Introduction: Anastomotic leakage (AL) is a major complication after intestinal and colorectal surgery due to its
severity, high frequency and poor outcome.
Aim of work: The aim was to evaluate the role of serum C-reactive protein (CRP) and Total Leucocytic count
(TLC) in detection of early anastomotic leakage in preclinical stage following open and laparoscopic colorectal and
intestinal surgery.
Patients and methods: In the elective department of Kasr-Al Ainy hospital, Faculty of Medicine, Cairo University
the study include a total of 115 patients who were indicated for colonic anastomosis as cancer colon patients,
closure colostomy etc. Post-operative serum CRP & TLC were withdrawn and the patients were followed up for 5
days.
Results: Out of 115 patients 19.1% had leakage with mean time to leakage 5.1+1.2 days with range days 3-7
days, while 80.9% had no leakage. Comparison of TLC and CRP levels between patients who developed AL and
those who did not showed that baseline TLC and CRP showed no statistically significant difference between groups,
while Day 1, Day 2, Day 3 and Day 4 showed significantly higher among leakage group with p values <0.01 all. The
highest difference was reported in Day 5 in terms of CRP and TLC with p values <0.001, and <0.001 respectively.
Conclusion: Patients undergoing elective colorectal surgery should routinely have their CRP levels measured. After
the second postoperative day, persistently elevated CRP levels predict anastomotic leakage anastomosis.