic centers. All infections until postoperative day (POD) 30 were recorded. The inflammatory markers were analyzed daily until POD 4. Areas under the ROC curve and diagnostic values were calculated in order to assess their accuracy as a predictor of intra-abdominal infection.
resultsFive-hundred-one patients were included. The incidence of intra-abdominal infection was 11.8%. The median levels of C-reactive protein (CRP) and procalcitonin (PCT) were lower in the laparoscopy group at each postoperative day (p < 0.0001). In patients without intra-abdominal infection, they were also lower in the laparoscopy group (p = 0.0036) but were not different in patients presenting with intra-abdominal infections (p = 0.3243). In the laparoscopy group, CRP at POD 4 was the most accurate predictor of overall and intra-abdominal infection (AUC = 0.775). With a cutoff of 100 mg/L, it yielded 95.7% negative predictive value, 75% sensitivity, and 70.3% specificity for the detection of intra-abdominal infection.
conclusionThe impact of infection on inflammatory markers is more important than that of the surgical approach. Defining a specific cutoff value for early discharge according to the surgical approach is not justified. A patient with CRP values lower than 100 mg/L on POD 4 can be safely discharged.
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