Jose L Martinez1, Enrique Luque-de-León2, Eduardo Ferat-Osorio2, Alicia Estrada-Castellanos2. 1. Department of General and Gastrointestinal Surgery, UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI (IMSS), Av. Cuauhtémoc 330. 3er. Piso, Servicio de Gastrocirugìa, Colonia Doctores, Del. Cuauhtémoc, México DF, CP 06725, México. Electronic address: jlmo1968@yahoo.com. 2. Department of General and Gastrointestinal Surgery, UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI (IMSS), Av. Cuauhtémoc 330. 3er. Piso, Servicio de Gastrocirugìa, Colonia Doctores, Del. Cuauhtémoc, México DF, CP 06725, México.
Abstract
BACKGROUND: Recurrence rates after surgical repair of enterocutaneous fistula (ECF) have not changed substantially. Serum C-reactive protein (s-CRP) has been used as an indicator of postoperative complications in abdominal surgery. The aim of this study was to determine the predictive value of preoperative s-CRP for recurrence after definitive surgical repair of ECF. METHODS: Fifty consecutive patients with ECF persistence submitted electively to definitive surgical repair (ECF resection with primary anastomosis) were included. Among several variables, preoperative s-CRP (primary independent variable) was assessed as a factor related to recurrence (dependent variable). Univariate and multivariate analyses were performed. RESULTS: ECF recurred in 19 patients (38%). Univariate and multivariate analyses disclosed operative blood loss greater than 325 mL (P < .05) and preoperative s-CRP greater than .5 mg/dL (P < .01) as the only risk factors for recurrence. ECF recurrence rates were significantly higher for patients with preoperative s-CRP above this level (53% vs 11%, P < .01). After conservative and surgical management, overall ECF closure was attained in 40 patients (80%). CONCLUSIONS: Our results suggest that s-CRP may serve as a useful parameter to predict potential failure (recurrence) in patients submitted to definitive closure of ECF.
BACKGROUND: Recurrence rates after surgical repair of enterocutaneous fistula (ECF) have not changed substantially. Serum C-reactive protein (s-CRP) has been used as an indicator of postoperative complications in abdominal surgery. The aim of this study was to determine the predictive value of preoperative s-CRP for recurrence after definitive surgical repair of ECF. METHODS: Fifty consecutive patients with ECF persistence submitted electively to definitive surgical repair (ECF resection with primary anastomosis) were included. Among several variables, preoperative s-CRP (primary independent variable) was assessed as a factor related to recurrence (dependent variable). Univariate and multivariate analyses were performed. RESULTS: ECF recurred in 19 patients (38%). Univariate and multivariate analyses disclosed operative blood loss greater than 325 mL (P < .05) and preoperative s-CRP greater than .5 mg/dL (P < .01) as the only risk factors for recurrence. ECF recurrence rates were significantly higher for patients with preoperative s-CRP above this level (53% vs 11%, P < .01). After conservative and surgical management, overall ECF closure was attained in 40 patients (80%). CONCLUSIONS: Our results suggest that s-CRP may serve as a useful parameter to predict potential failure (recurrence) in patients submitted to definitive closure of ECF.
Authors: Jose L Martinez; Ilka Bosco-Garate; Luis Manuel Souza-Gallardo; José D Méndez; Marco A Juárez-Oropeza; Ruben Román-Ramos; Eduardo Ferat-Osorio Journal: J Gastrointest Surg Date: 2019-02-01 Impact factor: 3.452
Authors: Fleur E E de Vries; Jasper J Atema; Oddeke van Ruler; Carolynne J Vaizey; Mireille J Serlie; Marja A Boermeester Journal: World J Surg Date: 2018-03 Impact factor: 3.352