Abstract
Using biological markers to predict serious complications and global postoperative recovery, to ensure safe and timely patient discharge after elective colorectal surgery represents a major challenge. The aim of this study was to demonstrate that C-reactive protein levels < 172mg/l on postoperative day 3 were associated with postoperative recovery within 5days. This is a prospective study of a consecutive bicentric cohort. Successive patients scheduled for bowel resection with anastomosis, without stoma, were included. The main composite endpoint for overall postoperative recovery included absence of fever, absence of pain > 2 on the visual analog scale, intestinal gas transit, and patient autonomy for mobility and body care. One hundred sixty-height patients, with a mean age of 65years old, were analyzed. Ninety patients (53%) underwent right colectomy and 131 (77%) were operated on by laparoscopy. Severe postoperative complications were observed in 11 patients (6%). One hundred twenty patients (71%) recovered within 5days. C-reactive protein levels < 172mg/L on postoperative day 3 had a negative predictive value of 80% to predict recovery within 5days. Ninety-five percent of patients with C-reactive protein < 172mg/L at postoperative day 3 had no severe postoperative complications. Levels of C-reactive protein < 172mg/L at postoperative day 3 corresponded with an early recovery in 80% of cases, thus allowing safe and early discharge without risk of serious complications.
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