title: C-reactive protein is a predictor of complications after elective laparoscopic colorectal surgery: five-year experience.
abstract: BACKGROUND
  With the development and improvement of laparoscopic surgery, procedures have become common. However, post-operative complications occur when patients are released from hospital. These complications increase patients' morbidity and mortality. They also lead to re-hospitalization, an extended recovery period, and an increase in the cost of treatment.
  
  
  OBJECTIVE
  To evaluate and determine the prognostic properties of C-reactive protein in the early diagnosis of postoperative complications after a laparoscopic colon resection.
  
  
  METHODS
  The prospective study included patients who underwent laparoscopic colorectal surgery in 2010-2014. The patients were divided into two groups - uncomplicated ones and those with complications. C-reactive protein concentrations in their blood serum were measured on the 2(nd), 4(th) and 6(th) day after surgery. Logistic regression analysis was used to evaluate the relation between C-reactive protein values measured on the 2(nd), 4(th) and 6(th) postoperative day and related complications. Receiver operating characteristic curves were used to determine the sensitivity and specificity of each C-reactive protein value measured on the 2(nd), 4(th) and 6(th) postoperative day.
  
  
  RESULTS
  One hundred and six patients were included in the trial; 14 of them had complications. On the second day, a C-reactive protein cut-off value of 88.6 mmol/l provided the highest sensitivity and specificity for predicting evolving complications, being 71.4% and 84.8% respectively (p = 0.003). The significant predictive cut-off value decreases and becomes more sensitive and specific each post-operative day.
  
  
  CONCLUSIONS
  It is possible to detect developing post-operative complications early on by monitoring C-reactive protein concentration levels in the blood serum on the 2(nd), 4(th), and 6(th) post-operative days.
authors.affiliation: Abdominal Surgery Department of Vilnius University Hospital, Santariskes Clinic, Vilnius, Lithuania.
authors.forename: Eligijus
authors.initials: E
authors.lastname: Poskus
authors.affiliation: Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
authors.forename: Ignas
authors.initials: I
authors.lastname: Karnusevicius
authors.affiliation: Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
authors.forename: Gintare
authors.initials: G
authors.lastname: Andreikaite
authors.affiliation: Abdominal Surgery Department of Vilnius University Hospital, Santariskes Clinic, Vilnius, Lithuania.
authors.forename: Saulius
authors.initials: S
authors.lastname: Mikalauskas
authors.affiliation: Abdominal Surgery Department of Vilnius University Hospital, Santariskes Clinic, Vilnius, Lithuania.
authors.forename: Tomas
authors.initials: T
authors.lastname: Poskus
authors.affiliation: Abdominal Surgery Department of Vilnius University Hospital, Santariskes Clinic, Vilnius, Lithuania.
authors.forename: Kestutis
authors.initials: K
authors.lastname: Strupas
keywords: C-reactive protein; colorectal; laparoscopic