Early detection of infectious complications using C-reactive protein and the procalcitonin levels after laparoscopic colorectal resection: a prospective cohort study

Teppei Tatsuoka,Emiko Takeshita,Hideyuki Yoshitomi,Takashi Okuyama,Masatoshi Oya,Haruka Oi,Takashi Mitsui,Takuji Noro

doi:10.1007/s00595-020-02111-6

Abstract

PurposeThe predictive values of the C-reactive protein (CRP) and procalcitonin (PCT) levels for postoperative infectious complications were investigated in patients who underwent elective laparoscopic resection of colorectal cancer.MethodsA total of 154 consecutive patients who underwent elective laparoscopic resection for colorectal cancer (CRC) were prospectively studied. The CRP and PCT levels on the first postoperative day (POD1) and the fourth postoperative day (POD4) were measured. Any correlations between the CRP and PCT levels on POD1 and POD4 with the occurrence of infectious complications were examined.ResultsInfectious complications occurred in 18 (11.7%) patients. CRP on POD1 and CRP and PCT on POD4 were significantly higher in patients who developed infectious complications than in those who did not. The areas under the receiver operating characteristic curves of CRP on POD1 and CRP and PCT on POD4 were 0.597, 0.763 and 0.768, respectively. The cut-off values of CRP and PCT levels on POD4 were 14.33 mg/dl and 0,264 ng/ml, respectively. Whereas the positive predictive value of an elevated CRP level was high, the negative predictive value of an elevated PCT was high.ConclusionThe CRP and PCT levels on POD4 are both considered to be useful for the early detection of infectious complications after laparoscopic resection of CRC.

Highlights

Infectious complications are relatively common after colorectal resection even in high-volume surgical centers [1, 2]
The C-reactive protein (CRP) and PCT levels on POD4 are both considered to be useful for the early detection of infectious complications after laparoscopic resection of colorectal cancer (CRC)
The predictive values of the CRP and PCT levels for postoperative infectious complications after laparoscopic colorectal resection performed at a single surgical department were explored

Summary

Introduction

Infectious complications are relatively common after colorectal resection even in high-volume surgical centers [1, 2]. Intra-abdominal infections such as anastomotic leakage and intra-abdominal abscess in particular may cause sepsis and even result in postoperative death. Laparoscopic surgery for colorectal resection has become very prevalent. The usefulness of inflammatory makers including C-reactive protein (CRP) and procalcitonin (PCT) has been described in several reports including a meta-analysis [4, 5]. The predictive values of the CRP and PCT levels for postoperative infectious complications after laparoscopic colorectal resection performed at a single surgical department were explored

Patients and methods

Results

Discussion

Compliance with ethical standards