SynthesisInternational journal of colorectal disease2021
C-reactive protein can predict anastomotic leak in colorectal surgery: a systematic review and meta-analysis.
Synthesis in International journal of colorectal disease, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
43 citing papers in PubMed, 1 synthesis or guideline pooled it, 99 citations in OpenAlex.
- CRP in Drain Fluid as a Predictive Marker of Anastomotic Leak in Colorectal Surgery: A Systematic Review of the Literature.In vivo (Athens, Greece)Pooled it
- Comparison of two bundles for reducing surgical site infection in colorectal surgery: multicentre cohort study.BJS open · 2024Trial
- Prevention, Recognition, and Management of Anastomotic Leakage and Pelvic Sepsis After Rectal Cancer Surgery: A Structured Narrative Review.Journal of clinical medicine · 2026Review
- From Recognition to Prevention: Modern Approaches to Complication Reduction in Colorectal Surgery.Journal of clinical medicine · 2026Review
- A Systematic Review and Meta-Analysis of Prediction Scores for Anastomotic Leak Following Colorectal Surgery.Maedica · 2026Review
- Trend of C-Reactive protein after colorectal surgery may increase predictive value of anastomotic leak: a prospective analysis.BMC surgery · 2026Article
- The Clinical Presentation of Anastomotic Leakage Compared Between CRS-HIPEC and Conventional Colorectal Surgery.Annals of surgical oncology · 2026Article
- Early CRP kinetics predict surgical outcomes in patients with Hartmann reversal.Frontiers in surgery · 2026Article
- Multimodal biomarker panel for early prediction of anastomotic leak after colorectal surgery: from inflammation to ischemia.Frontiers in surgery · 2026Review
- Preoperative and early postoperative albumin thresholds, rather than ΔAlb, predict severe complications after colorectal cancer surgery: a multifactorial model and nomogram.Frontiers in oncology · 2026Article
- Anastomotic Leak Following Colon Cancer Resection: An Independent Predictor of Non-Oncologic Mortality and Morbidity.Journal of surgical oncology · 2025Article
- Machine Learning Models Using Post-operative CRP Trends to Predict Colorectal Anastomotic Leak: A Pilot Study.Cureus · 2025Article
- Evaluation of the Diagnostic and Predictive Significance of Postoperative C-Reactive Protein to Transferrin or Albumin Ratio in Identifying Septic Events Following Major Abdominal Surgery.Journal of clinical medicine · 2025Article
- Utility of C-reactive protein on the fourth postoperative day to detect complications beyond anastomotic dehiscence.International journal of colorectal disease · 2025Observational
- Early prediction of anastomotic leakage after rectal cancer surgery: Onodera prognostic nutritional index combined with inflammation-related biomarkers.World journal of gastrointestinal surgery · 2025Article
- Postoperative C-Reactive Protein Trend Is a More Accurate Predictor of Anastomotic Leak than Absolute Values Alone.Journal of clinical medicine · 2025Article
- Observational
- C-reactive protein and digestive pathologies: A narrative review for daily clinical use.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2025Review
- Clinical analysis of different intestinal reconstruction methods after primary cytoreductive surgery combined with rectal resection for advanced ovarian cancer.Frontiers in oncology · 2025Article
- Predictive Value of C-Reactive Protein for Infectious Complications After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: A Single-Center Prospective Study.Annals of surgical oncology · 2024Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAnastomotic leakage (AL) is one of the most significant complications after colorectal surgery, affecting length of stay, patient morbidity, mortality, and long-term oncological outcome. Serum C-reactive protein (CRP) level rises in infective and inflammatory states. Elevated CRP has been shown to be associated with anastomotic leak.
objectivePerform a meta-analysis of current CRP data in AL after colorectal surgery. DATA SOURCES: MEDLINE, EMBASE, CINAHL, CENTRAL databases STUDY SELECTION: Comparative studies studying serum CRP levels in adult patients with and without AL after colorectal surgery. INTERVENTION(S): Elective and emergency open, laparoscopic or robotic colorectal excisions for cancer and benign pathology.
main outcome measuresMean serum CRP measurements between post-operative days (POD) 1 through 7 in patients with and without AL. Perform ROC analysis to determine cut-off CRP values to indicate AL.
resultsTwenty-three studies with 6647 patients (482 AL). Pooled mean time to diagnosis of AL was 7.70 days. AL associated with higher CRP on POD1 (mean difference (MD) 15.19, 95% CI 5.88-24.50, p = 0.001), POD2 (MD 51.98, 05% CI 37.36-66.60, p < 0.00001), POD3 (MD 96.92, 95% CI 67.96-125.89, p < 0.00001), POD4 (MD 93.15, 95% CI 69.47-116.84, p < 0.00001), POD5 (MD 112.10, 95% CI 89.74-134.45, p < 0.00001), POD6 (MD 98.38, 95% CI 80.29-116.46, p < 0.00001), and POD7 (MD 106.41, 95% CI 75.48-137.35, p < 0.00001) compared with no AL. ROC analysis identified a cut-off CRP of 148 mg/l on POD3 with sensitivity and specificity of 95%. On POD4 through POD7, cut-off levels were 123 mg/l, 115 mg/l, 105 mg/l, and 96 mg/l, respectively, with sensitivity and specificity of 100%. LIMITATIONS: Study heterogeneity, some characteristics unreported, no RCT
conclusionsAL is associated with higher CRP levels on each post-operative day compared to no AL after colorectal surgery. The cut-off CRP values can be used to predict AL to expedite investigation and treatment.
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