ArticleUpdates in surgery2022
C-reactive protein and its ratio are useful indicators to exclude anastomotic leakage requiring intervention after laparoscopic rectal surgery.
Article in Updates in surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 4 citations in OpenAlex.
- Early C-reactive protein as a predictive biomarker for postoperative complications following robot-assisted surgery for rectal cancer.Updates in surgery · 2026Article
- Phocaeicola coprophilus-Derived 6-Methyluracil Attenuates Radiation-Induced Intestinal Fibrosis by Suppressing the IDO1-Kynurenine-AHR Axis.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- What affects the selection of diverting ileostomy in rectal cancer surgery: a single-center retrospective study.BMC surgery · 2024Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The goal of this study was to determine whether C-reactive protein (CRP) levels and its ratios can be used as indicators to exclude postoperative anastomotic leak (AL) requiring intervention in patients undergoing elective laparoscopic total mesorectal excision (TME) without a diverting ileostomy for middle or low rectal cancer. We measured CRP values on postoperative days (POD) 1, 2, and 4 and CRP ratios between two PODs in 1278 consecutive patients undergoing rectal surgery. The incidence of AL requiring intervention was 5.9%, and 92% of AL occurred by POD 4. The CRP levels on POD 4 had a maximal area under the curve (AUC) of 0.956 with a negative predictive value (NPV) of 99.7% when the cutoff was established as 80 mg/l. Also, the ratio between CRP levels on POD 4 and CRP levels on POD 2 (CRP POD 4/2) was the most accurate indicator among the CRP ratios, with an AUC of 0.959 and an NPV of 99.5% when the cutoff was set at one. CRP on POD 4 < 80 mg/l and the ratio of CRP POD 4/2 < 1 can be used to rule out AL requiring intervention in patients undergoing elective laparoscopic TME without a diverting ileostomy for middle or low rectal cancer.
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