ArticleSurgical endoscopy2018
Procalcitonin and C-reactive protein as early markers of anastomotic leak after laparoscopic colorectal surgery within an enhanced recovery after surgery (ERAS) program.
Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
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Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 79 citations in OpenAlex.
- C-reactive protein can predict anastomotic leak in colorectal surgery: a systematic review and meta-analysis.International journal of colorectal disease · 2021Pooled 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
- Trial
- Early prediction of anastomotic leakage within 24 h after minimally invasive colorectal cancer surgery using postoperative inflammatory markers: development and temporal validation of a machine learning model.Surgical endoscopy · 2026Article
- Lactate in Drainage Fluid to Predict Complications in Robotic Esophagectomies-A Pilot Study in a Matched Cohort.Journal of clinical medicine · 2025Article
- Management of Low Colorectal/Coloanal Anastomotic Leak: Results of a French National Intergroups Practice Survey (FRENCH-GRECCAR-SFCD).World journal of surgery · 2025Article
- Cost Saving Analysis of an Enhanced Recovery After Surgery (ERAS) Program for Elective Colorectal Surgery in an ERAS Qualified and Training Center.World journal of surgery · 2025Article
- C-reactive protein for detection of colorectal anastomotic leakage and safer early discharge.Revista do Colegio Brasileiro de Cirurgioes · 2025Article
- Prognostic prediction models for postoperative patients with stage I to III colorectal cancer based on machine learning.World journal of gastrointestinal oncology · 2024Article
- Article
- Review
- Procalcitonin and C-reactive protein as early markers of anastomotic leakage in intestinal resections for advanced ovarian cancer (EDMOCS).Acta obstetricia et gynecologica Scandinavica · 2024Observational
- C-Reactive Protein as a Predictive Marker for Anastomotic Leak Following Restorative Colorectal Surgery in an Enhanced Recovery After Surgery Program.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Serum and peritoneal biomarkers for the early prediction of symptomatic anastomotic leakage in patients following laparoscopic low anterior resection: A single-center prospective cohort study.Cancer reports (Hoboken, N.J.) · 2023Article
- The Predictive Value of PCT and Other Infection Indicators in Postoperative Infection of Epithelial Ovarian Cancer.Infection and drug resistance · 2023Article
- C-Reactive Protein Taken on Postoperative Day 3 Has No Role in Predicting Complications After Elective Colorectal Surgery: an Observational Study from the Randomized Multi-Center Prospective SOAP Trial.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Observational
- The importance of inflammatory markers in detection of complications in patients with gastric cancer undergoing the Enhanced Recovery After Surgery (ERAS) protocol: a prospective cohort study.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2022Article
- C-Reactive Protein as Predictor for Infectious Complications after Robotic and Open Esophagectomies.Journal of clinical medicine · 2022Article
- Predictive value of C-reactive protein levels for the early and later detection of postoperative complications after cytoreductive surgery and HIPEC.Frontiers in oncology · 2022Article
- Anastomotic leak after colorectal surgery: does timing affect failure to rescue?Surgical endoscopy · 2022Article
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundC-reactive protein (CRP) and procalcitonin (PCT) have been described as good predictors of anastomotic leak after colorectal surgery, obtaining the highest diagnostic accuracy on the 5th postoperative day. However, if an enhanced recovery after surgery (ERAS) program is performed, early predictors are needed in order to ensure a safe and early discharge. The aim of this study was to investigate the efficacy of CRP, PCT, and white blood cell (WBC) count determined on first postoperative days, in predicting septic complications, especially anastomotic leak, after laparoscopic colorectal surgery performed within an ERAS program.
methodsWe conducted a prospective study including 134 patients who underwent laparoscopic colorectal surgery within an ERAS program between 2015 and 2017. The primary endpoint investigated was anastomotic leak. CRP, PCT, and WBC count were determined in the blood sample extracted on postoperative day 1 (POD 1), POD 2 and POD 3.
resultsAnastomotic leak (AL) was detected in 6 patients (4.5%). Serum levels of CRP and PCT, but not WBC, determined on POD 1, POD 2, and POD 3 were significantly higher in patients who had AL in the postoperative course. Using ROC analysis, the best AUC of the CRP and PCT levels was on POD 3 (0.837 and 0.947, respectively). A CRP cutoff level at 163 mg/l yielded 85% sensitivity, 80% specificity, and 99% negative predictive value (NPV). A PCT cutoff level at 2.5 ng/ml achieved 85% sensitivity, 95% specificity, 44% positive predictive value, and 99% NPV.
conclusionsCRP and PCT are relevant markers for detecting postoperative AL after laparoscopic colorectal surgery. Furthermore, they can ensure an early discharge with a low probability of AL when an ERAS program is performed.
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