C reactive protein as a predictor of anastomotic leakage in colorectal surgery. Comparison between open and laparoscopic surgery
C reactive protein as a predictor of anastomotic leakage in colorectal surgery. Comparison between open and laparoscopic surgery
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DOI：
10.1016/j.ciresp.2017.08.003
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发表时间：
2017-11-01
期刊：
影响因子：
1.9
通讯作者：
de la Portilla de Juan, Fernando
中科院分区：
文献类型：
--
作者：
Ramos Fernandez, Maria;Rivas Ruiz, Francisco;de la Portilla de Juan, Fernando
前言：吻合口漏（AL）是结直肠手术中的一种严重并发症，其发病率和死亡率均有所增加。这项前瞻性非随机研究的目的是确定是否C-反应蛋白（CRP）是一个有用的预测AL患者接受开放与腹腔镜surgery.Methods：共168例择期结直肠手术。术后前5天每天测量CRP。结果：开腹组32例（45.7%）出现并发症，腹腔镜组15例（18.7%），中转组12例（29.4%）（P=0.153）。开放手术后9例患者发生AL，腹腔镜组中检测到5例，转换组中无一例（P=0.153）。3组间CRP值差异有统计学意义（P=0.03）。ROC曲线显示开放手术和腹腔镜手术的AUC分别为0.731和0.760。在第4天，开放组的AUC为0.867，腹腔镜组为0.914。第4天的截断点为：开放：159.2 mg/L，敏感性75%，特异性89%，NPP 96%（P
Introduction: Anastomotic leak (AL) is a serious complication in colorectal surgery due to its increase in morbidity and mortality. The aim of this prospective non-randomised study is to determine whether C-reactive Protein (CRP) is useful as a predictor of AL in patients undergoing open versus laparoscopic surgery.Methods: A total of 168 patients undergoing elective colorectal surgery were included. CRP was measured daily during the first 5 postoperative days. Complications, specially AL, were analysed.Results: Following an open approach 32 patients (45.7%) presented complications, 15 (18.7%) in the laparoscopic group and 12 (29.4%) in the converted group (P=0.153). Following open surgery 9 patients experienced AL, 5 were detected in the laparoscopic group and none in those converted (P=0.153). There were significant differences in CRP values between the 3 groups (P=0.03). ROC Curves showed AUC for the open and laparoscopic approach of 0.731 and 0.760 respectively. On day 4 the AUC was 0.867 for the open group and 0.914 for the laparoscopic group. Cut-off points on day 4 were: Open: 159.2 mg/L; sensitivity 75%, specificity 89% and NPP 96% (P