Exclusion of Anastomosis Leakage after Colorectal Surgery using C-reactive protein: a retrospective study

Anastomotic leak (AL) is one of the common complications of colorectal surgeries. In COVID-19 pandemic, shortening the hospitalization period seems valuable in reducing postoperative complications

 C-reactive protein is valuable in early diagnosis and also exclusion of AL.

This study was a survey of laboratory tests. The patients were enrolled with the elective of colorectal surgery between 2017 and 2019. We measured the symptoms of Anastomotic leak such as high-level C-reactive protein, leukocytosis, body temperature, and ileus by passing five days from the surgery. Moreover, we evaluated the value of C-reactive protein to exclude Anastomosis leakage within 5 postoperative days.

three hundred and fifteen patients were enrolled in this study. The mean age of the patients was 56.2 years old. Anastomotic leak was detected in 26 patients. C-reactive protein levels in the second day, third day, fourth day, and fifth day were significant for the Anastomotic leak (P-value <0.05). In postoperative days 2 and 4, CPR levels below 44 mg/L and 27.2 mg/L were found to be significant for the exclusion of anastomosis leakage.

Postoperative serum CRP, especially on postoperative days 2 and 4 with cut off value of 44 mg/L and 27.2 mg/L in the absence of ileus, fever, leukocytosis, and normal abdominal examination, could be considered as a highly sensitive adjutant to exclude AL and shorten the hospitalization period.