Emeric Abet1, Farouk Drissi2,3, Clément Couëtte1, Marc-Henri Jean1, Fabrice Denimal1, Juliette Podevin4, Emilie Duchalais4, Guillaume Meurette4. 1. Department of Digestive Surgery, Vendée Medical Center, Les Oudairies, 85000, La Roche-sur-Yon, France. 2. Department of Digestive Surgery, Vendée Medical Center, Les Oudairies, 85000, La Roche-sur-Yon, France. farouk.drissi@gmail.com. 3. Department of Digestive and Endocrine Surgery, University Hospital of Nantes, 1, Place Alexis Ricordeau, 44093, Nantes, France. farouk.drissi@gmail.com. 4. Department of Digestive and Endocrine Surgery, University Hospital of Nantes, 1, Place Alexis Ricordeau, 44093, Nantes, France.
Abstract
BACKGROUND: Using biological markers to predict serious complications and global postoperative recovery, to ensure safe and timely patient discharge after elective colorectal surgery represents a major challenge. The aim of this study was to demonstrate that C-reactive protein levels < 172 mg/l on postoperative day 3 were associated with postoperative recovery within 5 days. METHODS: This is a prospective study of a consecutive bicentric cohort. Successive patients scheduled for bowel resection with anastomosis, without stoma, were included. The main composite endpoint for overall postoperative recovery included absence of fever, absence of pain > 2 on the visual analog scale, intestinal gas transit, and patient autonomy for mobility and body care. RESULTS: One hundred sixty-height patients, with a mean age of 65 years old, were analyzed. Ninety patients (53%) underwent right colectomy and 131 (77%) were operated on by laparoscopy. Severe postoperative complications were observed in 11 patients (6%). One hundred twenty patients (71%) recovered within 5 days. C-reactive protein levels < 172 mg/L on postoperative day 3 had a negative predictive value of 80% to predict recovery within 5 days. Ninety-five percent of patients with C-reactive protein < 172 mg/L at postoperative day 3 had no severe postoperative complications. CONCLUSION: Levels of C-reactive protein < 172 mg/L at postoperative day 3 corresponded with an early recovery in 80% of cases, thus allowing safe and early discharge without risk of serious complications.
BACKGROUND: Using biological markers to predict serious complications and global postoperative recovery, to ensure safe and timely patient discharge after elective colorectal surgery represents a major challenge. The aim of this study was to demonstrate that C-reactive protein levels < 172 mg/l on postoperative day 3 were associated with postoperative recovery within 5 days. METHODS: This is a prospective study of a consecutive bicentric cohort. Successive patients scheduled for bowel resection with anastomosis, without stoma, were included. The main composite endpoint for overall postoperative recovery included absence of fever, absence of pain > 2 on the visual analog scale, intestinal gas transit, and patient autonomy for mobility and body care. RESULTS: One hundred sixty-height patients, with a mean age of 65 years old, were analyzed. Ninety patients (53%) underwent right colectomy and 131 (77%) were operated on by laparoscopy. Severe postoperative complications were observed in 11 patients (6%). One hundred twenty patients (71%) recovered within 5 days. C-reactive protein levels < 172 mg/L on postoperative day 3 had a negative predictive value of 80% to predict recovery within 5 days. Ninety-five percent of patients with C-reactive protein < 172 mg/L at postoperative day 3 had no severe postoperative complications. CONCLUSION: Levels of C-reactive protein < 172 mg/L at postoperative day 3 corresponded with an early recovery in 80% of cases, thus allowing safe and early discharge without risk of serious complications.
Entities:
Keywords:
Bowel resection; C-reactive protein (CRP); Postoperative recovery; Severe postoperative complications
Authors: Christopher Skusa; Romy Skusa; Moritz Wohlfarth; Philipp Warnke; Andreas Podbielski; Kristina Bath; Justus Groß; Clemens Schafmayer; Hagen Frickmann; Marc-André Weber; Andreas Hahn; Felix G Meinel Journal: Diagnostics (Basel) Date: 2022-02-14
Authors: Sufana H Alsaif; Ailín C Rogers; Priscilla Pua; Paul T Casey; Geoff G Aherne; Ann E Brannigan; Jurgen J Mulsow; Conor J Shields; Ronan A Cahill Journal: World J Surg Oncol Date: 2021-03-13 Impact factor: 2.754