title: Does C-reactive protein monitoring after colorectal resection with anastomosis give any practical benefit for patients with intra-abdominal septic complications?
abstract: OBJECTIVE
  This study aimed to assess the influence of the C-reactive protein (CRP) level on the early outcome after elective colorectal resection.
  
  
  METHODS
  Patients with colorectal cancer operated on between 2006 and 2013 were identified retrospectively. They were divided into a study group operated on between 2010 and 2013 when CRP was measured routinely on the fourth postoperative day and a control group operated on between 2006 and 2009 when the CRP level was not measured routinely. Mortality, intra-abdominal septic complications (IASC), abscesses and anastomotic leakage (AL), the need for reoperation, the interval from index surgery to relaparotomy, length of hospital stay and imaging studies were compared by multivariate analysis.
  
  
  RESULTS
  A total of 1189 patients were assessed, including 598 (50.3%) in the study group (mean age 61.3 ± 13 years; 282 female) and 591 (49.7%) in the control group (mean age 61.8 ± 11 years; 267 female). There were seven (1.2%) postoperative deaths in the study group and nine (1.5%) in the control group (P = 0.598). Abdominal ultrasound (US) was performed more often in the study group [97 (16.2%) vs 71 (12.0%); P = 0.037]. In the study group the interval to diagnosis of IASC was shorter than in the control group (5.7 ± 1.5 days vs 7.3 ± 1.3 days; P = 0.029). The decision to reoperate was also made earlier in the study group (6.2 ± 1.7 days vs 7.4 ± 2.8 days; P = 0.043).
  
  
  CONCLUSIONS
  Routine measurement of CRP can help to make an earlier diagnosis of IASC and earlier decision for relaparotomy, without any influence on mortality or length of hospital stay.
authors.affiliation: Department of General and Colorectal Surgery, Medical University of Lodz, Lodz, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Mik
authors.affiliation: Department of General and Colorectal Surgery, Medical University of Lodz, Lodz, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Berut
authors.affiliation: Department of General and Colorectal Surgery, Medical University of Lodz, Lodz, Poland.
authors.forename: L
authors.initials: L
authors.lastname: Dziki
authors.affiliation: Department of General and Colorectal Surgery, Medical University of Lodz, Lodz, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Dziki
mesh_terms: D034841:Abdominal Cavity / Q000473:pathology; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D057868:Anastomotic Leak / Q000097:blood / Q000209:etiology; D002097:C-Reactive Protein / Q000032:analysis*; D003082:Colectomy / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000601:surgery; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D011184:Postoperative Period; D012086:Reoperation; D012189:Retrospective Studies; D018805:Sepsis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology
chemical_list: D002097:C-Reactive Protein
keywords: C-reactive protein; anastomotic leak; colorectal cancer; septic complications