FTP3.2 Differences in the Acute Phase Response in Right-Sided Colorectal Surgery: Evaluation of the Kono-S Anastomosis

Abstract

Abstract Aims CRP monitoring has become routine post-operative practice in resectional colorectal surgery and is useful as a predictive tool for identification of anastomotic leak. Day 3 CRP > 150 has been shown to be highly predictive of anastomotic leak. The acute phase response observed in surgery for Crohn’s disease (CD) is often more pronounced compared to malignancy and this is not accounted for in post-operative monitoring. This study looks at the difference in CRP in patients undergoing right hemicolectomy for cancer versus CD and evaluates any difference in CD patients who have conventional versus Kono-S anastomosis. Methods A single-center retrospective analysis of patients undergoing right hemicolectomy for malignancy and CD was undertaken, including CD patients with conventional and Kono-S anastomosis. Primary outcomes included CRP on Day 1 and 3 post-surgery. Length of stay, leak rate and post-operative infections were recorded. Analyses were carried out including and excluding patients with post-operative leak and infection. Results Day 1 CRP was significantly higher in patients undergoing surgery undergoing surgery for CD compared to malignancy (p <0.001). Day 3 CRP was significantly higher in patients undergoing surgery for CD compared to malignancy (p = 0.017). There was no significant difference between CD patients undergoing surgery with Kono-S anastomosis compared to conventional anastomosis. Kono-S anastomosis was not associated with any difference in leak, infection, or length of stay. Conclusions The rise in post-operative CRP is more pronounced in CD patients compared to cancer patients. CD patients with Kono-S anastomosis do not have significantly different post-operative CRP from patients with conventional anastomoses.