Exclusion of Anastomosis Leakage after Colorectal Surgery using C-reactive protein: A Retrospective Study

ABSTRACT

Background: Anastomotic leakage (AL) is one of the common complications of colorectal surgeries. Shortening the hospitalization period due to the COVID-19 pandemic might be effective in the reduction of post-operative complications. Objectives: This study aimed to define the role of serum CRP, WBC, and body temperature (BT) in the detection of AL and the value of postoperative CRP levels in excluding AL. Methods: This study was a survey of laboratory tests. The patients with elective colorectal surgery were enrolled between 2017 and 2019. The symptoms of AL, such as high-level C-reactive protein, leukocytosis, body temperature, and ileus, were measured for five days after the surgery, and CRP levels were measured for five postoperative days to exclude anastomosis leakage. Results: In total, 315 patients were enrolled in this study. The mean age of the patients was 56.2 years. Anastomotic leakage was detected in 26 patients. The CRP values for AL on days 2, 3, 4, and 5 after surgery were significant (P<0.05). The CPR values below 44 mg/L and 27.2 mg/L were found to be significant for the exclusion of anastomosis leakage on postoperative days 2 and 4. Conclusion: Post-operative serum CRP, especially on postoperative days 2 and 4, with cut-off values of 44 mg/L and 27.2 mg/L, could be considered a highly sensitive marker to exclude AL and shorten the hospitalization period in the absence of ileus, fever, leukocytosis, and normal abdominal examination.