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116350

Evaluation of the Predictive Value of Serum C-Reactive protein and Procalcitonin Levels in Early Detection of Anastomotic Leakage after Gastrointestinal Surgery

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Last updated: 04 Jan 2025

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Abstract

Background: Anastomotic leak (AL) after gastrointestinal surgery is a serious postoperative complication that leads to significant morbidity and mortality. Objective: To evaluate the role of sequential postoperative serum determinations of C-reactive protein (CRP) and Procalcitonin (PCT) in the identification and prediction of anastomotic leakage after gastrointestinal surgery and to describe the kinetics of PCT and CRP after surgery and their relative usefulness for the early detection of anastomotic leaks after gastrointestinal surgery. Patients and Methods: This study is a clinical prospective randomized observational analytical cross-sectional study conducted in the elective and emergency surgery theaters of the department of general surgery at Suez Canal university hospital from Jan 2015 to Jan 2016 on 45 patients who underwent small bowel, colonic and rectal surgery with resection and primary anastomosis. The data was collected using a questionnaire and lab results. Results: In our study, 22.2% of study patients developed anastomotic leakage, 48.9% of the studied population was between the ages of (46–60) (range 18-72 years), and 62.2% of the study populations were female. Both biochemical markers were elevated in patients with anastomotic leakage at day2, 3, and 4 and showed slightly similar curves, percentages but the upper hand was for PCT than CRP in the point of early detection and in the much more sensitive and more specific. The Pearson correlation with fistula was more powerful for CRP than for PCT. Conclusion: Patients with PCT greater than 0.65mg/dL and CRP greater than 21 mg/dL on Day4, even in the absence of clinical signs, are not permitted to leave the hospital and a diagnostic work-up for sepsis (lung, urinary tract, intra-abdominal, or wound) is actively pursued.

DOI

10.21608/scumj.2020.116350

Keywords

Anastomotic leakage, Procalcitonin, C - reactive protein, gastrointestinal surgery

Authors

First Name

Mohamed

Last Name

Elkerkary

MiddleName

A

Affiliation

Department of Surgery, Faculty of Medicine, Suez Canal university, Egypt

Email

m_kerkary@med.suez.edu.eg

City

-

Orcid

-

First Name

Mahmoud

Last Name

Elnagar

MiddleName

-

Affiliation

Department of Surgery, Faculty of Medicine, Suez Canal university, Egypt

Email

nagar@med.suez.edu.eg

City

-

Orcid

-

First Name

Moustafa

Last Name

Abu Ali

MiddleName

-

Affiliation

Department of Surgery, Faculty of Medicine, Suez Canal university, Egypt

Email

-

City

-

Orcid

-

First Name

Hamdy

Last Name

Shaban

MiddleName

-

Affiliation

Department of Surgery, Faculty of Medicine, Suez Canal university, Egypt

Email

hamdy_shaban@med.suez.edu.eg

City

-

Orcid

-

Volume

23

Article Issue

1

Related Issue

17184

Issue Date

2020-03-01

Receive Date

2020-10-01

Publish Date

2020-03-01

Page Start

30

Page End

40

Print ISSN

1110-6999

Online ISSN

2090-2581

Article File

SCUMJ_Volume 23_Issue 1_Pages 30-40.pdf

PDF . 392.2kB

Link

https://scumj.journals.ekb.eg/article_116350.html

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https://scumj.journals.ekb.eg/service?article_code=116350

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4

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Original Article

Type Code

938

Publication Type

Journal

Publication Title

Suez Canal University Medical Journal

Publication Link

https://scumj.journals.ekb.eg/

MainTitle

Evaluation of the Predictive Value of Serum C-Reactive protein and Procalcitonin Levels in Early Detection of Anastomotic Leakage after Gastrointestinal Surgery

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Article

Created At

22 Jan 2023