title: Can postoperative complications be predicted by a routine CT scan on day 5? A study of 78 laparoscopic colorectal resections.
abstract: BACKGROUND
  Postoperative computed tomography (CT) scan patterns after colorectal resection are difficult to analyze for both clinicians and radiologists. This study aimed to assess the role of single CT scan on postoperative day 5 in predicting postoperative morbidity.
  
  
  METHODS
  From October 2007 to August 2009, 78 patients undergoing laparoscopic colorectal resection were enrolled in a research study involving a routine contrast-enhanced multi-detector CT scan on postoperative day 5. Two groups were defined: patients with intra-abdominal postoperative morbidity requiring specific management, i.e., surgical or radiological procedure, and/or antibiotic therapy ("complications" group), and patients with uneventful postoperative outcome ("uneventful" group). CT findings were compared between the two groups with Fisher's exact test or chi-square test.
  
  
  RESULTS
  Postoperative abdominal complications occurred in 16 patients (21 %). Of the CT findings on day 5, pneumonia, pulmonary embolism, portal or mesenteric thrombosis, operative area fat infiltration, peritoneal effusion, pneumoperitoneum, intra-abdominal collection, parietal inflammation or collection, and subcutaneous emphysema were observed in both groups without any significant difference. Only small bowel distension [25 % (4/16) in the "complications" group vs. 5 % (3/62) in the "uneventful" group; p = 0.029] and pleural effusion [81 % (13/16) vs. 48 % (30/62); p = 0.024, respectively] were observed significantly more often in the "complications" group.
  
  
  CONCLUSIONS
  This study suggested that abdominal complications cannot be predicted by a CT scan on day 5 after laparoscopic colorectal resection. Thus, it cannot be recommended for routine use.
authors.affiliation: Department of Radiology, Beaujon Hospital, Universitary Hospitals Paris Nord Val de Seine, Beaujon, Clichy Cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Wagner
authors.forename: M
authors.initials: M
authors.lastname: Zappa
authors.forename: L
authors.initials: L
authors.lastname: Maggiori
authors.forename: F
authors.initials: F
authors.lastname: Bretagnol
authors.forename: V
authors.initials: V
authors.lastname: Vilgrain
authors.forename: Y
authors.initials: Y
authors.lastname: Panis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000601:surgery*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D012002:Rectal Diseases / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014283:Triiodobenzoic Acids
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C093233:iobitridol; D007472:Iohexol; C044834:iodixanol