Postoperative Inflammatory Response in Crohn's Patients: A Comparative Study.
OBJECTIVE
Surgery for Crohn's disease [CD] can be complicated by an enhanced inflammatory response. This retrospective study aims to compare the inflammatory response measured by C-reactive protein [CRP] in patients operated for CD with patients undergoing similar surgery for colorectal cancer [CRC].


METHODS
All CD patients undergoing an ileocaecal resection between February 2001 and December 2013 were retrieved from a prospectively maintained database. The same number of patients with a CRC of the ascending colon, undergoing a laparoscopic right hemicolectomy between March 2009 and June 2014, were retrieved from a CRC database. CRP level during the first 7 postoperative days was used as primary outcome.


RESULTS
Totals of 112 consecutive CD patients (male 40.2%; median age: 32.3 yrs; interquartile range [IQR]: 25.2-45.1) and 112 consecutive CRC patients [male 53.6%; median age 71.6 yrs; IQR: 64.7-77.5] were included. Postoperative CRP level in the CD group was on average 27% higher compared with the CRC group [p = 0.02]. The day-specific differences in CRP values were 21% (p = 0.021, 95% confidence interval [CI]: 3% 41%), 41% [p = 0.005, 95% CI: 11%-79%], 49% [p = 0.007, 95% CI: 11%-96%], and 49% [p = 0.006, 95% CI: 12%-100%] higher for CD patients at Days 1, 4, 5, and 6 respectively. The difference in postoperative CRP level was partially due to differences in preoperative CRP level.


CONCLUSIONS
CD patients develop a higher postoperative CRP level, probably reflecting an enhanced postoperative inflammatory response, which may be triggered by a higher preoperative inflammatory state.
University Hospital Leuven, Department of Abdominal Surgery, KU Leuven, Belgium anthony.debuckvanoverstraeten@uzleuven.be.
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de Buck van Overstraeten
University Hospital Leuven, Department of Abdominal Surgery, KU Leuven, Belgium.
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Van Hoef
University Hospital Leuven, Department of Gastroenterology, KU Leuven, Belgium.
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Vermeire
University Hospital Leuven, Department of Gastroenterology, KU Leuven, Belgium.
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Ferrante
KU Leuven - University of Leuven & Universiteit Hasselt, I-Biostat, B-3000 Leuven, Belgium.
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Fieuws
University Hospital Leuven, Department of Abdominal Surgery, KU Leuven, Belgium.
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Wolthuis
University Hospital Leuven, Department of Gastroenterology, KU Leuven, Belgium.
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Van Assche
University Hospital Leuven, Department of Abdominal Surgery, KU Leuven, Belgium.
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D'Hoore
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002432:Cecum / Q000601:surgery*; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000601:surgery; D003424:Crohn Disease / Q000097:blood / Q000601:surgery*; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007249:Inflammation / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis; D012189:Retrospective Studies
D015415:Biomarkers; D002097:C-Reactive Protein
C-reactive protein; Crohn’s disease; Postoperative inflammatory response; ileocaecal resection; right hemicolectomy